FASlink Fetal Alcohol Disorders Society

Impulse Control

Why can't they control their impulses?
Teresa Kellerman

<<That is the part I don't understand. If they can understand why can't they control it. I don't understand.>>

Fact: John understands the rules
Fact: John understands the consequences.
Fact: John goes ahead and does it anyway (AGAIN).
Fact: John can later relate the exact rules and consequences.
Fact: Mom emits a long sigh.
Fact: John still cannot control his behaviors MUCH of the time.


Remember hearing about how the prenatal exposure to alcohol affects the corpus callosum? That's the membrane between the left brain and the right brain that passes information between the two hemispheres of the brain. The corpus callosum of kids with FAS/FAE is damaged, and in some cases it is absent.

The left brain is the one that handles facts, rules, order, thoughts, language and logic. The right brain is the one that handles music, feelings, intuition, creativity, and impulses. Is it beginning to become clear yet? The "do's and don'ts" are sitting there in the left brain, but when that impulse hits the right brain, a child with FAS acts first, and processes the information later, information that is there but cannot be accessed in time to prevent disaster.

This is very similar to what happens when a "normal" person drinks alcohol. After a few drinks, alcohol shuts down the left brain, which kind of falls asleep and no longer functions the way it should. So the person is now acting on the right brain only, feeling, acting on impulse, disregarding consequences.

A person with FAS is kind of like an inebriated person. You all know how a person who has had one too many might try to drive home, even if he knows he shouldn't, or a person might say things impulsively that she wouldn't dare say when she's sober. A man and woman are more likely to have unprotected sex when they have been drinking.

You all know what I'm talking about. I have heard this behavior described for FAS and alcoholics as "F--k it" syndrome, because a person does something anyway, even when they know it is likely to cause trouble.

Impulse control has NOTHING to do with knowing the rules or understanding the consequences when rules are broken. Impulse control is a neurological function of the frontal lobe, which is damaged by prenatal exposure to alcohol.

The frontal lobe, when it functions properly, controls inhibitions and judgment.

When the frontal lobe has connections that are not wired properly or when it has holes in it, well, it just is not going to function well. It is NOT a matter of will power.

Giving John cues and reminders helps him to control his impulses because it interrupts the process between impulse and action long enough for the information to get where it needs to go.

Medication seems to sober John up... really! And when his meds wear off, its just like watching him get drunk. He turns into Mr. Silly, immature, center of attention, pain in the butt. With meds, he's almost human!

I have explained this to John enough times that I actually think he understands the concept pretty well. As a matter of fact, when John does something really stupid, I never ask him "Why did you do that?" because he just might explain it to me.

Teresa in Tucson