Fetal Alcohol Spectrum Disorder (FASD) is an umbrella term used to describe a range of effects that can occur in a child whose mother consumed alcohol in the pregnancy. FASD occurs in all economic, racial, and religious groups around the world. Not all individuals prenatally exposed to alcohol are necessarily affected. Yet, many have physical, learning, and/or sensory challenges that result in behavioral issues.

Although similarities exist, no two individuals are affected the exact same way. FASD is considered a whole-body disorder. It is a lifelong medical diagnosis that the child will not grow out of. Although there is much in the media describing isolated tragedies of living with FASD, there are also many, many stories of hope and success.

There are over two hundred different physical possibilities that require medical evaluation by a FASD diagnostic-trained physician. Many genetic syndromes mimic FASD in physical, intellectual, and sensory manifestation. A medical evaluation by a specialized team of professionals is essential for children being considered for adoption. The intelligence in FASD children ranges from very low-functioning to superior abilities. Regardless of intellectual abilities, many have difficulty managing in day-to-day living and require additional supports at home, at school and in the community.

Recently, researchers have discovered the importance of identifying physical anomalies in children with FASD. Many present as intentionally defiant behavior when, in fact, it is as a direct result of a physical issue. For example, a child with a tall, raised palate or roof of the mouth may get some soft foods stuck, causing them to put their fingers or whole hand in their mouth to get it out. This may appear to be bad manners or the child acting spoiled if they refuse to eat certain foods. Once the child’s unique physical, learning, and sensory factors are identified, prevention strategies and intervention techniques can be designed. In this case, the parent would be mindful of certain foods that may cause this problem for the child. They may also practice more appropriate ways of removing the food. Some very severe cases may require special utensils to assist them in daily living.

Developing strategies for coping with undesirable behaviors with adopted children with FASD is important. Focus on the child’s strengths and abilities in all three areas of functioning while acknowledging and providing supports in their areas of need. Here are some key considerations:

  1. What physical issues could be contributing to the behavior?
  2. Does the child have learning problems, such as poor memory or short attention span that could be contributing to the behavior?
  3. Are they over- or under-sensitive to light, sound, taste, or movement around them that could trigger what seems to be defiant behavior?

The key is in accepting that their challenges are a direct result of their body and brain dysfunction, not intentionally “pushing your buttons.”