- It is critical that people impacted by FASD are diagnosed or recognized as early as possible; however, this can be a challenge given the limited diagnostic services in Ontario. In the absence of a formal diagnosis, it is recommended that parents/caregivers and service providers consider the possibility of FASD, when the person’s behaviours or difficulties meet the general profile. Once FASD is identified or suspected, it is important to provide appropriate supports for successful intervention and a positive long term prognosis.
- Due to the effects of brain damage, typical behavioural modification approaches such as the use of rewards and punishment, are often unsuccessful with this population. Service providers need to focus on first gaining a good understanding of FASD, the impact on the brain and the presenting behaviour. Knowledge of FASD will allow teachers and service providers to approach affected individuals with more understanding and empathy.
- The use of a positive, strength based approach to services is strongly recommended for this group. Using a neurobehavioural approach for intervention and accommodation will build on cognitive strengths and support weaknesses. Effective programs understand that behaviours are the result of brain damage and are not seen as wilful. Focusing on what they can do will help to develop their skills, self-esteem and build confidence.
- It is critical to provide support, supervision, structure and routine. External supports should focus on developing and maintaining a routine and providing structure to day to day living, including free time. Supervision levels may vary depending on the functioning level of the individual, however, some support should be accessible, at all times.
- Communication should be concrete with visual support provided whenever possible (i.e. tell them and show them). Keep comments short and simple. Recognize that they may take longer to attach meaning to what they hear, and as a result, it may take them longer to answer. Repetition may be necessary because they may not remember what has been said.
- Sensory Integration Disorders are prevalent in this group. Try to determine what their particular sensory sensitivities are and modify the environment to support them. Generally, environments should be minimalist in nature with few distractions. Items should be organized and labelled. Sensory information should be limited (i.e. avoid bold primary colours, avoid fluorescent lighting, reduce or eliminate different sounds and smells)
- Planning for life long interdependent supports is critical. Some level of understanding and support will always be needed.
- Lastly, given the complexity of FASD, there may be a need for multiple service provider involvement. This dictates the needs for one agency to take the lead as case manager and organize a collaboration of services. This will ensure that all providers are aware of each other and avoid duplication of service. In addition, this allows for the case manager to ensure that all service providers are trained to support FASD effectively.
For the full report see Advancing Effective Service Provider Practices in Fetal Alcohol Spectrum Disorder