Commentary: Addressing Fetal Alcohol Spectrum Disorders in Addiction Treatment
• Women may have used alcohol and drugs while pregnant and be afraid to discuss in group;
• Women may have children with undiagnosed FASD, and may not be educated on appropriate parenting techniques; and
• Clients themselves may have been prenatally exposed to alcohol and have unidentified learning and behavioral disorders as a result.
If a woman drinks while she is pregnant, there is a risk for having a child with FASD regardless of ethnicity, education or socio-economic status. A woman does not have to be an alcoholic to have a child with effects; however, women that suffer with alcoholism are at the highest risk. Women who use other drugs are also at high risk for having a child with FASD, since many use alcohol as well. Women who drink should be counseled about using effective contraception to avoid pregnancy.
People with FASD often go unnoticed as having a brain disorder because the majority of individuals have borderline intelligence or above. This is a lifelong disability and the cognitive, behavioral, emotional and social difficulties can each appear across a continuum of severity, from mild to profound. They may experience a daily fluctuation of attention and focus. Many will struggle with understanding cause and effect relationships or the ability to predict future behaviors. Individuals are typically naïve and are easily led into situations. They may have problems in judgment, memory and social skills, but because they have strong expressive language skills they appear higher functioning than they are. It is not uncommon for a client with FASD to be unsuccessful and sometimes terminated from treatment. These individuals need structure, support and understanding. If counselors better understood the typical behavioral profile of a client with FASD, and how to modify treatment, treatment outcomes could improve.
• Train staff to modify treatment plans and treatment;
• Plan for long-term treatment and aftercare options;
• Include the entire family in treatment;
• Assist clients with housing, vocational, educational, day-care, respite, recreational and other services;
• Assist clients with Supplemental Security Income, public assistance, food stamps, Medicaid/Medicare and other disability programs;
• Counselors should consider the possibility of past victimization in these clients;
• Counselors should know best treatment practices and recommendations for clients with FASD; and
• Addiction treatment agencies should pursue assessments and diagnosis for clients (and/or children of clients) when they suspect a person has FASD.