Behavioral guidelines that work for people with FASD

There are behavioral guidelines that can be effective for people with other disorders, but not for people with fetal alcohol spectrum disorder (FASD) . These are behavior modification strategies based on learning theory, such as time-outs, punishments, token systems, and so on. These strategies are often used because they are popular, and we are all familiar with using consequences and cause-and-effect reasoning to manage behavior.

These methods fail to consider the difficulties and differences experienced by individuals with FASD, assuming that the child will learn from the consequences. However, individuals with FASD have difficulty making cause-and-effect associations , exhibiting more concrete thinking that makes it harder for them to generalize their learning to future situations, and struggle to predict or anticipate events. This difficulty with cause-and-effect thinking means they don't properly connect an action with its outcome, potentially leading them to repeat the same mistake over and over.

To manage the behavior of a person with FASD, it is important to consider:

• Strategies based on learning theory are not incorrect, but they are not adapted to the difficulties of FASD.
• Think about strategies for anticipating and adapting to the environment. Sometimes it's more about modifying the environment than the person themselves.
• She believes that some difficulties are hard to change because their behavior is due to organic damage caused by prenatal alcohol exposure, but with support, structure, supervision, and consistency , improvements can be achieved.
• Their developmental age is less than their chronological age in many aspects, therefore, expectations and demands must be lowered in certain aspects of behavior.
• Be specific. People with FASD improve their behavior when spoken to in concrete terms. It is recommended to avoid using double meanings or ambiguous phrases. If you want them to do something, it's better to say what you want them to do, not what you don't want them to do.
• Be consistent . Given the difficulties patients with FASD have in generalizing their learning from one situation to another, they function better in an environment with fewer changes. This includes the language we use, such as asking for and reminding them of their daily routines in the same way, always using the same words.
• Repetition. People with FASD have problems with short-term memory; they forget things they really want to remember, and they also forget information they have learned. To help them remember things long-term, they will need to be reminded repeatedly. They will also need to be reminded of the steps to follow in their routines.
• Routine . A stable routine, one that doesn't change from day to day, makes it easier to anticipate what action comes next. Routine also reduces stress levels, allowing for better learning. Some people may have a more rigid mindset and not understand some exceptions, so when we set out to acquire a habit, the more consistent we are and the fewer exceptions we make, the easier it will be to solidify the learning.
• Simplicity . People with FASD become overwhelmed in certain situations where there are too many stimuli, sometimes leading to behavioral problems. It is important to identify early on when more information will no longer be assimilated or will generate more stress.
• Supervision . People with FASD need more supervision to develop good behavior patterns and protect them from risks they are unable to see.