How FASD affects behaviour

Imagine having no common sense. You take your pills today but don't realize you must take them again tomorrow. You break into a house and the cops find you eating chips in front of the TV. Money is an abstract concept, so you give yours away to anyone who asks. When people say "I'll be there in a second" you think they really will.

For many people with Fetal Alcohol Spectrum Disorder, that's what life is like.

"Imagine if you can't learn from the past and you are always in the moment and it's all brand new everyday," said Brenda Bennett, who works with adults who fall through the cracks as the head of FASD Life's Journey. "People are almost constantly in crisis. The chaos is unavoidable."

The trouble with FASD is that every person is dramatically different, depending on when and how much their mother drank and what parts of the brain got damaged. One adult with FASD could have the developmental age of an eight-year-old, with trouble reading, making friends and telling right from wrong. Others with less severe FASD can lead totally normal lives.

To be diagnosed with FASD, you must have deficits in three of the following brain domains. In most cases, you also need confirmation that your mother drank.

Academic Achievement

Ability to keep up with grade level reading, writing and math skills.

• Often are visual instead of verbal learners, so a teacher talking just doesn't register.
• Tries hard in class but just doesn't get it.
• Poor study skills, seen as slow or behind.

Social adaptive

Ability to navigate daily life, communicate effectively, make and keep friends, respond to social cues and cope with change.

• Impulsive, often blurts out things inappropriately, always seems to be in trouble. Sexually inappropriate. Lacks empathy.
• Easily led and manipulated, eager to please, which could lead to compulsive lying.
• Often seems immature or plays with younger kids.

Executive Functioning

A big one -- the ability to set a realistic goal, get organized and achieve it. Also, the ability to look ahead and see the consequences of your actions or take a lesson learned in one situation and apply it elsewhere.

• z Doesn't know right from wrong. For example, doesn't know the difference between stolen, borrowed or found.
• Often needs step-by-step instructions for tasks most people find intuitive, like doing the dishes.
• Seems willfully disobedient or maliciousness. "Just doesn't get it."

Communication

Ability to speak and use grammar and proper sentence structure and put thoughts and feelings into words.

• Delays in speech.
• Stories or thoughts don't make sense or are repetitive.
• Can't follow multi-step instructions.

Memory

Ability to remember and retrieve short and long term information.

• z Can't remember simple things, like how to do chores or where an item is.
• Can't do more than one thing at a time.
• Slow to come up with answers, so they make them up.

Brain Structure/Motor skills

Ability to use and coordinate large and fine muscles.

• Late to walk, tie shoes, ride a bike.
• Clumsy, poor posture, messy handwriting

Sensory

Ability to process, filter and make sense of all the information being thrown at your five senses.

• Overly sensitive to light and sound, like loud classrooms, video games or even the buzz from fluorescent lights.
• Extra sensitive to touch and texture, even spicy foods, scratchy sweaters or too much air conditioning. Or the opposite -- not sensitive enough to pain.
• Often seen as cranky or aggressive, or just shuts down.

Cognition/IQ

Thinking ability, especially abstract thinking.

• Trouble with abstract concepts like money and time.
• Thinks more slowly and need time to process. May only understand every third word people say. Makes people with FASD seem stupid or slow when they are just processing.
• Could have a low IQ, but many people with FASD have normal IQs.

Attention Regulation

Ability to stay focused for a sustained period, or return to a task when distracted.

• Easily distracted by clutter, knicknacks, posters on the wall or people walking by.
• Can't sit still. Fidgets and bothers others. Needs calming rituals like body rocking or squishy balls to stay focused.
• Often seen as disruptive hyperactive or fidgety.

Republished from the Winnipeg Free Press print edition February 26, 2011 H3