Overview of Behavioral Issues Associated with Fetal Alcohol [Spectrum Disorder]

Specific Behavior Plan for child

I. Create rules that target specific behaviors.

II. Provide constant positive feedback when rules are not being broken.

III. Provide immediate, unemotional time-outs when a rule is broken.

IV. Adjust the environment to make it easy to follow rules.

V. Assess effectiveness of plan on a regular basis and make adjustments.

Overview of Behavioral Issues Associated with Fetal Alcohol Effects In working with and managing his behavior, it will be helpful to understand a few things about fetal alcohol affected brains:

• For most of us, the part of the brain that has impulses and the part that knows the rules are in constant easy communication. So we have an impulse to do something, we check it against what we know to be acceptable rules of behavior, and we make a conscious choice whether or not to break a rule. But in fetal alcohol affected brains, the connection between those two areas is faulty or missing. So the child has an impulse to do something, and by the time the part of the brain that knows the rules is even aware of the impulse, the action has already taken place, and most likely somebody is already yelling at the child about it. So you can have a kid who knows the rules, wants to follow the rules, is upset about breaking the rules, yet still breaks them. At the moment of action, he’s working purely on impulse.

• And since impulsive behavior is almost by definition without reason, asking a fetal alcohol affected child why he did something and not taking “I don’t know” for an answer is pretty much insisting that he lie. They don’t know why they do it. They may not even know what they did. So you’ll either get gobs of denial and defensiveness, or you’ll get a spontaneous excuse that defies credulity. Imagination and creativity are some of the positive attributes of people with FAE [FASD], but when they’re used in service of getting out of trouble, they usually result in a tall tale that makes matters worse.

• Social and emotional development lags way, way, way behind in people with FAE. Teens and young adults with FAE often have an emotional developmental age of about 6. So with an elementary-school-aged child, you have to figure they may be working at a toddler stage at best. You have to adjust everything to that level — expectations, supervision, privileges, rules, discipline. People with FAE tend to be verbal well beyond their level of understanding, and it may be tempting to assume that that clever and talkative child is able to understand social rules at a much more sophisticated level. It’s a mistake.

• Stress makes things worse. A confusing thing with FAE [FASD] kids is that sometimes they seem to be able to do things and sometimes they don’t, and it’s natural to assume that that indicates willfulness. But in fact their ability to control their behavior declines in proportion to the amount of stress they are experiencing. This can be obvious stress — a noisy place, difficult schoolwork, disruptions of routine — or less obvious, particularly in kids with sensory integration problems who react to things in the environment the rest of us wouldn’t even notice. Sometimes the loss of control happens well after a stressful event — if a child uses up a lot of resources getting through something hard early in the day, he may run out of control late in the day. Because of these relatively unchangeable facts of an FAE [FASD] child’s life, strategies that rely on self-control and presume willfulness; that require an advanced level of maturity and responsibility; or that increase the level of stress will be ineffective at best and may in fact escalate bad behavior.

These may include:

• Negative consequences.

• Big positive consequences.

• Escalating consequences.

• Nagging to stop behavior.

• Pressure not to break rules.

• Abstract rules like “Be respectful.”

• A choice offered between compliance and negative consequence.

• Behavior modification On the other hand, strategies that do not presume control; that don’t put undue weight on behavioral slip-ups; that are suited to the child’s level of emotional maturity; and that decrease the level of stress will be more effective, and at the least will not escalate bad behavior.

These may include:

• Positive consequences, on a modest scale, delivered immediately.

• Distraction from misbehavior.

• Brief time-outs, delivered consistently and matter-of-factly.

• Changing of environment to make success more likely.

• Behavior analysis to assist in changing of environment.

• Constant positive feedback and encouragement.

• Specific rules like “No hitting.”

• Choices in which both options are acceptable to adult.

• Behavior management

To read more of this article click here.  Thanks, Jill for the info.