Following are sample scripts to help you communicate with a family regarding FASD.
It is good to see you and (child’s name). (Child’s name) is a very sweet/cooperative/(other adjective) child. You do a great job parenting/taking care of her/him. You appear to be concerned about fetal alcohol effects/fetal alcohol spectrum disorders/fetal alcohol syndrome given the history of prenatal alcohol exposure. Based on what we see today, (child’s name) meets full criteria for fetal alcohol syndrome (mention facial, growth, and central nervous system features as needed or based on how conversation flows). The diagnosis helps guide everyone around (child's name), so that they know how best to help him/her. Based on our developmental screening, she/he is strong in _____ and _____ but delayed in ____________.
- It may be helpful to refer her/him to an FASD clinic/developmental-behavioral pediatric clinic to determine her/his developmental abilities in the various domains (eg, gross motor, fine motor, language, cognitive/IQ, educational). We could also make referrals to 0 to 3/school system/developmental therapists (based on age/needs). (If the child has focal findings on a neurologic examination, it may be helpful to refer to a neurologist.)
Here is some literature on FASDs. There are some parenting strategies that other parents have found helpful. There are educational strategies that can be helpful to (child’s name). I can have you connect with our family advocate (or social worker) or give you some information about family supports. We will follow (child’s name) and coordinate her/his care. Do you have any questions so far?
- If speaking to biological mother: You made a very important decision for both your health and (child’s name)’s health when you stopped drinking at ___ months (or when you found out you were pregnant). At this time, we want to just make sure to monitor (child’s name) and ensure that her/his medical, developmental, and educational needs are met. Here is some literature on FASDs.
There is a group of birth mothers through the National Organization on Fetal Alcohol Syndrome (or NOFAS) that you may wish to contact. Here is some information on support groups. (If the mother is trying to seek help to stop drinking: If you wish, we can help connect you with neighborhood agencies that address this issue. Here is the contact number. Our family advocate can also help you contact these agencies if you wish to get you the help you need.)
This diagnosis is only one piece of (child’s name)’s puzzle. She/he is a unique individual, and it is important that we figure out the best way forward for her/him and your family. There can be other factors including genes, early nutrition, and environment. We are happy you are trying to provide the best environment for (child’s name). You have done a great job being her/his advocate. By getting her/him diagnosed and helped, you are giving (child’s name) the best possible outcomes.
Children with FASDs and their families may need the following services/supports:
- Developmental services (developmental interventionist, speech-language pathologist, occupational therapist, neuropsychological evaluation)
- Educational services and supports, including an Individualized Education Program
- Parent training/support program—give parent resources that are outlined in the toolkit (some of these are general and some may be state-specific). Generally, children with FASDs need a very structured environment in which parents/caregivers can provide supports for the neurobehavioral differences. Learning self-care skills may be hard and may require the parents/therapists to break down life skills into manageable steps, which will need to be learned through repetition and practice and often with visual aids/picture schedules.
- Teaching good behaviors requires gentle modeling, guidance, and redirection, in the background of realistic expectations. For_______, we need to adjust our expectations for her/his behavior/learning knowing that developmentally, she/he is more like a ___-year-old (developmental age) than a ___-year-old (chronological age). REMEMBER TO USE HER/HIS STRENGTHS TO HER/HIS ADVANTAGE IN ANY THERAPY PLAN.FASD-specific interventions (evidence-based)
- Medication management, as needed, for comorbid diagnoses, such as ADHD, anxiety disorder, etc
- Medical issues—vision/hearing/other diagnostics/referrals (cardiology, neurology, as needed).
Other Helpful Resources
1. Fetal Alcohol Syndrome Multimedia Guide—Professional FAQ
2. How to Talk to Your Child With FASD about FASD