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


Some clients will have children with an FASD. The stress of caring for children with these disorders, coupled with the shame and guilt that often accompany the diagnosis, can overwhelm many women. The counselor can provide helpful guidance in caring for children with an FASD as part of the woman's recovery process. Many of these strategies will help provide structure and routine, which can aid in the woman's recovery by avoiding the chaos that can trigger relapses.

Young boy sitting next to a caregiver

Ideas the counselor can share include:

  • Provide a structured environment for the child. Keep the child's room neat, with a place for everything. Always put things back in the same place. Minimize decorations, toys, and other items that can create sensory overload or distractions.
  • Avoid sensory triggers, such as crowded malls or museums, that can cause sensory overload.
  • Have a routine. Create a daily schedule and review it with the child. Use drawings or photos to illustrate where you'll be going and what you'll be doing. If you need to deviate from the routine, give the child plenty of notice.
  • Give one direction at a time and wait until the child completes the task before moving on.
  • Repeat rules and routines often. Prepare the child for events. For example, tell the child that you'll be leaving for the store in 15 minutes. Then remind the child 5 minutes later and 5 minutes after that. Tell the child what will happen at the store and what the rules are (e.g., walk, don't run).
  • Role play different situations. Practice going to the store or eating at a restaurant. Show the child appropriate behavior.
  • Use literal language. Children with an FASD do not understand slang or metaphors. For example, if you say, "I'm sorry, I got carried away," they might reply, "No, you're still here."
  • Do not isolate the child. Sending persons with an FASD to their room to think about what they have done will most often only increase a sense of isolation. If the child makes a mistake, talk about why the behavior is unacceptable. Focus on teaching and guiding, rather than punishing.

More tips can be found in FASD—The Basics at

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