Always Remember the Brain: 30 Strategies for Parents of Children with a Fetal Alcohol Spectrum Disorder

People who have been exposed to alcohol in utero have brain differences that express themselves behaviorally. As parents of children with FASDs it’s important to keep these brain differences in mind when caring for our children. Remembering brain differences and providing environmental change and accommodations to help support people with FASDs is called the neurobehavioral, or NB, approach. The scenarios and strategies below are examples of how to put this knowledge into action.

Celebrate when they follow through on a 2 part instruction, even if the initial request was 3 parts. Remember MEMORY.
When you check if your child put his laundry away and you find that it’s not really sorted, sort it for him or with him. Think about EXECUTIVE FUNCTIONING.
Use terms like “confabulation” and “lack of boundaries” instead of lying and stealing. Consider MEMORY, REACTIVITY, PROCESSING, and LEARNED DEFENSIVENESS.
When you know school is hard for your child and he resists going and the teachers are writing notes home about his behaviors, tell him you are proud of him for working so hard and trying. Because it’s true! Recognize STRENGTHS, EFFORT, and ENERGY NEEDS.
Allow “mental health” days when the thought of school is just too overwhelming. Focus on STRENGTHS, EFFORT, and ENERGY NEEDS.
Clean their room with (or for) them. Remember EXECUTIVE FUNCTIONING, ORGANIZATION, and need for SUPPORT.
Tell him how much you enjoy his company… Even if he’s beeping and clicking all freaking day! Focus on the POSITIVE. Encourage RELATIONSHIP.
When she’s struggling to grasp a math concept on paper…make it real life with something she loves. Mini, regular, jumbo marshmallows anyone? Use LEARNING STRENGTHS to your (and their) advantage!
Resist the urge to re comb her hair when she says she brushed it and she’s happy with it. Focus on the POSITIVE. Don’t let your VALUES get in the way of their NEEDS.
Remember when the blank stare happens he is processing. Slow down and wait! Give time for REAL communication. Remember PROCESSING SPEED!
Be kind to yourself so you can give them the benefit of the doubt. Happy parent, less stressed child. SELF CARE is crucial!
Even if your child has raged and screamed and said really mean things to you, when he calms down and comes to you later with a “sorry” and a hug, ACCEPT the apology. Realize REACTIVITY is just that, and doesn’t reflect your child’s actual feelings. Don’t let your VALUES get in the way of their NEEDS.
When she starts looking up porn on the internet immediately institute a nanny and supervision system, calmly explain the effects of porn on her brain and don’t let her know you are screaming into your pillow. Remember her IMPULSIVITY!
Remove opportunity for actions that impulsivity cannot control (taking inappropriate items, using tools dangerously, compulsively eating snacks). Modify the ENVIRONMENT to accommodate their need for supervision in light of IMPULSIVITY or poorly understood BOUNDARIES.
Build a strong relationship with child so that you can maintain some influence over time. Focus on RELATIONSHIP!
Behavior is communication of something the child/person can not verbalize…and usually the message is some variant of “I am overwhelmed, please help me” Be a BRAIN DETECTIVE! Understand FASD and your child’s brain differences. Step back, OBSERVE, and ask yourself what your kiddo needs!
Wait before you respond and meet them where they are. Recognize REACTIVITY. Understand BRAIN FUNCTION. Focus on RELATIONSHIP! Consider your VALUES when responding to behavior!
Use visual cues when explaining in addition to verbal. STRENGTHS-BASED LEARNING! If someone processes visually better than verbally, provide visual cues.
Be aware that they will imitate bad habits so watch and listen and monitor frequently. If a STRENGTH is copying others’ behaviors, use this to your advantage! Provide lots of opportunity for good modeling and inclusion in a controlled, safe setting!
When your child wants macaroni and cheese for breakfast and he makes it himself, roll with it! Don’t get caught up in your own VALUES when it comes to caring for a person with FASD. Focus on STRENGTHS!
Give proper clear short instructions don’t be like me this morning as my girl was throwing up everywhere. I said, with bucket in hand, try and be sick inside something, hence the drawer full of vomit. Remember that difficulty with ABSTRACTION can mean LITERAL thinking!
When your dad thinks that she “has no respect for him as a grandfather” because she told him to stop yelling, tell him he is wrong…dead wrong. And tell him in front of her. And ask him to apologize to her…in front of her. ( and yes, he did!). Remind others that they need to check their interpretation of behaviors at the door! Don’t let their VALUES get in the way of understanding BRAIN FUNCTION!
When she says she’s not doing any schoolwork today, ask her if she needs a day off instead of replying “oh, yes you will!” Then watch her pick up her books and start anyway because you gave her the understanding that she needed instead of losing it. Focus on RELATIONSHIP. Respect how hard her BRAIN had to work at school all day. Remember PROCESSING SPEED.
Watch the actions and listen to the dialogue, bleeping out the unkind words. That’s her frustration talking- not her heart. So “I’m going to stupid Grandma’s” = I’m on the way to grandma’s and I love her but I want to stay home; I’m sick of transitions even if I love the people there. Reflect to her with “you don’t want to go to grandma’s. You love her so much, but you really want to stay home. I hear that. I’m so glad tomorrow we get three stay home days together! Wanna make a plan for fun?” Remember IMPULSIVITY and difficulty with LANGUAGE and COMMUNICATION.
Remember they are excitable always on simmer ready to boil if they are challenged! Encourage calm downs instead. FIGHT or FLIGHT is often a constant for people with FASD. Remember to create ENVIRONMENTS that promote calm and predictability.
Think half their chronological age. Remember DEVELOPMENTAL AGE.
Just because it went smooth yesterday doesn’t mean it will today. Don’t set unreal expectations for you as a parent or your child. BRAIN FUNCTION FLUCTUATES from day to day, or hour to hour.
Create and post a visual schedule so they always know what to expect. Unplanned surprises are not usually fun! ACCOMMODATE BASED ON STRENGTHS, remember that predicting is an EXECUTIVE FUNCTION.
Tell other family members, friends, youth coaches, etc (that are actively involved in your family ) you parent with NB approach and you would like them to take time to read about it so they can help foster a safe, reliable, and structured environment for your kiddo to thrive. An INFORMED SYSTEM OF CARE can help prevent negative secondary outcomes.
Don’t forget to ask yourself the question: is this brain differences I’m seeing? Always, always, always THINK BRAIN.