Children with fetal alcohol syndrome (FAS) may experience physical, mental, and behavioral difficulties. Providing appropriate care and support can help a child with FAS reach their full potential.

Developmentally, a child with fetal alcohol syndrome (FAS) may need a level of support that is appropriate for a child of half their chronological age.

Caregivers can help a child with FAS in many ways, including by seeking early diagnosis and intervention services, adapting the child’s environment, and identifying and building on the child’s unique capabilities and strengths.

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FAS is a type of fetal alcohol spectrum disorder (FASD). These disorders occur as a result of prenatal exposure to alcohol when a pregnant person consumes alcohol.

A child or adult who has FAS or any other form of FASD may experience difficulties in the following areas:

  • learning and remembering information
  • understanding and following directions
  • switching attention between tasks
  • managing their emotions
  • controlling impulsive behaviors
  • communicating
  • developing social skills
  • performing daily activities, such as:
    • eating
    • bathing
    • counting money
    • telling the time
    • being aware of their personal safety

People with FASD may also be at increased risk of developing mental health conditions such as depression and anxiety.

People who are concerned that their child may have FASD can ask a pediatrician for guidance on seeking a diagnosis.

The diagnostic procedure may involve multiple steps, such as the following:

Screening for prenatal alcohol exposure (PNAE)

Screening for PNAE is the first step a parent or caregiver can take in seeking a diagnosis of FASD for a child. The screening process involves questions about exposure to alcohol and other substances during pregnancy. It relies on self-reports from the parent and other key adults in the child’s life.

Physical assessment

Because children with FAS often have delayed growth or distinctive physical characteristics, a physical assessment can help doctors screen for the condition.

This assessment may involve measuring the child’s height and head circumference and assessing the child’s facial features. These features may be enough to diagnose FAS without confirming PNAE.

Neurobehavioral assessment

A neuropsychologist will conduct a neurobehavioral assessment to check for any neurodevelopmental signs of FASD, such as:

  • impaired ability to think
  • problems with self-regulation
  • problems with communication, social interaction, and activities of daily living

The Centers for Disease Control and Prevention (CDC) highlights the importance of early intervention services for children with FASD.

These services are appropriate for children from birth to 3 years of age and can help a child learn important skills such as walking, talking, and interacting with others.

The CDC also explains that early diagnosis and intervention can help with the following:

  • placing the child in appropriate educational programs so that they can reach their full potential
  • enabling the child and their family to access appropriate social services
  • helping the child’s family or school staff understand why the child may act differently from peers

The Center for Parent Information and Resources provides tips on how people can connect with an early intervention program in their community. These include:

  • asking the child’s pediatrician for a referral to the local early intervention system
  • contacting the pediatrics branch of a local hospital and asking who to contact about early intervention services in the area
  • visiting the Early Childhood Technical Assistance Center’s “contacts” page to find early intervention services by state

Here are some helpful strategies to support a child with FAS.

Be conscious of their social/developmental age

Children with FAS often develop social and emotional skills more slowly than their peers, and they may need more support and supervision than many other children of the same age.

According to the United Kingdom’s National Organization for FASD (NOFASD), caregivers should provide a level of support that is appropriate for a child of half their child’s chronological age.

For example, a child who is 10 years old may require a level of parenting that is appropriate for a 5-year-old, and a child who is 16 years old may require a level of parenting appropriate for an 8-year-old. This is the level of scaffolding and support a child with FAS needs.

Keep things simple

Children with FAS can become overwhelmed easily. Simplifying tasks can help prevent this.

Ideas to consider include:

  • breaking down complex tasks into simple, achievable steps
  • giving one instruction at a time
  • focusing on one task at a time
  • allowing time for breaks during learning and leisure activities
  • ensuring that the child’s environment is free of clutter and distractions

Adapt their environment

For a child with FAS, adaptations to their environment can help them reach their full potential.

Adaptations to consider include:

  • creating an environment that is calming and not overly stimulating or distracting
  • limiting distractions at school by ensuring that the child sits at the front of the class and away from windows
  • allowing the child to wear headphones to help block out external noises when necessary
  • providing clear and consistent instructions and routines
  • communicating appropriately

Build on their strengths

Every child with FAS will have their own unique strengths and interests. Caregivers can work to identify these strengths and use them when planning daily learning and leisure activities. This will help boost the child’s confidence and self-esteem.

The NOFASD website provides a downloadable worksheet called “What Matters,” which caregivers can use to help them identify their child’s values, strengths, and goals for the future and list the steps necessary to achieve those goals.

Be patient and remain calm

Children with FAS may not learn as quickly as children without this condition and may forget what they have learned. They may also need extra time to process information.

Caregivers will need to remain calm and patient so that the child does not feel overwhelmed. The following strategies may be helpful:

  • speaking slowly and clearly
  • offering encouragement and reassurance
  • maintaining a positive tone

Offer unconditional support and affection

It is important that children with FAS receive praise, even for small achievements. Providing consistent recognition and encouragement can help a child reach their full potential.

The CDC also highlights the importance of a loving and stable home, noting that children with FASD can be more sensitive to the following experiences:

Teach them coping strategies

NOFASD provides a list of coping strategies for people with FASD. Strategies that caregivers can use to help a child with FASD include:

  • creating a calm space that the child can go to when needed
  • providing sensory items to help the child relax and focus, such as:
    • a stress ball
    • fidget toys
    • putty
  • providing the child with headphones to wear in crowded places
  • avoiding taking the child to crowded areas and going out during busy times of day
  • ensuring that the child gets enough exercise

The NOFASD website also provides downloadable charts that a child can fill in to help them with the following skills:

  • self-esteem and personal values
  • communication
  • decision making
  • weekly planning and organization

Work as a team

Children with FAS may need supervision and support from a wide network of people, including:

The NOFASD recommends that caregivers request meetings with teachers or health professionals to encourage information-sharing about the child and their specific needs, if necessary.

People may also want to consider joining a support group to access information and resources relating to FASD, as well practical and emotional support. Options to consider include:

A small 2020 study involving 46 caregivers of children with FASD found that caregivers tend to experience elevated levels of stress, which can negatively affect their mental and physical health.

Self-care strategies can help reduce stress and improve satisfaction in the parenting role.

According to the CDC, families of children with FASDs who receive support in the form of counseling or respite care can have more positive experiences than families who do not receive such support.

Respite care may involve having a family member or friend take the child out for an activity or having them stay at home with the child while the caregiver goes out.

Either option can give a parent or caregiver time to decompress or complete tasks that they find difficult to get done when actively attending to the child.

People can also ask their child’s school or mental health professional for a list of respite programs in their area.

There are many ways that parents and caregivers can support a child with FAS. The first step caregivers can take is to seek an early diagnosis and early intervention services for their child.

Other ways to provide support include adapting the child’s environment, identifying and building on the child’s personal strengths, and offering unconditional encouragement and affection.

Caring for a child with FASD can be challenging, and caregivers may experience high levels of stress that can affect their physical and mental health.

Caregivers may benefit from support in the form of counseling or respite care. People can find FASD support groups and respite services online or via their child’s school or a mental health professional.