FASlink Fetal Alcohol Disorders Society
FAS/FAE Cycle: With Early Identification
Diane B. Malbin, M.S.W. FAS Resource Coalition (503) 246-2635
  1. Intervention in parental alcoholism/chemical dependency; the home is stabilized, parenting improves. Subsequent impaired births are prevented. Abuses are prevented.
  2. Full range of assessments (vision, hearing, speech, motor skills) determine deficiencies at an early age.
  3. Infant stimulation programs and specific ameliorative work is implemented. Little remedial work is necessary.
  4. Environments are structured to enhance development. Early failures and sadnesses are prevented.
  5. Parental supports for recovery and parenting skills continue. Rates of relapse decline.
  6. Care is coordinated; smooth transitions are accomplished between infancy, toddlerhood and school.
  7. Headstart and other appropriate programs are accessed. The home-school continuum is established.
  8. 'Preventative parenting' techniques are taught, i.e. conscious problem solving, structure rather than control.
  9. Identification of strengths, inclinations and interests; these are reinforced.
  10. Optimal learning mode is identified.
  11. 'Preventative parenting' continues: Advocating and educating to prevent the erosion-of self esteem which results from inappropriate levels of expectation and unresolved frustration.
  12. Prevention of alcoholism and chemical dependency through early identification of FAS/E occurs through intervening in the cycle of early school failure, poor peer and family environments, unstable homes, and unaddressed impulsivity.
FAS/FAE Cycle: In the Absence of Identification
  1. Poor bonding, failure to thrive, interrupted sleep patterns, difficulty feeding, withdrawal
  2. Possible physical and emotional issues, abuses and neglect. Early removal from home, multiple residences, inconsistency and abrupt transitions exacerbate early developmental problems.
  3. Early inconsistent memory, poor sequencing, hyperactivity.
  4. Developmental delay, may be mild or masked by some, skills speech and language, motor, vision and auditory processing deficits.
  5. Partial diagnosis = incomplete intervention: vision, hearing, cognition, behaviour, etc.'
  6. Early school failure: Attention deficit disorder/hyperactive. Majority are "grey area kids", unidentified, ineligible for services.
  7. Function at levels lower than indicated by testing (performance, verbal) FAS and FAE are functionally the same
  8. Differential interpretation of behaviours by parents and school compounds problem; ie, wilful misconduct rather that organicity = punish rather than support. Internal frustration and sadness without resolution leads to outbursts of anger, inappropriate responses.
  9. Difficulty with abstractions: Math scores typically lowest communication nuances lost.
  10. Not competitive by fourth grade academically. School refusals start at 4th grade when called upon to use higher cognitive processes.
  11. Socially isolated: Intrusive, inappropriate, few friends
  12. Early school refusal (fourth grade), problems with family
  13. Early first use of drugs, other behaviour problems shoplifting, arson, aggression.
  14. Sexual victimization/acting out: Experimentation, other inappropriate behaviour.
  15. Alcoholism / chemical dependency; early first use, rapid deterioration.
  16. Traditional attempts at intervention ineffective, end up 'blaming the victims (ie, insight therapy doesn't work). Treatment for substance abuse fails to incorporate functional processing deficits. This population "talks the talk but doesn't walk the walk". Treatment fails.
  17. Pregnancy: Latter births of former teen parents at greatest risk for FAS. AIDS and other sexually transmitted diseases pose a major risk. High rate of male, female prostitution, topless dancing.
  18. Involvement with the legal system; truancy, shoplifting, arson, run aways, prostitution
  19. Termination of parental rights
  20. High rates of depression, suicide, incarceration
  21. Highly suggestible, 'unrealistic', impulsive
  22. Unable to manage money, time
  23. May get jobs, not be able to keep them
  24. Persistent narrow repertoire of behaviours, ie, anger / withdrawal. Apparent inability to modify behaviours based on past experiences.
  25. Unstable relationships with significant others, abuses, abandonment.