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Primary Symptoms of FASD - Difficulty Predicting Outcomes

Last summer my sixteen year old son donned his bike helmet and announced he was going for a ride. We live on a dead end road in a rural area so I gave him a thumbs up and praised him for remembering his helmet. I hopped on an online call as he peddled down our driveway.

About an hour later he returned red-faced and out of breath. I commented on the heat (it was 90 degrees); he complained about the hills. Our road is flat, so I asked, “What hills?” Beaming, my son declared, “I rode my bike to the library!”

Danger Ahead!

I could feel my blood pressure spike. We live three miles from the library. To get there one has to navigate a five way intersection of village streets and a state highway frequented by large dump trucks and fast cars. My son had not ridden his bike or even walked on those streets. We’d never planned or practiced for such an excursion.

When I questioned what he did at the library my son explained he’d asked a nice lady where to put his bike. She told him to lock it up in the bike rack outside. Then my sweet son said, “I rode home because I don’t have a bike lock. Can we order one on Amazon?”

My teenage son with Fetal Alcohol Syndrome could not predict the possible dangers involved in riding his bike alone for six miles round trip in the heat on dangerous roads without his parents knowledge and without identification or a cell phone.

Thinking Differently

Individuals prenatally exposed to alcohol are vulnerable to dangers they cannot anticipate. Before becoming FASD (Fetal Alcohol Spectrum Disorder) informed and equipped, I would have responded with an accusatory, “What were you thinking?” followed by a wordy lecture about his bad decision.

Now I understand it’s not that my son wasn’t thinking, but rather his brain thinks differently. In fact, after dissecting the incident, I realized his actions were triggered by a book we’d been reading where the main characters rode bicycles to a library.

My son, inspired by the story, impulsively acted without stopping to think about the dangers. Impulsivity and difficulty predicting outcomes are primary symptoms of FASD.

What does the brain have to do with it?

Our brains learn to predict outcomes as part of the decision making process. For example, if I run into the street (or ride my bike through a five-way intersection), I could get hit by a car. Conclusion—this is not safe, therefore I should not do it.

Prenatal exposure to alcohol alters the structure and function of the developing brain. Decision making, predicting outcomes, and controlling impulses are all part of the brain’s executive function. This process takes place in the prefrontal cortex—part of the brain which is often harmed by alcohol exposure in utero.

So what can we do to keep our kids safe?

Lecturing and issuing consequences for poor decisions often do not work with kids prenatally exposed. Due to poor short-term memory and the inability to link information (also symptoms of FASD) these behavior modifications techniques fail miserably.

Instead, we must understand our child may have a brain-based disability and become educated about how our child’s brain works differently.

Next, we need to predict what our kids might do and plan accordingly. By anticipating possible problems and having a plan in place, and practicing the plan, we can possibly prevent disasters—or at least decrease them.

After my son’s bike riding debacle, we had a brief discussion about safety. Due to his brain difference, I avoided the lecture and used as few words as possible. Then, I implemented some of the safety precautions listed below.

Predict Problems, Plan and Practice

Your child’s age, both actual and developmental, as well as where he or she is on the FASD spectrum must be taken into consideration when creating a safety plan. Here are some suggestions to get you started:

  • Provide identification for your child to keep on them

  • Provide a cell phone with safety restrictions together.

  • Create a poster of safety rules and review regularly. Don’t assume if your child can repeat the rules that they will remember, understand or apply them (it’s a brain thing).

  • Contact your local police dept. to inform them of your child’s disability.

  • Request a tour of the local police department so your child and officers can meet and have positive interactions.

  • Provide supervision at all times.

My son is now eighteen, but cognitively he is more like an eight year old—an eight year old with a brain-based disability. Therefore, we do not leave him home alone or permit him to roam our community without adult supervision.

FASD is a brain-based lifelong physical disability that affects the brain and

body of people exposed to alcohol in the womb. We must provide protections and accommodations for people with FASD just as we would anyone with a physical disability.

Yes, trying to stay ten steps ahead of our kids is both exhausting and impossible. However, understanding our child’s brain-based difference and planning for possible pitfalls can help to avoid potential disasters.

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