Curriculum for Addiction Professionals > Competency 3: Treatment Strategies for Working with Clients with an FASD > 5b. Chronological Age Compared to Developmental Age

Please Select One 1. Competency Description 2. Pretest 3. Learning Objectives 4. Introduction 5. Adults 5a. Assessment and Treatment Plan Development 5b. Chronological Age Compared to Developmental Age 5c. Ways To Modify Facility Treatment Plans and Staff Expectations 5d. Counseling Strategies 5e. Counseling Strategies: Boundaries 5f. Counseling Strategies: Strengths 5g. Counseling Strategies: History of Abuse 5h. Counseling Strategies: Loss and Grieving 5i. Counseling Strategies: Stigma 5j. Counseling Strategies: Self-Esteem and Personal Issues 5k. Counseling Strategies: Resistance, Denial, and Acceptance 5l. Motivational Coaching 5m. Education, Direction, and Support for Families 5n. Appropriate Birth Control and Referral for Pharmaceutical Assessment 5o. Ongoing Assessment for Comprehension of Information 5p. Transitional Planning and Case Management 6. Adolescents 6a. Treatment Plan Development 6b. Treatment Plan Development: Points to Consider 6c. Medical and Mental Health Assessments 6d. Ongoing Assessment for Comprehension of Information 6e. Educational Support (IDEA and FAPE) 6f. Transitional Planning and Case Management 7. Children 7a. Medical and Mental Health Assessments 7b. Educational Support 7c. Case Management 8. Issues Related to Professional Values and Ethics 9. Matching Activity 10. Posttest 11. References

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

Adults

Chronological Age Compared to Developmental Age

As seen in the diagram, the emotional and social age of adults with an FASD is often younger than the chronological age. The table shows possible cognitive impairments that can lead to inappropriate behaviors. These behaviors can interfere with the person’s ability to participate in treatment. Understanding the reasons for the behaviors can help in adapting treatment to meet the person’s needs. Not all adults who have an FASD show the same pattern of strengths and deficits.

Cognitive Impairments That Lead to Inappropriate Behaviors

Impairment	Inappropriate Behavior
Memory problems	Saying things that are not accurate; perceived as lying
Failure to understand ownership	Taking things that don't belong to them; perceived as stealing
Little understanding of value of objects	Destructive behavior
Slow cognitive or auditory pace	Defiance
Poor judgment	Easily victimized
Attention deficits	Unfocused/distractible; poor functioning in school or work environments
Arithmetic disability	Difficulty handling money
Memory impairment	Difficulty learning from experience
Difficulty abstracting	Difficulty understanding consequences, conceptualizing past, present and future, understanding concept of days, weeks or months, and understanding ownership
Difficulty understanding concepts of time and space	Late for appointments; in other people's "space"
Impulsivity	Poor frustration tolerance, safety issues, issues with the law, and acting without considering the consequences
Impaired sensory thresholds	Difficulty with concentration, frustration, rage; and occupational performance (i.e. school)
Impaired body boundary conceptualization	Overly friendly, personal safety issues, and sexual victimization

Source:  Adapted from Streissguth, A. 1997. Fetal Alcohol Syndrome: A Guide for Families and Communities. Baltimore, MD: Paul H. Brookes Publishing Co., p. 106, 1997; and Leveille, R. (Producer/Director). No date. Fetal alcohol syndrome and effect: Stories of help and hope [Film]. Center City, MN: Hazelden Educational Materials.

Understanding the causes of inappropriate behaviors can help in establishing procedures to govern the conduct of clients with an FASD. Persons with an FASD are rarely cruel or hostile on purpose. What looks like lying may be an attempt to cover a memory lapse by making things up. Stealing may be an attempt to buy friends with nice things. Anger and frustration may result from sensory overload or difficulty processing information. Similarly, the person with an FASD may appear defiant and refusing to complete tasks. In reality, the person may be avoiding the task due to fear of failure or an inability to understand the instructions.

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