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.
Why?
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
|