Before information about FAS/ARND:

    Johnny was a fourth-grade-student with ARND and his behaviors were increasingly frustrating. For example, after a two-week break for Christmas vacation, Johnny walked into his school and had a look of confusion on his face. He had forgotten the location of his locker, where his classroom was located, and what his teacher's name was. As the guidance counselor approached Johnny, she asked him to hang up his coat and go to his classroom. Johnny promptly looked up at the counselor and said that he didn't know which way to go. The counselor shook her head, placed her hand on his shoulder, and firmly repeated her instructions. Johnny then looked up at the woman and said, "But I don't know which way to go". Out of patience, the counselor stated to Johnny, "Of course you know which way to go, now get there before you are late and have to stay in from recess!". Johnny began crying and the counselor became increasingly frustrated with him. It made no sense that Johnny wouldn't remember where his classroom was.

After receiving information about FAS/ARND:

    This is a good example of a scenario that commonly happens prior to people getting information about brain damage from prenatal exposure to alcohol and other drugs. After attending workshops about FAS/ARND, this school counselor was able to link Johnny's prenatal history with his confusing behaviors and everything began to make sense. Only then was she able to adjust her expectations and ask Johnny what would help him reorient himself to the school surroundings. This different way of thinking supported Johnny and contributed to the prevention of high frustration levels for Johnny and the counselor.

    Below are examples of behaviors we may see and a description of neurodevelopmental characteristics that are commonly associated with FAS/ARND. When considering these brain differences and working with children with FAS/ARND differently, positive changes begin to happen.

• sarcastic retorts
• anger
• withdrawal
• crying

  Brain differences that contribute to Johnny's behavior:

  • difficulty storing information
  • difficulty retrieving information
  • generalizing (walking in the front door of Johnny's school is a different environment than walking into his classroom)
  • short-term memory problems
  • developmental delays

  For example:
      Johnny has difficulty with storing and retrieving information, one of the hallmark characteristics of FAS/ARND. If Johnny has trouble generalizing from one area to another, he might be able to picture his classroom, while unable to find the location.
      Also, Johnny acts like a four-year-old in many ways, while his chronological age is ten. Question: "Would we expect a four-year-old to locate a room after a two-week hiatus?".
      This is a very important question to consider when identifying our expectations for Johnny as he experiences various transitions throughout his day.

  Before information about FAS/ARND:

      Susie is a seven-year-old girl whose grandmother is visiting. Susie is asked to place her clean clothes in a dresser and she begins throwing a temper tantrum. The grandmother proceeds to lecture the girl about this behavior, the girl's screaming escalates, and she is sent to her bedroom for time out. Susie's screaming becomes louder and louder and the grandmother becomes anxious because she doesn't know what her next step should be. Susie's grandmother knows that she has lost control of her granddaughter and she fears that the neighbors might call the police due to the screaming. Susie is allowed to come out of her room and her grandmother proceeds to explain the situation, which only makes matters worse. Grandmother throws up her hands in exasperation and walks away from Susie.

      Another puzzling behavior involves frequent snacking by Susie. Approximately one hour before dinner, Susie asks her grandmother if it is okay to have a snack. Her grandmother looks at the clock, realizes that dinner is only one hour away and tells the girl "no, it will spoil your dinner". Susie immediately goes to the refrigerator, opens the door, and grabs a slice of cheese and starts to run outdoors. Grandmother, frustration rising, catches up with Susie and sits her on a kitchen chair. Another confrontation takes place and the girl tantrums and is unable to stop screaming. By this time, frustration levels are extremely high and Susie's grandmother feels that there is no solution.

  After receiving information about FAS/ARND:

      A few weeks after Susie's grandmother returned home, she attended a workshop on FAS/ARND. This information about brain differences helped to make sense of situations she and Susie experienced over the past few years. Learning that developmental lags are a hallmark characteristic of FAS/ARND, made it easier for Susie's grandmother to change her expectations and how she reacted. This simple modification lowered frustration levels for both and provided a nurturing environment.

      Further information revealed that kids with FAS/ARND are often hungry and may need to eat frequent snacks throughout the day. Recalling events, Susie's grandmother realized that Susie ate three balanced meals even though she snacked throughout the day. This changed the belief that Susie's grandmother held and frustration levels decreased tremendously.

  Behaviors we might see during confrontations with grandmother:

  • aggression
  • shut down
  • anger
  • tantrums

  Brain differences that contribute to Susie's behavior

  • developmental lags (acts younger)
  • inability to link cause and effect
  • inability to predict outcomes
  • hunger

      For instance, Susie's developmental age might be that of a two-year-old. Temper tantrums are normal for this age group and understanding how a younger child responds allows us to think younger and change our expectations. In turn, this supports the process and prevents uncomfortable confrontations. This new understanding Susie's grandmother had of brain differences due to FAS/ARND changed hers and Susie's interactions and their relationship became stronger.