Formerly known as MOFAS: Minnesota Organization on Fetal Alcohol Syndrome

Exciting News
from MOFAS

If you're looking for the Minnesota Organization on Fetal Alcohol Syndrome (MOFAS) you have come to the right place. We have some exciting news about our organization. We have a new name! MOFAS has officially been renamed Proof Alliance. Our mission remains the same: to prevent prenatal alcohol exposure and to improve the quality of life for people living with fetal alcohol spectrum disorders (FASD).

Why PR%F

We now have the proof that prenatal alcohol exposure is a leading cause of brain injury in children. We have the proof that FASD is 100% preventable and people living with an FASD can reach 100% of their potential.

Why Alliance?

We seek to build powerful alliances with people with an FASD, their families, legislators, experts in the field, new partners, and community members to bring awareness, research, and services to this field.

What's Next?

Proof Alliance is rebranding, expanding, and we're moving! We have a new logo, website, and prevention campaign to help change the norms around drinking during pregnancy. And in May 2019 we will be moving to a stand-alone building. Proof Alliance commits to the people of Minnesota and we will continue to develop transformative programs to help Minnesotans impacted by FASD.

Understanding Behaviors of Fetal Alcohol Spectrum Disorders (FASD)

Understanding Behaviors of Fetal Alcohol Spectrum Disorders (FASD) PDF

Understanding behaviors of FASD

Won’t…or can’t?

Without an understanding of the physical, behavioral and cognitive challenges faced by people with fetal alcohol spectrum disorders (FASD), typical misbehaviors can be misinterpreted as intentional misconduct or deliberate disobedience, when it is often just the opposite. When it seems like your child won’t do something, it might be that they can’t do it – at least not without support.1 Remember that everyone with an FASD has the ability to succeed. Strategies, support, and interventions can help reduce the long-term effects of prenatal alcohol exposure and improve outcomes, behavior, and well-being for people with an FASD.2

Domains impacted by prenatal alcohol exposure

Due to the brain injury caused by prenatal alcohol exposure, people with an FASD may have difficulty with the following:3-7

Sensory processing: They may have issues processing sensory information, such as touch, sound, or movement. This can lead to overstimulation and anxiety, aggressive behavior, or inability to learn or perform.

Cognitive skills: This can include learning difficulties, poor impulse control, and issues with memory and attention.

Abstract reasoning: If the frontal lobe has been affected by prenatal alcohol exposure, abstract reasoning can be difficult for the brain to process. Instead, be concrete and speak in literal terms. When giving directions, provide them step-by-step in detail.

Cause and effect reasoning: Remembering consequences can often be difficult due to impulsivity and memory issues. Because of this, consequences often will not shape future behavior for people with an FASD.

Generalization: What is understood or done in one setting does not automatically transfer to similar settings. Be aware that if you change one part of the person’s routine, you have created an entirely new routine and this can require some adjustment.

Hyperactivity: This can include difficulty staying focused, being easily distracted, and having issues self-regulating when they are overstimulated or tired.

Memory: People with prenatal alcohol exposure often have issues with memory, especially working memory. Visual memory is often better. “Show” them, rather than “tell” them. Use fewer words. Understand that at times, a person with an FASD may not be able to complete a task that they had successfully completed many times before.

Adaptive functioning: People with an FASD might have issues with functioning independently and developing and maintain daily living skills.

Secondary Characteristics

FASD is a lifelong disability, and “secondary characteristics” can occur as a result of living with the struggles associated with prenatal alcohol exposure. Secondary characteristics can include:8-11

  • Fatigue
  • Tantrums
  • Irritability, frustration, and/or anxiety
  • Avoidance, withdrawal, being shut down, lying, and/or running away
  • Trouble at home and/or school
  • Legal trouble, drug/alcohol abuse
  • Mental health issues

The impact of these secondary conditions can be reduced when caregivers and professionals understand the challenges associated with the individual’s history of prenatal alcohol exposure and plan strategies and interventions that can most effectively support both the individual and their family.

Adjusting Expectations

Caregivers should adjust their expectations of the person with an FASD to the developmental stage they are at in that moment. Expect variability: some days they may seem to function well, and other days they will have frequent struggles. This is typical but not intentional. Provide additional support when they become overwhelmed. Learn to read their behaviors and intervene as early as possible. Know that it’s okay to ask for help or support.

Strategies

Each person on the FASD spectrum is unique, and a strategy that works well with one child on the spectrum might not work at all for another. You might have to try different strategies before finding which ones work well for your family.

  • Be proactive versus reactive. This will help you avoid issues before they have a chance to occur.
  • Allow plenty of processing time when talking with your child. For example, when asking them a question, count 10 seconds in your head before expecting a response from them.
  • Repeat instructions/tasks as many times as it takes for your child to understand what to do. It can be helpful to write down instructions and give reminders.
  • Provide supervision whenever possible.
  • Allow frequent breaks from activities.
  • Give concrete examples and instructions; children on the spectrum can have difficulty with idioms, sarcasm, and other language that isn’t straightforward.
  • Set consequences that are immediate and related to what occurred.
  • If your child is feeling frustrated, anxious, or irritable, provide them with a quiet space (when possible) that doesn’t have a lot of sensory stimulation.

Sources: 

  1. Gross AC, Deling LA, Wozniak JR, Boys CJ. Objective measures of executive functioning are highly discrepant with parent-report in fetal alcohol spectrum disorders. Child Neuropsychology. 2015;2(4):531-538.
  2. Rodríguez JJ., Smith VC. Prenatal Opioid and Alcohol Exposure: Understanding Neonatal Abstinence Syndrome and Fetal Alcohol Spectrum Disorders to Safeguard Maternal and Child Outcomes. Zero to Three. 2018;38(5):23-28.
  3. Masotti P, Longstaffe S, Gammon H, Isbister J, Maxwell B, Hanlon-Dearman A. Integrating care for individuals with FASD: results from a multi-stakeholder symposium. BMC Health Services Research. 2015;15(1):1-12
  4. Green CR, Mihic AM, Nikkel SM, Stade BC, Rasmussen C, Munoz DP, Reynolds JN. Executive function deficits in children with fetal alcohol spectrum disorders (FASD) measured using the Cambridge Neuropsychological Tests Automated Battery (CANTAB). Journal of Child Psychology & Psychiatry. 2009;50(6):688-697.
  5. Flak AL, Su S, Bertrand J, Denny CH, Kesmodel US, Cogswell ME. The association of mild, moderate, and binge prenatal alcohol exposure and child neuropsychological outcomes: A Meta-analysis. Alcohol Clin Exp Res. 2014;38(1):214-26.
  6. Noor S, Milligan ED. Lifelong Impacts of Moderate Prenatal Alcohol Exposure on Neuroimmune Function. Frontiers in Immunology. https://www.frontiersin.org/articles/10.3389/fimmu.2018.01107/full
  7. Subramoney S, Eastman E, Adnams C, Stein DJ, Donald KA. The Early Developmental Outcomes of Prenatal Alcohol Exposure: A Review. Frontiers in Neurology. 2018;9(1108).
  8. Weyrauch D, Schwartz M, Hart B, Klug M, Burd L. Comorbid Mental Disorders in Fetal Alcohol Spectrum Disorders: A Systematic Review. J Dev Behav Pediatr. 2017;38:283-291.
  9. Glass L, Moore EM, Akshoomoff N, Jones KL, Riley EP, Mattson SN. Academic difficulties in children with prenatal alcohol exposure: Presence, profile, and neural correlates. Alcoholism: Clinical and Experimental Research. 2017;41(5):1024-1034.
  10. Streissguth, AP, Bookstein FL, Barr HM, et al. Risk factors for adverse life outcomes in fetal alcohol syndrome and fetal alcohol effects. Journal of Developmental and Behavioral Pediatrics. 2004;25(4):228-238.
  11. Knopf A. New DSM diagnosis proposed for prenatal alcohol exposure. Brown University Child & Adolescent Behavior Letter. 2016;32(12):1-7.

Last updated: June 2019

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