Intervention Strategies

Just as people with disabilities may need external support to accomplish daily living tasks, so do people with FASD. But instead of needing ramps and wheelchairs to maneuver through their daily life, they may require an "external brain". The "external brain" idea as an approach to develop strategies to help people affected by FASD. It consists of an outside system of people and prompts that serve to monitor and suggest adjustments to the environments of individuals with FASD to maximize predictability and structure to their daily lives. Below are the main areas of concern where "external brain" strategies can to be implemented. Since the range of disabilities varies from one child to another, all children may not need help with all of these skills.

Social Skills

Social isolation is all too common in individuals with FASD. The potential for poor communication, an inability to predict the consequences of their actions, and poor impulse control may make it hard to make and keep friends and to interact with their peers. This can lead to anxiety and depression. These skills should be taught and supported in all of their environments since they may have difficulty transferring an appropriate learned behavior from one environment to another.

Communication Skills

A child affected by FASD may require extra help in learning basic communication skills. They need help learning how to use appropriate language in various settings. Teach them to be aware of verbal and nonverbal expressions as well as gestures and other behaviors used by others as prompts to help convey information.

Another part of basic communication is making choices. This is not always easy, in part because we must sometimes honor the individual's choice even if we do not agree with it. At times when we can not honor the choice, we may instead communicate that their choice is not valid. Teaching how to make choices can be very time consuming and frustrating. It must be done in a systematic way, beginning with giving a few concrete choices and slowly offering him/her more complex choices.

Functional or Adaptive Living Skills

Many adults with FASD need to learn a variety of skills to live independently. These skills need to be taught in the environment where they will be used - i.e. school, work, and home, along with other public places. For example, they need to not only learn how to fill out an application and find a job, but also how to keep the job. In addition, they need to learn how to perform daily living skills, including independence in transportation.

Behavior Management

Behavior management is perhaps most important part of any program dealing with children with FASD. Structure is a key element in creating a successful behavioral program. The structure should be simple, well-defined and consistent. It may help to think in terms of "black and white", avoiding any grey areas.

If behavior "A" equals consequence "B" today, then it must also equal consequence "B" tomorrow, next week, next month, next year. If you keep in mind that children with FASD have a hard time communicating, their inappropriate behavior no longer a seems malicious or irrational. It is a form of communication for them. It is then up to us to understand the meaning behind the inappropriate behavior and find a better way to help them communicate that message to us.

Plan Ahead

Another challenge is planning ahead. A crisis is not the time to decide how we are going to react to a certain situation or what the consequences for the behavior will be. Finally, in dealing with children's behavior, always remember: in order to keep control, you must be in control!


Home What is FAS? Intervention FAQ Resources Training About FEN FenPen Research Retreats FASD Awareness "It's hard to talk about what may be our most profound grief, to be exposed and vulnerable to the reactions of others." - Counselor and birth mother of a child with FAE	Intervention Strategies Just as people with disabilities may need external support to accomplish daily living tasks, so do people with FASD. But instead of needing ramps and wheelchairs to maneuver through their daily life, they may require an "external brain". The "external brain" idea as an approach to develop strategies to help people affected by FASD. It consists of an outside system of people and prompts that serve to monitor and suggest adjustments to the environments of individuals with FASD to maximize predictability and structure to their daily lives. Below are the main areas of concern where "external brain" strategies can to be implemented. Since the range of disabilities varies from one child to another, all children may not need help with all of these skills. Social Skills Social isolation is all too common in individuals with FASD. The potential for poor communication, an inability to predict the consequences of their actions, and poor impulse control may make it hard to make and keep friends and to interact with their peers. This can lead to anxiety and depression. These skills should be taught and supported in all of their environments since they may have difficulty transferring an appropriate learned behavior from one environment to another. Communication Skills A child affected by FASD may require extra help in learning basic communication skills. They need help learning how to use appropriate language in various settings. Teach them to be aware of verbal and nonverbal expressions as well as gestures and other behaviors used by others as prompts to help convey information. Another part of basic communication is making choices. This is not always easy, in part because we must sometimes honor the individual's choice even if we do not agree with it. At times when we can not honor the choice, we may instead communicate that their choice is not valid. Teaching how to make choices can be very time consuming and frustrating. It must be done in a systematic way, beginning with giving a few concrete choices and slowly offering him/her more complex choices. Functional or Adaptive Living Skills Many adults with FASD need to learn a variety of skills to live independently. These skills need to be taught in the environment where they will be used - i.e. school, work, and home, along with other public places. For example, they need to not only learn how to fill out an application and find a job, but also how to keep the job. In addition, they need to learn how to perform daily living skills, including independence in transportation. Behavior Management Behavior management is perhaps most important part of any program dealing with children with FASD. Structure is a key element in creating a successful behavioral program. The structure should be simple, well-defined and consistent. It may help to think in terms of "black and white", avoiding any grey areas. If behavior "A" equals consequence "B" today, then it must also equal consequence "B" tomorrow, next week, next month, next year. If you keep in mind that children with FASD have a hard time communicating, their inappropriate behavior no longer a seems malicious or irrational. It is a form of communication for them. It is then up to us to understand the meaning behind the inappropriate behavior and find a better way to help them communicate that message to us. Plan Ahead Another challenge is planning ahead. A crisis is not the time to decide how we are going to react to a certain situation or what the consequences for the behavior will be. Finally, in dealing with children's behavior, always remember: in order to keep control, you must be in control!
Copyright 2003 University of Wisconsin-Madison Department of Family Medicine . E-mail us with your comments, questions or suggestions! fen@fammed.wisc.edu Last updated: August 2007