Just Call Me Jiminy Cricket

I think that the saying "Children Learn What They Live" is an overused cliché that has lost its importance.  But that is the key.  Children can be exposed to media and experiences outside the home, but it is what they experience in their home, what they are exposed to in their immediate family, that is going to have the greatest impact on their learning responsibility and developing a conscience.  

The focus of my studies and work has been children with Fetal Alcohol Spectrum Disorders (FASD).  So before we apply the "children learn what they live" principle to all children, we need to look first at the child's ability to learn, to remember, to control their own behavior.  In children with FASD this ability is compromised by damage to the brain, particularly the frontal lobes that control executive functions.  (See explanation on my web site: http://www.come-over.to/FAS/FASbrain.htm)   The child with FASD has problems in three areas:  memory, impulse control, and judgment.  Even though the child with FASD has been taught the rules and might understand the difference between right and wrong, the information they learn may not be retrieved from their memory when they need it.  Or they may remember but just act on impulse without really thinking first.  Or they might remember the rule, stop and think about the consequences, but do it anyway - that's the poor judgment, where they cannot weigh the risk of breaking the rule against the wisdom of doing the right thing.  These are all brain functions that are not working properly.  The brain may function well in one of those three areas at one time, and not in any of those areas at another time.  If a child breaks the same rules over and over, or displays the same behavior problems again and again, due to brain dysfunction, how can we hold that child accountable?  Is the child truly able to learn responsibility.   

You may have read my article on conscience development in the child with FASD.  (http://www.come-over.to/FAS/conscience.htm) If the child knows what is right and wrong, but cannot act accordingly because of a stunted social development and no impulse control and poor judgment, is it right to expect the child of 12 to function as if he/she had a working brain and a mature conscience?   

For children with FASD, there are two very important things to remember.  They learn by imitating the behavior of others.  This means mom and dad and siblings.  And later they imitate the behavior of their classmates, neighbors, and TV or movie characters.  It is extremely important that these children have healthy role models.  Parents have to be very careful about what behaviors they are teaching their children through their own actions.  Once children with FASD learn a behavior, a mode of reacting to others (pushing, hitting, yelling, etc.), it is extremely hard for them to unlearn that behavior and relearn new, healthy behaviors.  

The other thing to remember is that even though parents are very careful to teach their children healthy behaviors by example, children will still imitate unhealthy behaviors, if they have the opportunity.  And since the conscience is not working properly, they will need an "external conscience" in place - the presence of mom or dad or teacher or mentor of some kind, a person recognized as an authority, a Jiminy Cricket.  They are somewhat like Pinocchio - innocent, gullible, vulnerable, impressionable, immature, so the Jiminy Cricket analogy is one that fits, only the child with FASD will need that external conscience even when they become adults.  That is why supervision for these kids/adults is so important, because their conscience just doesn't work right all the time.  

My son John is 25 years old and has full FAS.  John requires close supervision at all times.  I cannot leave him at home alone for 15 minutes while I run to the store, or he may make a phone call to someone and say something inappropriate that might be construed as sexual harassment, or he might pay a visit to the neighbors and get into trouble, or he might set the house on fire, etc.  He cannot be left in public alone either, because he cannot determine when he is being socially or sexually inappropriate, or he may have an idea that he is and not be able to stop himself from making unwanted advances.  Does he have a conscience?  Yes, but it just doesn't work right all the time.  Is he responsible?  Yes, he wants to be a good person, he chooses not to offend or hurt anyone, he wants very much to do the right thing, but he just can't, not all the time, not consistently.  At any given time, he may think and act like a 25-year-old man or like a 5-year-old boy in a 25-year-old man's body. Currently he lives at home with me, and wherever I go, he goes along with me, and where he goes, he has me accompany him. I am constantly cuing him about rules he forgets, about when behavior is inappropriate, when he forgets manners, when he is about to engage in behavior that borders on wrong, and he may not have a clue. Just call me Jiminy Cricket.

At some point in the future, John will live in a group home placement with 24/7 supervision. He is one of the lucky ones who qualify for services. Most individuals with FASD do not qualify for services, and are at high risk of getting into trouble with the law because of behavior that they cannot control due to brain dysfunction.  

I think it is important to take a good look at behaviors of children with FASD, because it is believed that one out of 100 kids now are born with significant alcohol effects, but only 10% of these kids are recognized as having alcohol effects, the rest are just seen as "bad kids" or as "behavior problems."  Also, there may be many kids and adults struggling with their behaviors due to subtle effects from minimal damage from prenatal exposure to alcohol.  Think of this:  More than 50% of women of childbearing age drink.  Most pregnancies are unplanned.  Damage to the developing brain takes place during the entire pregnancy, including the first month or two that the woman may not even know she is pregnant.  There are lots of people walking around with mild effects who have difficulties controlling their behavior and don't know why.  

People with FASD have brains that function in ways similar to those of people who are "normal" but inebriated - looser inhibitions, poor judgment, lack of impulse control, etc.  People who have had more than a few drinks will act in ways that are not responsible (drive while inebriated, engage in risky sexual behavior, forget to use contraception, break laws, engage in abusive behavior, neglect children or duties, forget commitments, be unfaithful, etc.).  When inebriated, the person who has a working conscience will not be able to rely on their conscience, because it will have been shut down by the alcohol's suppressing the executive functions of the frontal lobes.  Children and adults with FASD are imprisoned with this brain dysfunction by no choice of their own.  Healthy unaffected adults have a choice to drink or not, but many choose to drink and deny that it has adverse effects on their ability to act in a responsible manner.  

If we eliminated alcohol effects, we would see children with greater ability to learn to be responsible, with greater capacity to develop a healthy conscience.  We would see fewer behavior problems in children, lower drop-out rate in schools, lower rate of crime, fewer incidents of abuse of alcohol and other drugs, fewer unwanted pregnancies, lower suicide rate, etc.  But that won't happen until we recognize alcohol as a major problem in our society.  If we recognized alcohol as a drug that has detrimental effects, we might have an easier time helping our children grow into responsible adults with a healthy conscience.

For more information on Fetal Alcohol Syndrome and Fetal Alcohol Spectrum Disorders: