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Fetal Alcohol Spectrum Disorder in Children & Adults: Interventions for Families & Caregivers
Fetal Alcohol Syndrome continuing education psychologist CEUs

Section 4
Adolescents with Fetal Alcohol Syndrome

CEU Question 4 | CEU Test| Table of Contents | Addictions
Psychologist CEs, Counselor CEUs, Social Worker CEUs, MFT CEUs

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On the last track, we discussed FASD in the early stages of life and the most effective familial structure for them.  The three stages we will examine in this track included:  infancy; toddlers and preschool years; and school-age years. 

On this track, we will examine three aspects of adolescents with FASD.  These three aspects of adolescents with FASD include:  difficulties; independence with structure; and help for parents.

Three Aspects of Adolescents with FASD

Aspect #1 - Difficulties
The first aspect of adolescents with FASD is difficulties. The adolescent years, I have found, can be the most difficult for clients with FASD and their families. During these years, families are faced with the recognition that their son or daughter is not fitting the expected pattern of development and is not "catching up." 

Such factors as parental panic and confusion, peer group pressure, decreased interest in school as success diminishes, and normally developing adolescent sexuality can destabilize whatever equilibrium that was developed in childhood.  Teenagers with FASD will face increased failure and less satisfaction in academic classes, more social isolation as peer interactions are dominated by cliques; uncertainty or unrealistic expectations, and a looming sense of low self-esteem and depression. 

Evan, age 16, expressed a great deal of frustration after his first two years of high school. Evan stated, "I can’t do anything right. When I answer a question wrong, the other people laugh at me and say I am a freak. They like to make fun of me, even though I am a very nice person who doesn’t do anything mean to them." Evan, who had been adopted by Chris and Pam at the age of six, had made remarkable improvements during his childhood years. 

However, the peer pressure accompanying high school made his life at school difficult while his life at home remained supportive yet confusing. Pam stated, "I don’t know how to help him.  We love him so much and we want him to make friends, but teenagers are cruel." 

I stated to Pam, "Evan needs to be reassured of his ability to succeed.  At this time, he cannot seem to keep up with his work or understand the more complex tasks." I suggested that Pam and Chris hire a specialized tutor, one trained in working with FASD teens, to help Evan with his schoolwork. An FASD educated tutor knows how to break down assignments to attainable tasks that can improve the client’s self-esteem.

Think of your Evan.  What difficulties does he or she face in the adolescent world?

Aspect #2 - Independence with Structure
The second aspect of adolescents with FASD is balancing independence with structure. Families who can allow some appropriate sense of autonomy, growth, and increased responsibility within the family context have a greater chance of monitoring and guiding his or her behavior without massive power struggles. 

Families of adolescents diagnosed with FASD need to search creatively for alternate paths to maturity other than total freedom, full independence, and complete lack of supervision. Adolescents with FASD may attract peer groups of an unpredictable and problematic nature.Peer groups who engage in drug use, promiscuity, and who fail to respect others’ needs can cause a regression in the progress of the FASD client.

Jared, age 17, had begun to spend most of his time with a questionable group of peers.  Capitalizing on Jared’s loyalty and enthusiasm for being accepted, they asked Jared to perform various acts of vandalism and theft. When caught, Jared’s friends denied ever having known him. I asked Jared why he felt he had to be friends with this particular group of teenagers. He stated, "They let me do what I want. I may get in trouble because of them, but at least they treat me like an equal. I don’t get any respect at home. My parents won’t even let me drive the car." 

I realized that Jared’s delinquency was an indirect result of his parents’ denial of independence.  I spoke with Jared’s parents, Linda and Wallace, stating, "Because Jared does not feel respected at home, he will go out to seek that respect elsewhere. By keeping him too structuralized, you are denying him the right to develop properly. It is crucial that you increase his responsibility level, yet keep him in an environment of control and relative predictability." 

After discussion, Linda and Wallace decided to allow Jared the use of the car as long as he was with a licensed driver. Also, they allowed him the opportunity to take on menial jobs around the neighborhood such as mowing lawns and trimming hedges. 

Think of your Jared.  How could his or her parents balance independence with structure?

Aspect #3 - Help for Parents
In addition to difficulties and independence with structure, the third aspect of adolescents with FASD is help for parents. In my experience, I have found that parents of adolescents with FASD are much more essential than clients without it.  Although some mental health professionals prefer to end interaction with parents after the FASD client has reached adolescence, I believe that effective solutions generally focus on adolescent development that does not sever family ties

Families will remain a supportive structure for the FASD client, even after he or she has moved out of the house. To help parents through the most difficult of the FASD years, I arrange a support group for the parents of FASD teens. These groups focus on relevant issues and the group learns from the personal experiences of others. Although the situations are almost always never exactly the same, I have found that parents gain needed confidence and aid from these support groups.

Stanly and Doreen were having difficulty raising their 17 year old daughter, Jill. Doreen stated, "Sometimes, I think that we’re all alone in our trouble, that no one has this much trouble helping their child." I stated to Doreen, "Even parents without FASD teens find the adolescent years the most difficult. No one is ever alone in their struggles and I’m sure if you looked hard enough, you could find more parents just like yourselves." 

I suggested that Stanly and Doreen join a support group for parents with teens diagnosed with FASD.  The next week, Doreen stated, "What a difference that made! I found people sympathetic to our problem and who made helpful suggestions! Instead of saying that we needed to punish Jill more, they actually gave us ideas to help her, not discourage her."

Think of your Stanly and Doreen. Would a support group help them through these difficult adolescent years?

On this track, we discussed three aspects of adolescents with FASD.  These three aspects of adolescents with FASD included:  difficulties; independence with structure; and help for parents.

On the next track, we will examine three aspects of clients diagnosed with FASD as they enter adulthood.  These three aspects of adult FASD clients include:  financial affairs; social skills; and depression.

Peer-Reviewed Journal Article References:
Liebschutz, J. M., Crooks, D., Rose-Jacobs, R., Cabral, H. J., Heeren, T. C., Gerteis, J., Appugliese, D. P., Heymann, O. D., Lange, A. V., & Frank, D. A. (2015). Prenatal substance exposure: What predicts behavioral resilience by early adolescence? Psychology of Addictive Behaviors, 29(2), 329–337.

Marceau, K., Rolan, E., Leve, L. D., Ganiban, J. M., Reiss, D., Shaw, D. S., Natsuaki, M. N., Egger, H. L., & Neiderhiser, J. M. (2019). Parenting and prenatal risk as moderators of genetic influences on conduct problems during middle childhood. Developmental Psychology, 55(6), 1164–1181.

McLachlan, K., Gray, A. L., Roesch, R., Douglas, K. S., & Viljoen, J. L. (2018). An evaluation of the predictive validity of the SAVRY and YLS/CMI in justice-involved youth with fetal alcohol spectrum disorder. Psychological Assessment, 30(12), 1640–1651.

Phelps, L., & Grabowski, J.-A. (1992). Fetal Alcohol Syndrome: Diagnostic features and psychoeducational risk factors. School Psychology Quarterly, 7(2), 112–128.

Spears, G. V., Stein, J. A., & Koniak-Griffin, D. (2010). Latent growth trajectories of substance use among pregnant and parenting adolescents. Psychology of Addictive Behaviors, 24(2), 322–332.

Young, I. F., Sullivan, D., & Hamann, H. A. (2020). Abortions due to the Zika virus versus fetal alcohol syndrome: Attributions and willingness to help. Stigma and Health, 5(3), 304–314.

Online Continuing Education QUESTION 4
What are three aspects of adolescents with FASD? To select and enter your answer go to CEU Test

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