Three Crucial Steps to Assisting the Teen or Adult with FASD
© 2004 Teresa Kellerman
1. Determine functional age. This is measured by a functional assessment, such as the Vineland or the SIB-R. In most cases of FASD, the functional IQ is much lower than the cognitive IQ, so a person with FAS or ARND who has an IQ of 95 or 100 might have a functional IQ of 60 or 70. This is the assessment score on which to base expectations and legal responsibility and objectives. A young person with FAE who is 20 years old may have a functional age of a 14 year old, or younger. My son John is 27 and has an IQ around 70. His functional IQ however is only about 40, and his functional age according to the assessment report is anywhere between 3 and 9 years old, an average of 6, which puts John at high risk. My son Chris is 24 and functions at the level of a 30 year old (very responsible and mature for his age). He will never have any trouble functioning in the social world. The important thing to remember is that the person with FASD is only able to function at an age level far below that of a typically rational adult. For the teenager, think 6 or 7 years old. For the mature adult, think 11 or 12 years old.
2. Keep a behavior journal. Keep track of all notable behaviors – the positive ones and the ones that get them into trouble. Since they are likely to forget the last time they got in trouble for breaking a rule, they may need reminding of what happened as a consequence. And it might be good to point out to them how they make the same mistakes over and over. Also, it would be beneficial to discuss what other potentially risky outcomes could occur if the behaviors are repeated. Make a note of all the decisions based on immaturity or poor judgment. Our teens and adults with FAS or ARND cannot always see their own behavior as risky or immature. They really need to be made aware of this in order to protect them from potentially dangerous situations that could put themselves or others at risk. Reinforce all the positive behaviors and instances of good judgment, but remember (and remind them) that good judgment is fleeting and unpredictable.
3. Communicate: Share your observations about your child and your knowledge about FASD with family members and professionals who are involved with your family. It is especially important to talk about FASD with your teen or young adult. It is crucial that they understand the risk of having FASD, the ramifications of social relationships and employment situations and functioning in society in general. It is critical that they accept the reality imposed by their disability and the need for intense support and guidance in everyday affairs. Help them to communicate their needs and wants to you so that they can more easily be open to suggestions about decisions they make before they make the wrong decision that can wreak havoc in their life and yours. Be upfront and honest. Offer encouragement to pursue their dreams and to develop their talents, but also be vigilant with warnings of impending danger of which they may not always be aware.
Review: Determine the person’s functional age and keep that age in mind when formulating expectations and plans for the future. Track behaviors in a journal so that you have documentation of immaturity and poor judgment in case you need to prove inability to make decisions on their own or to live independently. Communicate about FASD to everyone involved, especially the person with FAS or ARND.