Fetal Alcohol Syndrome

General Information

Fetal alcohol spectrum disorder (FASD) is an umbrella term for the range of harm that is caused by alcohol use during pregnancy. It includes

  • Fetal alcohol syndrome (FAS)
  • Fetal alcohol effect (FAE)
  • Partial FAS (pFAS)
  • Alcohol-related neurodevelopment disorder (ARND)
  • Alcohol-related birth defects (ARBD)

FASD is permanent brain damage. Many of the characteristics can be invisible, and the condition may go undetected. Children exposed prenatally to alcohol may not show the typical physical characteristics of FASD (see below), but they may still suffer from severe brain damage. Early diagnosis and intervention is important. Other conditions that may be observed in children with FASD can include learning disabilities and attention deficit hyperactivity disorder.

General Characteristics To Look For

  • poor memory
  • difficulty maintaining focus
  • stronger expressive language
  • information processing problems
  • problems sequencing and making choices
  • difficulty with transitions
  • difficulty reading non-verbal cues
  • impaired motor skills (e.g., poor hand-eye coordination)
  • makes the same mistakes over and over again- difficulty connecting cause and effect and changing behaviour
  • difficulty translating directions into action
  • struggles with abstract concepts (e.g., time, space, money)
  • frequently does not respond to reward programs.

  • characteristic facial features, including small eye openings, flat mid-face, thin upper lip, flattened ridges (physical characteristics appear only in the children/youth most severely affected)
  • ongoing slow growth
  • problems with balance, coordination, and SENSORY INTEGRATION.
  • higher than average difficulties with vision and hearing, heart problems
  • mental fatigue
  • Characteristic facial features include small eye openings, flat mid-face, thin upper lip, flattened ridges
  • Ongoing slow growth
  • Problems with balance and coordination
  • Higher than average difficulty with vision and hearing, heart problem
  • Mental fatigue

Behavioural and social:
  • difficulty generalizing behaviour from one situation to another
  • disturbed sleep, irritability, persistent restlessness
  • inconsistent behaviours
  • poor anger control
  • hyperactive, unable to wait his/her turn
  • impulsive
  • may be overly sensitive to bright lights, certain clothing, tastes and textures, loud sounds, and touch
  • socially immature, often choosing to play with younger children (usually five years younger)
  • difficulty perceiving social cues, misinterprets other people’s emotions
  • can be overly friendly, trusting
  • suggestible, easily lead by others
  • difficulty understanding personal boundaries and ownership

Other conditions may look similar to FASD. Always be mindful of this and cautious when talking to parents and guardians about any concerns.

Impact On Student Success

A student with FASD may have difficulties with areas such as organizing work time, learning new concepts, memorizing information, generalizing concepts, problem solving, attending, concentrating, controlling impulsivity, not react to behavioural corrections or directions, making appropriate social judgments, understanding concepts of money, following modelling, sensitivity ( hypo- or hypersensitive), sitting still, compliance

  • Some genetic conditions and acquired brain injuries may look similar to FASD. Care and discretion must be exercised when discussing a possible referral for FASD assessment and diagnosis.
  • Focus on the child’s strengths. These strengths can be useful tools.
  • Recognize and celebrate successes.
  • Be concrete in communicating with the child. Do not use figurative language or irony. Ensure that facial expression matches what is being said.
  • Establish signals for the child to use to show when he/she is frustrated or being overwhelmed by people, sound, etc.
  • Set limits and consistently follow them.
  • Be concrete when teaching a new activity/concept/skill. Show, don’t tell.
  • A team approach and planning are important. Work together with family, school, and community partners.
  • Encourage positive self-talk, “I think I can” talk.
  • Teach students to use self-talk to help stay focused.
  • Limit or eliminate homework. Any homework should be to reinforce the day’s learning.
  • Some students need to be taught boundaries and specific social skills. Individualize teaching in these areas based on the student’s strengths and needs.
  • Encourage decision making by giving students appropriately limited choices and allow them to carry through with the choices they make.
  • Have a consistent, predictable schedule of activities.
  • Teach concepts supported with visual representation.
  • Have a few simple rules, using language that is very concrete. For example, use concrete statements such as, “If you hit, you sit.”
  • Assist teachers in finding supportive consultation as needed.
  • Maintain current knowledge of available community resources.
  • Ensure solid transition planning between grades and provide opportunities for teachers, families, and community partners to share knowledge/information about what works for the child.
  • Support training opportunities for teachers and other staff.
  • Use the family as an information resource and ensure that there is active and positive communication between family and school.
  • Provide information about the child, including what motivates him/her, what interests him/her, what makes him/her special, what his/her strengths are, etc.
  • Help with transition planning and building consistency for the child in home and school expectations.
  • Be a supportive advocate for the child.
  • Consider use of community supports and participating in parent support groups.
  • Provide supportive consultation, resources, and referrals to other services.
  • Work collaboratively with other community resources to provide a “big picture” support system.