Suspecting and diagnosing an FASD is only the first step on the therapeutic journey for a child and caregiver. Fortunately, validated interventions for children with an FASD are available with additional interventions adaptable to the needs of these children and their families. The following section describes evidence-based and informed behavioral interventions that are adaptable for children with an FASD and their families.
Behavioral interventions improve facets of self-regulation, neurocognition, and adaptive functioning. Most were adapted specifically for the strengths and weaknesses of children with an FASD. They support positive behavioral techniques and provide specific instruction to children for skill building while helping parents reframe interpretations of behavior and develop specific parenting skills. Caregiver education and reframing of behaviors are key components of their effectiveness. Recognizing the neurodevelopmental challenges presented by an FASD may help guide therapy decisions and set expectations for parents and caregivers.
Pediatricians can direct parents and caregivers to these interventions to help them understand that children can benefit from structured environments with reasonable rules, routines, and supervision. Office follow-up provides opportunities to monitor progress, give feedback and encouragement, and adjust the therapeutic course as needed.
Going the Extra Mile: Improving Math and Behavior in Alcohol Affected Kids
The Math Interactive Learning Experience or MILE program uses adaptive materials and tutoring methods. MILE improves math knowledge and graphomotor (handwriting) skills in children. MILE includes teaching methods and manuals for caregivers, teachers, and tutors.
Parents and Children Together (PACT) uses group formats to teach children how to identify arousal and other states (e.g. hunger, fatigue) using a “How is your engine running?” metaphor. Group training for parents and caregivers is part of the program so that they have ready strategies for dealing with arousal states. The PACT method provides constructs adaptable to the pediatric setting and training for parents and caregivers to improve behavior regulation skills, executive functioning, and parent effectiveness for children with an FASD.
GoFAR: An Intervention for Affective and Metacognitive Control in FASD
The GoFar program focuses on disorders of affective and cognitive control that are central to behavioral and adaptive disorders from infancy through young adulthood. GoFar brings together computer game technology and behavioral techniques for affective and cognitive control to manage impulsive and problematic behavior. The methodology also includes parenting strategies to improve child behaviors.
Good Buddies uses a group format for children with an FASD and their parents that improves peer relationships, social skills, and parental understanding of FASD-related disabilities. This intervention teaches age-appropriate social skills over 12 weekly sessions for parents and children. Training is focused on small steps toward the child and family setting up and having a successful play date. The Good Buddies training uses explicit instruction of social skills (e.g., slipping into a group).
The Zones of Regulation is a framework to promote self-regulation and emotional control. Zones of Regulation uses a group format to teach children how to identify their internal states with the use of a color mapping paradigm. The method teaches children strategies and skills to manage states through activities and incorporates parent education and skill building. The concepts and parenting methods of Zones of Regulation are adaptable for individual children in pediatric office settings.
Families Moving Forward is an intervention that is most appropriate for children with severe, clinically significant behavior problems. Based on positive behavior support techniques, the model uses supportive consultation with a parent or caregiver rather than directly with a child. Mental health providers with specialized training lead the consulting sessions that last 9 to 11 months, involving semi-weekly meetings with parents and caregivers. The Families Moving Forward program has developed a large number of brief handouts for parents, caregivers, educators and service providers.
Triumph Today is a parent training/advocacy program. It is a 16-segment online training series that gives parents the tools and techniques to understand a child with an FASD. It helps to create structures and strategies to bring success to family members with the disability. There is a cost associated with Triumph Today training.
The Alert Program is an occupational therapy program that has been adapted for use for individuals with an FASD. The method has shown to improve executive function skills, emotional problem-solving, inhibitory control, and social cognition. The program is the basis for the PACT and Zone of Regulation interventions previously described.
Do2Learn is a resource for individuals with special needs. The intervention has a virtual reality game that can teach fire and street safety skills to individuals with an FASD. The Do2Learn site also provides an FASD ToolBox where supportive education and behavior materials are available for download.
View additional resources at the National Organization on Fetal Alcohol Syndrome
View FASDs: Treatments
Behavioral Intervention Availability
Formal programs for particular behavioral interventions may be unavailable in a community. If your practice has the capacity, key elements and adaptations of some of the behavioral interventions can be provided in the pediatric medical home setting or in consultation with an appropriate professional (e.g., psychologist).
Last Updated
11/29/2021
Source
American Academy of Pediatrics