Fetal Alcohol Spectrum Disorders (FASD)


Working with children and families who have been affected by Fetal Alcohol Spectrum Disorders requires advocates, physicians, educators, case managers, judges, addiction professionals, counselors and adoptive families to become more aware and to act collectively in the individual’s best interest. Many of the strategies seem to be generalized for the entire spectrum but they are successful throughout the course of the life of the affected person. Depending on the specific diagnosis and age, new physical and mental health problems may occur during the lifetime that requires specific and more specialized effort. Expectations have to be realistic and appropriate to each person with FASD.

First Things First

In addition to differing approaches by population all strategies should be implemented keeping these suggestions in mind:

  • Modify the environment
  • Modify expectations
  • Think younger or think "stage not age"
  • Think perpetual innocence
  • Make the world make sense
  • Rethink, re-teach, respect
  • See people not problems

Overall Treatment Strategies

  • Assess risk factors
  • Determine the need for further evaluation
  • Appropriately refer
  • Modify treatment, education and employment plans to increase individual success

Approaches by Population


Assessment Services Strategies

Diagnostic evaluation

Ongoing assessments

  • Medical
  • Mental health
  • Occupational and physical therapy
  • Speech and language
  • IQ and academic achievement

Family support

Early intervention

Case management

Modify the environment

  • Structure
  • Routine
  • Repetition
  • Support

Use literal, concrete language and check for understanding

Do not isolate the child


AssessmentServices Strategies

Ongoing Assessments

  • Medical
  • Mental health

Diagnostic evaluation for an FASD

Academic achievement

Social skills




  • Focus on strengths
  • Address issues such as abuse, grief, stigma, self-esteem, resistance, denial, and acceptance
  • Use motivational coaching

Educational Supports

  • Inform parents of laws regarding the education of children with disabilities
  • Offer guidance for initiating an evaluation

Coaching and Mentoring

Understand the need to blame others for their problems

Start where the person is!

Assist them in adjusting to a structured program or environment and learning how to trust new people

Share rules early and often

Provide opportunities to role-play or otherwise practice appropriate social behaviors

Refusal skills training

Work with the adolescent’s school on proven home strategies

Use multiple approaches to learning

Help set and adhere to boundaries


Assessment Services Strategies

Ongoing Assessments

  • Medical
  • Mental health

Revisit Diagnosis

Employment Screens

Transition Planning and Case Management

  • Community Resources
  • Financial Support


Supported Employment

Family involvement


  • Individual vs. group therapy
  • Set appropriate boundaries
  • Be aware of the client’s strengths
  • Understand the impact of abuse
  • Help the client cope with loss
  • Address the stigma associated with an FASD
  • Focus on self-esteem and personal issues
  • Address resistance, denial and acceptance

Medical and Educational Treatment Plans should include:

  • Strengths and limitations
  • Inconsistent abilities
  • Issues related to chronological vs. developmental age

Reduce stigma

Modify expectations

Modify environment

Reduce unemployment

Help make stable living arrangements

Reduce family conflict

Effective Communication

  • Check often for understanding
  • Review written materials
  • Repeat information
  • Use simple, concrete language
  • Present ideas or instructions one at a time

References Related to Treatment & Diagnosis

  • Ohio FASD Generalist Training 2005-2009, OSU Center for Learning Excellence funded by the Ohio Department of Alcohol and Drug Addiction Services
  • ACOG Drinking & Reproductive Health Prevention Tool Kit - Copyright 2006 A continuing education activity sponsored by the American College of Obstetricians and Gynecologists. Supported by the US Department of Health and Human Services, Centers for Disease Control and Prevention.
  • FASD Curriculum for Addiction Professionals Level 2, 2007, US Department of Health and Human Services, Center for Substance Abuse Prevention
  • Great Lakes FASD Regional Training Center, 2009, Framework for FASD Diagnosis