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Competency 3: Treatment Strategies for Working with Clients with an FASD

Adolescents

African American boy sitting on exam table in doctor’s office. Doctor smiling and touching the boy’s nose

Medical and Medical and Mental Health Assessments

Diagnosis is important and the counselor should refer clients suspected of having an FASD for diagnosis by a team familiar with FASD. A complete history and physical examination by a physician is essential. Further neuropsychological testing and assessment by a pediatric dysmorphologist and neuropsychologist may also be warranted.

If a client already has a diagnosis, further assessment by medical, mental, and allied health professionals may be needed to determine current level of function. The counselor will need to be familiar with any medication and observe any behaviors or physical symptoms that might indicate the need to reevaluate medication use or dosage. Hearing and speech tests may be warranted to identify any progress in communication or barriers that may affect the client’s treatment and ongoing recovery. Occupational therapy and physical therapy evaluations may be needed to assess the client’s daily living skills and motor function. In addition, the Wide Range Achievement Test may be used to determine achievement levels in reading, spelling, and math. Other helpful instruments include the Millon Adolescent Clinical Inventory, a validated clinical and personality assessment tool that measures change over time,18 and a social history. The social history may include information about family and occupation and assessment of cigarette and alcohol use and/or substance abuse. It should also note developmental milestones.

Some treatment programs assess clients using the Vineland Adaptive Behavior Scales19 to determine how the client compares to peers in receptive, expressive, and written communication; personal, domestic, and community daily living skills; and interpersonal relationships, play and leisure time, and coping skills. This information will help the counselor tailor the treatment plan and counseling strategies to the client’s strengths, needs, and preferences.

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