Cause, types and symptoms of FASD, accommodating FASD, relevant social work theories, a possible FASD-informed approach, supporting people prior to birth, approaches to accommodate FASD in children, adolescents, and adults
This page has three sections:
Background Material that provides the context for the topic
A suggested Practice Approach
A list of Supporting Material / References
Feedback welcome!
Background Material
FASD reflects a range of preventable and lifelong disorders that arise as a direct result of prenatal alcohol exposure. The primary symptoms associated with FASD mean it is difficult for people to learn from past experience, to generalise and apply what they have learnt in one situation to another, and to predict the consequences of their actions. They may also have difficulty in transitioning from one situation to another, or one task to another, or in learning and applying social rules in new settings.
What are fetal alcohol spectrum disorders?
The true incidence and prevalence of FASD in Australia is currently unknown, as children are not routinely screened for FASD in infancy or childhood. Estimates for FAS range between 0.01 to 1.7 per 1000 live births, but may be as high as 1.87 to 4.7 per 1000 births for Indigenous communities. It has been suggested, by a House of Representative Committee, that as many as 2% of all Australian babies may be born with some form of FASD.
What is the impact of FASD? Primary and secondary symptoms
Primary symptoms exhibit in:
memory problems (trouble learning and retrieving new information; remembering only inconsistently);
language difficulties (may be talkative but understand little of conversation, especially when non-literal language is used such as a metaphor; has little understanding of social conventions of conversation such as taking turns; may have stereotyped conversation; may repeat instructions well but be unable to enact them);
slower cognitive pace (can only understand instructions if given very slowly, may miss pieces of information);
attention and organisation problems (slow to grasp new tasks, easily distracted, slow to move from one task to another);
trouble in translating information gained from one modality or sense into actions and behaviour;
trouble applying learning from one situation to another (repeating the same mistakes, unable to predict consequences, difficulty in applying a rule to a different social situation);
trouble thinking in abstract (setting goals, planning time, money), trouble in seeing similarities or differences; and
impulsive behaviour (acts before he/she thinks).
Secondary symptoms exhibit in:
disrupted schooling;
trouble with the law;
legal confinement (e.g., detention, jail, psychiatric care);
inappropriate sexual behaviour;
vulnerability to alcohol or drug abuse; and
comorbid (or co-occurring) mental health issues.
Secondary symptoms arise over time as a result of interaction between FASD impairments, environmental risks and protective factors. They can be reduced with appropriate and timely support and time spent in a stable, caregiving household. There is a need to support caregivers, including foster carers, to ensure predictable, ongoing caregiving relationships and to assist with early and accurate diagnosis.
How preventable is FASD?
The relationship between alcohol consumption and the expression of FASD is complex; not all children who are exposed to high levels of alcohol during gestation will be affected to the same degree. A number of complex and interrelated factors influence the relationship between alcohol exposure and risk to the unborn child. These include the pattern and amount of alcohol consumption, the stage(s) of fetal development during which exposure occurred, and maternal factors unrelated to alcohol exposure such as genetics, socio-economic factors, age at conception and nutritional status. It is widely accepted that binge drinking behaviour (4 – 5 or more standard drinks per occasion) is one of the biggest risk factors for FASD. There is evidence that even low levels of alcohol exposure are related to observable changes in children’s behaviour later in their development.
The only known way to prevent FASD is to abstain from consuming alcohol during pregnancy. Prenatal alcohol exposure is the only cause of FASD and the leading cause of preventable brain damage
For women who are considered low-risk drinkers, education and monitoring may be sufficient, whereas risk assessment and engaging clients in behavioural contracts related to drinking may be advisable for those at moderate risk. High-risk and/or alcohol-dependant women may require inpatient admission and supervision.
Working with families and children living with FASD
Dr Vanessa Spiller (2020) has a diagram illustrating both proactive and reactive approaches to managing FASD. The link is in the Supporting Material/References section that follows the Practice Approach section.
Because research on effective interventions is inconclusive, it may be more helpful to think in terms of promising principles when working with families and children affected by FASD. These include:
early diagnosis and intervention to prevent the likelihood of secondary disabilities;
ensuring a no-blame, no-shame approach when engaging with families affected by FASD;
education and training for all services and professionals surrounding the child about the brain-based nature of the cognitive, learning and language difficulties experienced by the child;
providing an emphasis on supportive case management involving regular face-to-face support and advocacy, ensuring a common language and understanding;
placing an emphasis on developing caregiver skills in managing and advocating for environmental accommodations and consistency across settings;
explicitly teaching memory, attention, organisation and social skills to children and to caregivers in parallel, in order to assist children’s learning and transitions; and
increasing awareness among a range of professionals including doctors, teachers, family support workers, and youth justice professionals about the nature and implications of FASD for young people.
In brief: The social and behavioural issues faced by children, and the strategies that work will vary from individual to individual depending on age, setting and other factors. It is important to remember that social skills, daily living skills and academic skills will not necessarily be learned without being taught to the child in a focused way. The following methods have been found to be helpful:
Break complex tasks down into single steps. Then teach each step.
Simplify language, use repetition and rely on visual prompts to supplement your instructions.
Issue one direction at a time; tell the child what you want them to do in concrete terms. Do not use non-literal language, such as sarcasm, irony and metaphor.
Expect to repeat instructions. Do not assume a skill that is demonstrated is retained. Learning may not be retained from one day to the next. Dr Vanessa Spiller (n.d.) has information explaining why knowing right from wrong is not enough to prevent people with severe impairments in multiple brain areas from doing the ‘wrong thing’ (and why they shouldn’t be punished for having impairments)! You can access this using the link in the Supporting Material/References section that follows the Practice Approach section.
Use repetition or "overlearning" to overcome memory difficulties.
Provide information/learning through more than one sensory modality. The use of visual cues (picture social stories) is likely to be helpful in teaching household routines and social conventions (for example, saying hello to friends at the start of the school day). Using visual cues can also help children to anticipate transitions.
It is important to remember that a child's learning in one setting will not necessarily be retained, or applied, to another setting. Whenever possible, involve all other relevant adults (for example, teachers) to help the child to generalise their learning across many settings. Share your understanding with other significant adults in the child's life, using consistent language and expectations.
Emerging Minds Research Papers
Emerging Minds has a suite of 5 resources on FASD that social workers who are interested in the topic can access at https://emergingminds.com.au/resources/format/research-paper/?s=FASD. A brief summary of each resource follows.
1. What is FASD?
Fetal Alcohol Spectrum Disorder (FASD) is an umbrella term used to describe the range of distinct but related difficulties caused by exposure to alcohol in utero. FASD affects the developing child in a range of ways, including permanent changes in the development of the brain and other organs. Some children living with FASD will have sentinel facial features* but many may not look any different from their peers. This is why FASD is known as an ‘invisible’ disability.
* Facial features that are associated with a diagnosis of FASD include short palpebral fissure, smooth philtrum and thin upper lip. The palpebral fissure refers to the horizontal length of the eye opening, which is shortened in many children living with FASD. The philtrum refers to the ridge that normally occurs between a child’s mouth and their nose, which may be diminished or missing in children with FASD. The upper lip may be also be thinned or reduced in volume in children living with FASD.
The prevalence of FASD in the community is now recognised. FASD may be even more common amongst children in care and amongst those in contact with the justice system.
At present, it appears that the underlying cognitive difficulties related to FASD cannot be reversed. FASD is a significant issue in child development because it is associated with higher rates of mental health concerns, suicidality, contact with youth justice, and placement and educational instability over the child’s lifetime. Practitioners and services that are aware of FASD can take steps to minimise its impact on children and families over time by providing tailored and consistent support.
2. Understanding the impacts of FASD on child mental health
Though there currently does not appear to be any way to reverse the impact of prenatal alcohol exposure for the developing fetus, there are nonetheless some important ways in which practitioners can support children. By helping to create a better ‘fit’ between a child’s ability and their social and learning environment, practitioners can minimise the risk of educational disengagement, social and peer relationship difficulties, and behavioural and emotional concerns.
3. How to support children living with FASD
Children who are affected by prenatal alcohol exposure may experience one or more significant neurocognitive difficulties in one or more areas of development. At present, there does not appear to be any way to reverse the impact of prenatal alcohol exposure on the developing fetus.
Currently, the best way to support children is to create a better ‘fit’ between a child’s ability and their social and learning environment; thereby minimising the risk of educational disengagement, social and peer relationship difficulties, and behavioural and emotional concerns.
There are two main approaches to this:
applying universal strategies that modify the child’s environment to create a better ‘fit’ for the child and make the environment and expectations more manageable
applying targeted approaches to learning, supporting the child to build the skills necessary to strengthen their executive functioning and counteract the neurological challenges they experience.
Practitioners can play a key role in supporting caregivers and teachers to adopt both universal and targeted approaches. The evidence base for social learning and pharmacological interventions for children living with FASD is still growing. In the meantime, the approaches outlined in this resource can help to support children and may minimise the impact of FASD on children’s development.
4. How to support caregivers and families living with FASD
Fetal Alcohol Spectrum Disorder (FASD) is a life-long condition that is associated with significant family and caregiver stress. FASD is more common in the community than previously thought, meaning practitioners are likely to encounter children and families affected by FASD. Children living with FASD may be more likely to experience difficulties over time, including increased risk of family and caregiver strain, social isolation and lack of support.
Much of what is known about FASD and its impact on families comes from research on the experiences of foster parents raising children affected by FASD. The presence of a stable caregiver is one of the main protective factors for children living with FASD. Supporting a child’s family and caregivers is likely to be an important aspect of enhancing outcomes for children living with FASD. Therefore, it is important that all practitioners understand the likely impact of FASD on families, and how they can best support children and families living with FASD.
5. Systems and service supports for children and families living with FASD
Some key issues make it difficult for children living with FASD to access appropriate and tailored support. These issues revolve around services, interventions and supports that are not fit for purpose. Barriers to accessing services for children and families living with FASD include
assumptions about children’s language and cognitive skill levels
reliance on language-dependent counselling approaches
narrowly prescribed referral criteria
constraints imposed on the duration of treatments; and
therapeutic approaches unsuited to their needs.
Two service types that commonly encounter children living with FASD are child protective services and child mental health services.
There is a pressing need to upskill the child protection workforce in relation to FASD, which is 10 times more common in the out-of-home-care population than the general population. Child protection workers should not assume conventional parenting advice will be effective. They should, instead, educate parents in appropriate strategies to use.
Most mental health professionals are not confident in recognising and responding to FASD. In addition, FASD does not fit well with existing criteria for mental health services, increasing the chances of children living with FASD falling through the gaps in services.
Service provision for children and families living with FASD may be enhanced by offering more responsive approaches that are not constrained by existing service parameters and conventional models of intervention. Approaches based on collaborative casework models have been used effectively to support families living with FASD. In collaborative models, a key worker coordinates input from legal guardians and professionals working in health care, assisted living, financial management, and mental health. This model can more effectively coordinate the services needed to support an individual living with FASD across the lifespan. A collaborative approach may ultimately prove more effective for families than a number of visits to siloed services that do not fully address the complex developmental needs of affected children.
Practice Approach
A recent research by Boaden et al. (2023) suggests social workers have an emerging role in FASD treatment:
Social workers have an emerging role in the holistic assessment, diagnosis, and management of FASD in Australia.
Social workers are well placed in being first to recognise and identify an individual’s emotional, behavioural, sociocultural, and learning difficulties that are characteristics of FASD.
Social workers can contribute to ongoing care in a tailored FASD management plan that links the caregivers to appropriate local community resources, service provision, and disability supports.
The following extracts from the article illustrate these points more fully.
Social workers undertaking the BPSS assessment are well trained to sensitively ask questions about past and present biological factors, such as genetics and the history of pregnancy and birth, like in-utero exposure to substances or transgenerational transmission of trauma, which are considered apposite to the context of FASD.
Social workers, alongside multidisciplinary professionals in a range of settings like mental health services, schools, and early childhood education, are often first to identify children’s emotional, behavioural, and learning difficulties that may be a characteristic of FASD. Social workers can collaborate and advocate to engage appropriate support for the individual and their families and contribute to the assessment and management of FASD by addressing the BPSS characteristics related to FASD across the life course.
Holistic support by social workers includes working with individuals and their families from a person-in-environment lens that looks at the specific needs of the person and their family. Social workers examine the capacity of the support system around them to meet their disability-specific and psychosocial needs, including broader environments like school, social activities, friendships, health, and disability-specific services.
Many parents and caregivers continue to report difficulty and strain on the family in raising a child with FASD due to underlying emotion regulation problems and inconsistencies in their own expectations of their child in the home, school, and broader community. Social workers can support families living with FASD by providing specific family-focused behavioural interventions for children. The goal of such interventions may include supporting the family to access early assessment and diagnosis, specialist behaviour therapy and management, supporting the parents and caregivers through family therapy or parent coaching to use more effective and evidence-based parenting strategies.
There is more information about what health professionals can do at FASD Hub Australia (https://www.fasdhub.org.au/fasd-information/managing-fasd/Health-professionals-managing-FASD/). This site also provides extensive resources around understanding, managing and preventing FASD, research, training and support and a services directory.
Social workers can help address FASD by integrating alcohol screening and brief intervention (SBI) into routine care. Three steps include (NASW Foundation, 2021):
Start the conversation – providers often feel uncomfortable talking about alcohol use. Pregnant women who receive counselling are twice as likely to avoid drinking as those who don’t have the opportunity.
Use a validated screening instrument, e.g. AUDIT-C.
Screen all adult patients, including those who are pregnant – this will normalise conversations about alcohol use.
Social workers should consider each child with FASD as a unique individual whose expression of their FASD will be equally unique. This is because mothers who have children with FASD have often experienced multiple traumas (e.g. physical or sexual abuse, living below the poverty line and with a mental health issue, e.g. PTSD) and often use alcohol to self-medicate (Badry & Choate, 2015)
Parents and caregivers of children with FASD have high levels of stress, more so than even parents and caregivers of children with other types of developmental disabilities. They use the same sorts of parenting strategies as other parents, but these do not always work leading parents to feel discouraged, something compounded when support services cannot provide additional strategies (Gibbs et al., 2018)
For social workers to be effective they must be trained and knowledgeable in the causes of FASD, best practices in relations to supports and interventions, models of disability, protective and risk factors, and wider ecological factors that impact how FASD is viewed. They should also incorporate the relevant social work theories into their practice (Gibs et al., 2018).
Relevant Social Work Theories/Frameworks (Badry & Choate, 2015; Gibbs et al., 2018)
Developmental/Brain-based Framework: Many of the challenges faced by individuals with FASD, their families and caregivers are behavioural in nature and originate in the brain, requiring specific interventions that are FASD informed. This has enabled social workers to understand the difference between primary impairments (e.g. behavioural and social interaction challenges) and secondary and tertiary disabilities that arise when others misinterpret primary impairments and their symptoms and blame the child for bad behaviour (or the parents for poor parenting responses). So professionals and parents need to change their expectations and response. There is a need to take account of the person in their environment and ensure that appropriate changes and accommodations to people’s environments were made, rather than expecting people with FASD to constantly have to change their own thinking or behaviours. (Gibbs et al., 2018). Using the social work theories below is important:
Person in Environment: uncovers the relationships the person has with the environment in which they live. Mapping enables supports to be identified and assess the environmental influences on a person’s life (Badry & Choate, 2015).
Strengths Perspective: Work with the person’s deficits but, using person in environment, work with support systems to balance deficits through discovering and developing strengths (Badry & Choate, 2015).
Systems Theory: Focus on family or other interpersonal systems, both supports and risk elements. Explore how change in one aspect can ripple through the whole system. Use systems to explore intergenerational impacts, e.g. with First Nations communities (Badry & Choate, 2015).
Case Management: permits priority setting so the load of obligations don’t overwhelm the person. Without case management many people will fail because they do may possess the skill set to manage multiple expectations at once.
The following theories supports a rights-based Frameowork (Gibbs et al., 2018):
Advocacy: Highlighting the individual and group aspects of FASD to service providers and policy makers is important (Badry & Choate, 2015). This supports a rights-based framework.
Feminist Perspective: Highlighting most mothers who have children with FASD are already a member of a traumatized and marginalized population, and have not sought pregnancy (Badry & Choate, 2015).
Anti-Oppressive Theory: The mother can be thought of as a victim of her own history, a person in need of treatment and not as an abuser who is inflicting harm on her child (Badry & Choate, 2015). This also supports a rights b
Community Education: Connect with different populations about how those with FASD can be cherished, strengthened and included, i.e. change the conversation around FASD from failure to possibilities (Badry & Choate, 2015).
A suggested FASD-informed Approach (Rutman, 2016)
A Warning About Traditional Programs
People with FASD do not generally experience success in programs that assume people have the memory, cognitive and receptive language skills to understand, remember and carry out what is asked of them. Their lack of success in such program can have a deleterious impact leading to a sense of personal failure and loss of self-esteem. FASD programs specific to the person need to be designed and delivered (Rutman, 2016).
An FASD-informed approach, thus, recognizes that to achieve positive outcomes, it is the system, program, and/or service providers who need to make modifications rather than the person with FASD. The FASD-informed approach also recognised that the person with FASD will experience many social determinants of health risks (e.g. poverty, homelessness or housing instability, unemployment or difficulties maintaining employment, low education, lack of social supports or social exclusion, racism, poor access to health services, early life adversity, vulnerability to violence, or victimization). Thus, in working with adults living with FASD, attention to the social determinants of health is essential (Rutman, 2016).
Having awareness of FASD: There is tremendous variability in the capabilities and challenges of those with FASD.
Making person-centered accommodations: Make accommodations or modifications to programming because of the individual’s uniqueness.
Being strengths-based: Highlighting strengths and gifts is a means of countering service systems’ predominant focus on problems and deficits and the focus on penalising individuals for these difficulties.
Safety and being relationship based: Central to the relationship and relies on developing trusting, positive relationships and creating environments where the person feels safe physically and emotionally to share what is going on in his or her world.
Rutman then lists ways of accommodating people with FASD from three perspectives: in direct practice, when developing programs and the adapting the physical environment.
Another Resource
Benke (2016) answers in some detail a number of questions about FASD that are relevant to social workers.
What is the role of the social worker in preventing alcohol-exposed pregnancies?
How is FASD diagnosed?
What is the role of the Social Worker in recognizing FASD, referring for a diagnostic evaluation, and supporting persons with FASD?
What are the benefits of an FASD diagnosis to the individual/family?
What is the role of the Social Worker in lifelong care for individuals with FASD?
What are the therapeutic interventions that improve outcomes for individuals and families living with FASD?
What resources for FASDs are available to the Social Worker and health care practitioner?
What resources for FASDs are available to the family?
Prior to birth
Groups particularly affected by FASD include Indigenous Australians, children and young people in out-of-home care, and children and young people in contact with youth offending and justice programs.
Education around the impact of FASD on offspring, exploring potential genetic influences, discussing the amount of alcohol that can be consumed safely, the danger of binge drinking, and the need to adopt a healthy lifestyle (nutrition and other factors) could be part of an approach providing prenatal support.
Assistance to abstain from consumption may be necessary: supervision (including inpatient admission if necessary), as well as approaches drawn from problem solving, task-centred, solution-focused, and motivational interviewing practice models. Focus should be multi-disciplinary aiming to support the mother (and family) during current pregnancy via abstinence from alcohol and adopting a healthy living and nutrition lifestyle. Preventing further alcohol-exposed pregnancies if necessary may also need to be a focus.
After birth
Children and young people
The evidence base for intervention is not yet well developed, but both peer reviewed and grey literature suggest a range of guiding principles that are likely to be important.
1. Ensure, where possible, early diagnosis by asking about the impact of parental alcohol consumption on children's development.
A “no-blame, no shame” approach is critical. This means being sensitive to the issues surrounding alcohol consumption in pregnancy, including the impact of other substance use, partner alcohol consumption, socio-economic status and past trauma. On the whole, however, pregnant women do not find this conversation distressing. In addition, practitioners can encourage clients who are also parents to reflect on how alcohol consumption affects their parenting. Alcohol consumption can affect parental capacity to monitor, supervise and provide consistency in discipline
2. Ensure children are supported by ongoing and specialised case management.
Young people with FASD are likely to come into contact with multiple services and systems throughout life. The best outcomes seem to depend upon establishing an ongoing relationship with a key support person (e.g. a social worker) who understands the child's needs who can help facilitate good communication between medical, educational, community services and other professionals.
3. Adapt services in order to accommodate children with difficulties arising from FASD. Some examples of everyday difficulties are:
problems with memory (trouble learning and remembering new information; remembering only sometimes, despite previous successful learning);
problems with everyday language (may seem talkative but understands little of the conversation; may have little understanding about the social rules of conversations, such as taking turns; may be able to repeat instructions, but be unable to carry them out);
thinking at a slower pace (can only understand instructions given slowly, may need lots of repetition, may miss key pieces of information);
trouble in taking what is learned from one situation and applying it to another (always repeating the same mistakes, seems unable to link actions to consequences; trouble with generalising a rule from one setting to another;
trouble paying attention and organising self (slow to grasp a new task, slow to move from one task to another; easily distracted);
acting before thinking (difficulty in foreseeing danger, easily led, impulsive);
trouble thinking in abstract terms (finding it hard to plan and set goals about time and money; difficulty in reflecting on actions; trouble in seeing similarities and differences between situations).
These symptoms can be minimised by ongoing sensitive and skilled caregiving characterised by ongoing relationships with key people, explicit routine and structure, having expectations clearly explained using simple language, use of visual prompts and literacy support, the provision of high levels of external supervision and monitoring, and flexibility of service delivery in recognition of their poor capacity to manage time.
Strategies services can use to accommodate these difficulties include:
Provide frequent reminders about appointments; provide visual prompts
Ensure ongoing relationships exist with staff
Replace abstract and verbal counselling with approaches that set concrete goals and engage in explicit coaching
Provide regular supervision rather than relying on self-motivation
Non-compliance should be viewed as an issue of capacity, not one of motivation
Ensure a case manager is appointed to provide support and advocate on the person’s behalf.
4. Re-interpret the child’s behaviour, i.e. reframe the behaviour
5. Ensure the environment is simplified, structured and supervised.
Providing a highly structured environment will maximise children's learning opportunities; for example, providing concrete explanations and warnings about each upcoming activity, and ensuring the environment is as consistent as possible and designed to reduce overstimulation. There are four main changes that we can make to the environment that will help children:
Change their physical or social environment. Examples include modifying the sensory environment, changing where a child sits in class or reducing the number of children they need to interact with socially.
Change the nature of the tasks we ask them to do. Examples include breaking complex tasks down into steps, providing limited/forced choice options in decision making, rather than open-ended abstract processes, providing clear criteria for the child (How do they know they have completed a task?).
Change the nature of the prompts we give children. Examples might include providing visual prompts, visual schedules, providing task lists or steps, using alarms and timers as prompts.
Change the way we interact with children. Provide high levels of explicit skill instruction and external supervision and oversight. Monitor, support and provide feedback about the development of life skills, problem-solving skills and social skills.
6. Teach (and re-teach) children missing skills using enhanced methods.
A child affected by prenatal alcohol exposure will process the world in a way that differs from other children and is unable to learn from experience as easily as other children. Many of the everyday skills that other children acquire effortlessly need to be explicitly taught (and re-taught!) using methods that complement brain-based barriers to learning.
Adolescents and Adults
The principles for children and young people may be relevant for adolescents and adults exhibiting FASD behaviours.
Community Living British Columbia (2011) suggests that supporting adults with FASD as neighbours, employees, volunteers, and friends in our communities begins with knowledge and understanding about this brain-based disability. Successful support involves “trying differently, not harder” and focussing on success, dignity, self-esteem, and creativity. In most ways, adults with FASD share the same basic needs and desires as other adults:
To make a difference
To be cared about
To be heard and understood
To contribute to their communities
If these basic needs are not met, adults with FASD experience frustration, isolation, increased vulnerability, and failure. So too will their families and support persons.
The organisation has a 41-page booklet with practical recommendations around
Creating environments that support success (build on gifts, stay curious, language matters, environment makes a difference and safeguards are important)
Life’s daily routines (sleep, self-care, money and budgeting, shopping and meal preparation, house maintenance, time and schedules, work life)
Relationships and Community Involvement (social relationships, transportation, safety in community)
Spiller (2017) is somewhat pessimistic about services available in Australia for adults with FASD, contrasting ‘dream’ with ‘reality’.
Supporting Material
(available on request)
Note: Dr Vanessa Spiller now has her version of Explained by Brain in a web-based format. Cost for the course that has three streams of content—brain domains impacted by FASD, managing complex behavioural symptoms, and the needs of parents and carers—is $450AUD. Information about the online course is at https://sites.google.com/view/explainedbybrain-startpage/home
AUDIT-C Screening Instrument. Available from https://www.health.gov.au/resources/publications/assessing-alcohol-consumption-in-pregnancy-using-audit-c
Badry, D., & Choate, P. (2015). Fetal alcohol spectrum disorder: A disability in need of social work education, knowledge and practice. Social Work and Social Sciences Review, 17(3), 20-32. doi: 10.1921/12703170303
Benke, J. (2016). Fetal alcohol spectrum disorders (FASD: Social work champions. Retrieved from https://www.aucd.org/docs/webinars/FASD%20Handouts.pdf
Boaden, N., Lee, J-S., & Cumming, T. M. (2023). Fetal Alcohol Spectrum Disorders and Social Work Practice in Australia: A Narrative Literature Review. Australian Social Work. https://doi.org/10.1080/0312407X.2023.2193175
Bower C, Elliott EJ 2020, on behalf of the Steering Group. Report to the Australian Government Department of Health: “Australian Guide to the diagnosis of Fetal Alcohol Spectrum Disorder (FASD)”. Retrieved from https://www.fasdhub.org.au/contentassets/32961d4a5cf94de48ebcf985c34d5456/australian-guide-to-the-diagnosis-of-fasd_all-appendices_feb2020.docx.pdf
Community Living British Columbia. (2011). Supporting success for adults with FASD. Retrieved from https://www.communitylivingbc.ca/wp-content/uploads/Supporting-Success-for-Adults-with-FASD.pdf
FASD Australia. (2017). Toolkit for parents, caregivers and families. Retrieved from https://www.nofasd.org.au/parents-carers-and-families/resources/
This section of the FASD Australia website has a number of useful resources. The Toolkit is quite comprehensive. In uncomplicated language it describes FASD, stresses the importance of early diagnosis, looks at how FASD exhibits across the lifespan, considers common behaviours, including strengths of people with FASD, suggests interventions and management strategies that may be useful, deals with explaining FASD to children (including sex education), and has a section that supports adults with FASD.
The section also has a number of factsheets that may help develop an understanding of those with FASD. They cover characteristics across the lifespan, impulse control, information processing, memory, patterns and connections, and sensory issues and attention.
FASD Hub Australia. (2020). https://www.fasdhub.org.au/ Find information on Fetal Alcohol Spectrum Disorder (FASD) for Australian health professionals, teachers, justice professionals, service providers, researchers or parents and carers.
Gibbs, A., Bagley, K., Badry, D., & Gollner, V. (2018). Foetal alcohol spectrum disorder: Effective helping responses from social workers. International Social Work, 00(0), 1-14. doi: 10.1177/0020872818804032
Jumpstart Psychology. (2020). Managing the behavioural Symptoms of FASD. Available from https://www.jumpstartpsychology.com/News-or-Reviews.html
McLean, S. (2022). Fetal Alcohol Spectrum Disorder (FASD): An update on policy and practice in Australia. Child Family Community Australia (CFCA) Paper, 65. Retrieved from https://aifs.gov.au/cfca/publications/fetal-alcohol-spectrum-disorder-fasd-update-policy-and-practice-aust
McLean, S., & McDougall, S. (2014). Fetal alcohol spectrum disorders: Current issues in awareness, prevention and intervention. CFCA Paper No. 29. Retrieved from https://aifs.gov.au/cfca/publications/fetal-alcohol-spectrum-disorders-current-issues-awareness-prevention-and
McLean, S., McDougall, S., & Russell, V. (2014). Supporting children living with fetal alcohol spectrum disorders: Practice principles. CFCA Practitioner Resource—December 2014. Retrieved from https://aifs.gov.au/cfca/publications/supporting-children-living-fetal-alcohol-spectrum-disorders-practice-princ
NASW Foundation. (2021). Fetal Alcohol Spectrum Disorders. Retrieved from https://www.naswfoundation.org/Our-Work/Special-Projects/Fetal-Alcohol-Spectrum-Disorders
Rutman, D. (2016). Becoming FASD informed: Strengthening practice and programs working with women with FASD. Substance Abuse: Research and Treatment, 10(S1), 13-20. doi: 10.4137/SaRt.S34543
Spiller, V. (2017). Working with adolescents and adults with FASD. Retrieved from https://www.nofasd.org.au/wp-content/uploads/2018/03/FASD-adolecents-and-adults-Gold-Coast-July-2017-NoFasd.pdf
Spiller, V. (n.d.). They know better!!. Retrieved from https://www.jumpstartpsychology.com/EBBdownloadspodcastsvideos2021.html
Spiller, V. (2020). Managing the behavioural symptoms of FASD. Retrieved from https://www.jumpstartpsychology.com/EBBdownloadspodcastsvideos2021.html
Tan, G. K. Y, Symons, M., Fitzpatrick, J., Connor, S. G., Cross, D., & Pestell, C. F. (2022). Adverse childhood experiences, associated stressors and comorbidities in children and youth with fetal alcohol spectrum disorder across the justice and child protection settings in Western Australia. BMC Pediatrics, 22, 587-599. https://doi.org/10.1186/s12887-022-03654-y
This study of adverse childhood experiences of people with FASD in Western Australia identified exposure to drinking/substance misuse at home and domestic violence as the two most common issues. Additional stressors were disengagement from school, transiency, being victims of bullying, traumatic brain injury and homelessness. Furthermore, drinking/substance misuse at home, emotional neglect and physical neglect were positively associated with child protection system involvement. Additionally, exposure to domestic violence was positively correlated with justice system involvement. The study concluded that prevention, intervention and early diagnosis of FASD are important to reduce the negative effects of these adverse childhood experiences.