Guidelines for Daily Living with FAS/FAE

Clinicians, parents and educators who have worked with individuals affected by FAS/E stress the importance of the following factors when dealing with affected adolescents.

Structure
Create a structured environment for teens with FAS/E which includes choices within clear and predictable routines.

Supervision
Carefully supervise teens with FAS/E so that they do not get into trouble by placing themselves in dangerous situations. Although a child may be chronologically 15, his mental/emotional functioning may be at a lower level.

Simplicity
Offer simple directions and orders, stated briefly, rather than the elaborate verbal justifications and explanations often given to teens.

Steps
Break tasks down into small steps and teach each step through repetition and social reward.

Context
Teach skills in the context in which the skills are to be used. FAS/E adolescents will not generalize from one context to another. They do not understand when the behaviour is appropriate and when it is not.

 Encouraging Independence

  • Foster independence in self help, /learning activities
  • Encourage decision making
  • Encourage adolescent to self monitor
  • Encourage teen to try first before asking for help
  • Focus on daily living/survival skills
  • Make daily "to do" lists
  • Place problem solving strategies list in conspicuous place
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Encouraging Self Esteem

  • Increase self-confidence by identifying a sport or social activity for your child where he can be successful by himself (bowling, choir, art lessons)
  • Treat with respect & dignity
  • Encourage use of positive self talk
  • Reward rather than punish
  • Help adolescent see value of failure as a learning tool
  • Work on adolescents' body/self image
  • Offer support, not criticism
  • Encourage to help as valued member of family
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Hyperactivity

  • Protect adolescent from overstimulation
  • Stress listening skills
  • Use calming music
  • Have a plan in place for when the individual is feeling overwhelmed
  • Minimize waiting time
  • For long walks, give something to do with their hands (worry beads)
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Behaviour

  • Redirect behaviour. Work on compliance
  • Focus on behavioural standards
  • Parents should avoid asking questions that put the child in a position where they have to lie. Lying occurs because it is easier than trying to think through the facts.
  • Model/practice positive peer exchanges
  • Model/encourage self-talk to help control impulsivity
  • Offer help in understand the concept of ownership especially of unattended objects. Stealing may be a sign of some other stress that adolescents are unable to process and articulate, or they may be acting for the self-centered orientation of a younger child.
  • Don't expect fear to prevent them from doing something dangerous
  • Rehearse correct behaviours for risky situations (using matches, going with strangers, getting in cars, using alcohol) over and over
  • Focus on getting attention in ways other than negative behaviour
  • It is difficult for an FAS person to think, process information and to put words on things.
  • When all else fails - use habit
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Discipline

  • Set limits and consistently follow them
  • Talk about cause and effect relationships
  • Avoid repeated threats
  • Be brief
  • Reinforce school rules
  • Change rewards often to keep interest high
  • Remember negative behaviour may be symptom of unmet needs
  • Tell adolescents exactly what you want them to do
  • Review and repeat consequences of behaviour
  • Anticipate danger signs/situations and plan ahead
  • Avoid statements that place a value on behaviour
  • Don't debate over rules/infractions. 'Just do it'
  • Notice when doing/behaving well/appropriately
  • Specifically label obnoxious behaviour
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Providing Structure

  • Prepare adolescent for school before bedtime
  • Establish a few simple rules
  • Use same language repetitively
  • Develop Hello and Farewell rituals
  • Establish routines so future events can be predicted
  • Encourage adolescent to finish before starting next activity
  • Give auditory and visual advance warning activity will soon be over
  • Clearly define adolescent's space
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Social Behaviour

  • Teach social skills lessons. Help the adolescent be more aware of how people express their feelings non-verbally ie model different facial expressions, hand on hip, arms crossed.
  • How to negotiate to get what you want
  • How to show someone you like them
  • How to ask for something in a way that increases odds you will get it
  • How to give and take a compliment
  • How to say no to peer pressure
  • How to accept disappointment
  • What to do when someone hurts your feelings
  • How to disagree with someone in an appropriate way
  • How to accept criticism or negative feedback
  • Getting adult attention in a positive way
  • How to greet another person
  • How to start a conversation
  • How to handle anger
  • How to act when riding public transportation
  • What to do when you feel scared
  • How to ignore someone who is bothering you

Gentle reminders produce a positive attitude. Adolescents from dysfunctional homes may think words can't be trusted. Show them.