Normal conscience development is part a neurological program that progresses by levels to maturity as a child grows into adulthood.

Toddler level: Do what makes Mommy happy. Motivated by desire to please Mommy (or Daddy or Grandma) and to get affection. At this age they have a hard time understanding just what is right and what is wrong, but they begin to get it in concrete simple ways.

School age level: Do the "right" thing to avoid punishment. Desire to be a “good girl” or “good boy.” With poor impulse control, this might more frequently translate to: Do "whatever" I need to do to avoid punishment, even if it means lying to cover my cute little butt. They know what is right, but they still can't always make the right decision, poor judgment being affected by neural dysfunction in the frontal lobes.

Adulthood: Do the right thing because it's the right thing to do, because it feels right. Altruism is more obvious in the late teen and early adult years, making a commitment to a program, or adopting a cause. Kids with FAS/ARND usually never make it to this level. They usually stay stuck in the "avoid consequences whatever way possible" mode.

It is my humble opinion (and that of several professionals) that conscience development with our kids who are FAS or FAE is connected to the ability to link cause and effect. They have the knowledge in their heads, they know what is right and wrong, they know it is upsetting to us when they repeatedly fail to “do the right thing,” and sometimes it might appear to some people that they don't care But when you talk to them heart-to-heart, it is very clear that they do care, just at a very immature level.

When John has broken rules at school or displayed less than appropriate behavior and was confronted with his actions, he can seem flippant and uncaring, and might even say, "Who cares!" or "So what!" It has been reported to me that he has shown no remorse for wrong-doing. But I know John, and when he is mentally in a space where he can be honest about his actions and feelings, he is quite remorseful and expresses concern about how his actions affect himself and how they affect others, especially family who love him.

Some parents say, "My child has no conscience." Of course our kids have a conscience! It is just the conscience of a 6 or 7-year-old. Remember, moral development is a neurological process, a program that unfolds progressively in "normal" kids and is only fractionally complete at age 6, and this is where a lot of our kids stop developing emotionally and functionally, even if they continue to learn facts as they grow older, even if they have IQs in the normal range.

John as reached chronological adulthood, but is still maturing emotionally, and although sometimes he is capable of thinking like a 12-year-old, many times he is stuck at that 6-year-old level. I have to remember this when he acts as though he doesn't care or covers up what he has done wrong or denies responsibility or expresses other immature thoughts and ideas and feelings.

One mother reported that after the confession of stealing, her son thinks the solution is to give him a larger allowance so he won't have to steal. Makes sense to me! :-) Kid sense, anyway. You have to give him credit for trying.

Animal research also shows that the frontal lobes of the brain, which are vulnerable to damage from prenatal exposure to alcohol, are involved in fear conditioning, which is the subconscious association between antisocial behavior and subsequent punishment. In humans this is believed to be a key factor in developing a healthy conscience.

According to researchers, the mature conscience is the result of learning set of conditioned responses through the process of reward and punishment.

The function of a healthy human conscience depends on one’s ability to think rationally and analyze information, to process feelings and make judgments, and to control one’s responsive behavior accordingly. All these neurological functions are disrupted by damage from alcohol exposure in the womb.

The kids who don't have any conscience are the kids who give the impression that they don't really care (at all, ever) if what they do causes others to feel hurt. Our kids may have difficulty connecting their actions with the consequences, and they might not always understand the abstract reasoning behind the concept, but most of them do have a conscience, just at an immature level. The child who truly acts without a conscience is likely to be suffering from RAD - Reactive Attachment Disorder. (Not all children with FAS/ARND have attachment issues, and the cause of RAD in alcohol exposed children can involve many factors. This will be covered in a separate article.)

John has a conscience, sometimes he is aiming to please me or somebody else, and sometimes he just tries his best to avoid the consequence, including lies to cover up his screw-ups. I can usually get him to confess, but that can backfire too, as I can get him to admit to something he didn't do. Now that's scary. I'd say that John has a working conscience, it just doesn't work right.

Lying, stealing, noncompliance, inappropriate behavior, and an inability to integrate socially are all symptoms that are seen in children with FAS and FAE, and are all reflections of the underlying neurological dysfunction.

John saw some loose change on the table by the front door (at age 18, “old enough to know better” but obviously he didn’t) and picked it up and put it in his pocket. When I asked who took the money, he readily confessed, not realizing he had done something “wrong.” I asked him if the thought had crossed his mind that it might belong to someone else. His reply was that he liked the feel of change in his pocket, he liked making it jingle. In this household there is frequent discussion about moral and ethical issues, about respect and ownership. Sometimes he just doesn’t get it.