Finding Factors That Affect Behaviors
In Children with Fetal Alcohol Spectrum Disorders

© 2002-2011 Teresa Kellerman

Tommy is a 10-year-old boy with FAS. He has no other disorders other than the typical attention deficits. Poor judgment and lack of impulse control are ongoing problems. Tommy lives in a stable home, is on medications that help balance his brain chemicals to optimize control over his behavior. His parents have good parenting skills and Tommy has a healthy attachment to his family.

But… every so often, he just loses it! Tantrums might occur over small issues. A meltdown might occur unexpectedly, without any obvious reasons.

We already know that Tommy's brain was damaged by exposure to alcohol before birth.  But there are other factors, both psychological and environmental, that may impact his ability to control his behavior.  How many factors can you identify that might have an adverse effect on Tommy's behavior?

Hint: some are internal and some are external.

Internal Factors:

External Factors:



Dehydration (very important to avoid)


Exhaustion (not enough good sleep)


Nutrition/Diet (MSG, food coloring, nitrates, Nutrisweet) Read online article here.


Missed meds


Hunger (too long between meals)


Frustration, anger


Fear, anxiety


Unrecognized symptoms of illness


Too much independence




Clothing (elastic, labels, too scratchy)


Wind, weather, temperature, air pressure


Noises:  television, radio, people


Lighting (fluorescent)


Visual distractions that are “busy”


Chaotic household or classroom


Role models acting out with rudeness or aggression


Being yelled at, blamed, put down  


Changes in routine or transitions


Unrealistic expectations




The point of this exercise is to help us be cautious when assuming we know what is causing a particular behavior problem.  Without the knowledge of FASD, many foster/adoptive parents blame the birth mother or prior foster home for psychological damage, and many teachers and psychologists blame the adoptive parents for poor parenting skills.  With the realization that the child is or may be FASD, parents are sometimes tempted to assign all behavior problems to the FASD.  While it is good to keep in mind that the primary basis for behavior problems is the organic brain damage, it is also healthy to look at additional factors that can also be working against the child.  Some we can control, and some we cannot.  Let's try to identify those that we can control and make modifications.


The more common factors are sometimes those not easily recognized:  Medication issues and diet are two of the most important but often overlooked.  Does the child need medications to help give him/her control over behavior?  Does the medication need to be increased because of growth?  Is the medication no longer effective?  Is it the right medication for your child?  Do you eat at restaurants?  Do you cook from scratch or use a lot of pre-packaged food?  Do you serve real juice or the inexpensive beverages that are full of artificial coloring?  Start reading labels and me mindful of what foods might set your child off.  When your child has a sudden episode of off-the-wall behavior, look first at meds and diet and make adjustments there.  Then review some of the other factors listed above.  Identifying those that can be modified could make a difference in how well your child can control his/her behavior.  Life will be easier for the child and for everyone else around!


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