Day 66 of 99 Days to FASDay: Community-Based Supports and Interventions for Adults with FASD

We are two-thirds the way through our journey with Day 66 of 99 Days to FASDay. For 2022, the graphic and focus have changed to flow more with the focus we have been looking at over the last few days – supporting adults. (The original information for this day, which focussed on one characteristic, dysmaturity, remains, further down the page)

Day 66 of 99 Days to FASDay

The following information comes from a research paper published in 2018: Elements for developing community-based interventions for adults with fetal alcohol spectrum disorder: A scoping review by Ryan Quan, E. Sharon Brintnell and Ada WS Leung and Article Summary #8 prepared by CanFASD in 2019.

The authors of the study reviewed seven studies completed between September 2016 and July 2017 that explored successful interventions for adults with FASD. The following six themes were generated:

  1. Inclusion of functional context: Focuses on the roles of adults and develops everyday living skills, including the practical aspects of day-to-day life. For example, the functional context may include developing vocational skills, attaining employment or housing, and managing finances.
  2. Individualized support: This form of support may include family, friends, and professionals who provide individualized help. Specific support helps individuals to feel autonomous and in control of their lives.
  3. Education for service providers: The more formal training professionals received, the more prepared they felt to work with these individuals. Education may include basic professional education or continuing education through webinars and conferences.
  4. Structure and routine: Routines and structure help individuals create patterns in their days and weeks, which can increase success.
  5. Utilizing a strengths-based approach: A strengths-based approach focuses on the unique strengths that people with FASD have, instead of their challenges.
  6. Environmental adaptions: Adapting the environment to overcome challenges can be beneficial, as environmental changes can enhance their potential for success, decrease frustration, and maximize support. 

The recommendations were to:

  • involve occupational therapists in supporting adults with different functional needs
  • provide support and education to assist people with FASD with planning and using tools and strategies for their routines, and
  • use a strengths-based approach.

The next few days will highlight some lessons learned in providing successful support for adults with FASD.

ORIGINAL/PRIOR DAY 66 of 99 Days to FASDay: Dysmaturity

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Today we offer a reminder for those who are working with, supporting or just hanging out with someone with FASD – remember stage, not age. 

fasd-chrono-vs-develp

This classic sign of FASD as described by Clarren, Malbin and Streissguth. A person with FASD will simultaneously exhibit behaviours common to people of different ages. For example, someone with FASD might be 18 years of age, sound like a 22-year-old (expressive language), act like a 6-year-old in a social and moral sense, read like a young teen and understand time and money at about the same level as a 12-year-old.

People with FASD tend to catch up to themselves as much as they are going to by their early to mid-thirties.

Known as dysmaturity, it is the developmental “gaps” between a person’s chronological age vs. his/her developmental age in different domains (eg. life skills, expressive language, money and time concepts, etc). You can find a simple one-page handout on the website for FAS Arizona.

FASD United (formerly NOFAS) describes it this way:

The actions of a person with FASD may be inappropriate for chronological age while still being appropriate for the developmental age. Expecting a person with FASD to correct inappropriate behavior can be frustrating for both the caregiver and the child.

The FASD Network of Saskatchewan offers these tips:

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Generally, as parents or caregivers, we are told to “cut the age in half” and meet the child where they are developmentally. This can be difficult to do – and I have found although I understand the concept, actually putting it into practice, as the maiden has grown older, becomes more difficult to do. When the maiden was in grade 5 – she was 11 years old. However, in some of her skill sets she was much younger. This is the age where she really began to express herself differently from those around her. AT 18 diagram shows she is at an 11-year-old skill level for daily living skills (give or take – this is an example, not every person will be exactly like this). I find she is much younger than 11.  And this is where it becomes difficult to support youth or young adults with FASD. You need to respect their actual age, and their desire to do what people their age are doing, but you also know for many activities you still need to supervise or support. However, legally, the maiden is an adult and has adult rights and privileges.

There is some debate in the disability sector about using this way to describe individuals. The point being that it is measured against some standard created by a set of people. Even people without disabilities can vary in their skill levels – so the best advice is to meet a person where they are at by giving them the tools and time they need to succeed.

If you want more pearls of wisdom from Jeff Noble, who is quoted in the original graphic, check out his website FASD Success.

The next few days will highlight some lessons learned in providing successful support for adults with FASD.

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