How to Help Someone Who Has a Fetal Alcohol Spectrum Disorder

This is an article found on CPI’s website about understanding behaviours of persons living with an FASD and how you can be of help to them.  Source:

FASDBecause of the nature of their disability, individuals with Fetal Alcohol Spectrum Disorders (FASD) have very specific needs. CPI’s Nonviolent Crisis Intervention® training program is relevant for those supporting individuals with FASD, and there are specific considerations and possible adaptations for making your training as applicable as possible to this very unique group.

Similar to individuals on the autism spectrum, people with FASD are affected by and respond to
anxiety differently than neurotypical individuals. FASD is also an invisible disability and comes with a collection of specific key issues related to intellectual functioning that can affect how to best respond when supporting individuals through a crisis.


Individuals with FASD can spend a large amount of time in a state of anxiety. As a result of the significant difficulties receiving, processing, and responding to information due to their brain damage, individuals with FASD can become anxious at even the most basic tasks or expectations. When they’re anxious, they may not respond in the typical ways that you would expect, so if you don’t have specific knowledge of their behavior or a close relationship with them, you may not recognize their specific signs of anxiety, and may miss the opportunity to intervene in a supportive manner.

“Flying off the Handle”

Additionally, as individuals with FASD spend large amounts of time in a state of anxiety, people around them can start to see this as the “norm” for them and not take advantage of the opportunities to intervene at the earliest possible time. In this way, if people get used to the anxious behavior of an individual with FASD as being the norm, when an individual escalates and moves into the second level of the CPI Crisis Development Model℠ (taught in Nonviolent Crisis Intervention® training), it may be seen as if the individual “flies off the handle” quickly or without warning.

In fact, the warning was there in the form of the anxious behaviors, but those around the individual may just be used to this and therefore not respond in a timely manner.

FASD is an invisible disability

Since FASD is an invisible disability, people often have much higher expectations of the individual than are reasonable, given their actual intellectual abilities. The individual with FASD often looks “typical” and may have good or even above-average expressive communication abilities, which can convince others that they don’t have a disability at all. The reality is that often their receptive communication skills are very low and out of sync with their expressive skills. They can talk a good talk, but when it comes to really understanding what you are saying and knowing how to respond, they can be at a huge disadvantage.

Using verbal intervention strategies

This can be very confusing for people who support people with FASD. It can also have significant implications when you’re using verbal intervention strategies, as the strategies will not work in the same way as they would with a person who does not have FASD. If you’re part of a crisis intervention team for an individual with FASD, you should be sure to raise the issue of specific verbal intervention tips for that person and how they would fit into a crisis intervention plan.

Here are some strategies to help:

  • Use as few words as possible.
  • Always clearly state what you want to happen—the desired behavior.
  • Don’t argue, debate, or negotiate.
  • Being direct is good, but don’t become too authoritarian, or doors will close quickly.
  • Don’t expect the person to be reasonable or to act their age.
  • Go for a few “Yes” responses first. Use short questions you think the person will answer “Yes” to, just to get them out of being stuck in the “No” loop.
  • Be nonjudgmental.
  • Start with a clean slate. Don’t have any assumptions as to why the person is behaving the way they are. There is a good chance you may be incorrect.
  • Don’t get frustrated that you just dealt with this same type of issue yesterday. It may seem like the same issue, but to the person it’s likely a completely unique and unrelated crisis. It’s not that they aren’t paying attention; it’s that their brain isn’t letting them make the connection.
  • Be extra attentive to your nonverbal and paraverbal communication. The person with FASD may not understand all the words you’re using when they’re going through a crisis, but they are likely tuned in to your appearance and sound.
  • Keep in mind the strong Precipitating Factors related to the person’s brain damage as a result of prenatal alcohol exposure. It can help you maintain your Rational Detachment in a tough situation.

Misinterpreting behavioral motivations and Precipitating Factors

The differences between a person’s “normal” appearance and their significant cognitive issues can make it appear to others that the person with FASD is actually manipulative, lazy, a con artist, or sneaky. In fact, most of this is directly related to their disability.

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