[Shaylas_Mom]

Anyone have a child with Fetal Alcohol Spectrum Disorder? I currently have a 4 year old FS with it. He has ADHD symtoms, as well as ODD and learning disabilities. I am really struggling with him. Any tips on things to try?

[Hadley2]

Prozac. For you. Wish I were kidding.

Tips? Behavioral, cognitive, or physical? Things to look for? Ways to manage? Tips for the child or for you?

In our case, it is often clear that fd/soon ad's core belief is: All adults are stupid and I must control them or I will die. That would be RAD talking. FAS/FAE contributes confusion and disorientation to the mix.

No doubt to me, fetal alcohol exposure coupled with attachment issues/RAD (and ODD may point to a larger attachment/RAD dx) can be an exhausting combination for everyone all around.

Special needs board and FAS/FAE sites are very helpful.

With fd/soon AD, we had multiple basic physical issues to mitigate before we could delve into behavior and cognitive.

As for managing/parenting around, many of the strategies for RAD work well for FAS/FAE and ODD: Lots of structure, scripting, understand that carrying over concepts and rules and universalizing them doesn't always happen, understand that there may be underlying processing issues--sensory, auditory, visual, occupational--understand that there may be memory issues--and therefore a lot of extra clarity and patience.

Given time, I am coming to learn to recognize the difference between differently processing and oppositional behavior although sometimes it can be a close call and sometimes I think it is a combination.

If auditory processing is an issue, that can really complicate things. You ask one thing, they answer a different, tangential question. You tell them one thing, they do another. And on. If you notice he is just not "connecting the dots" in conversations, especially group situations--contributing related ideas but slightly or more than slightly off point, etc., he can hear fine but has trouble understanding in certain situations, or he has trouble integrating right- and left-brain functions--get him tested for CAPd.

But again, I would focus on physical/mechanical issues before diving into behavioral and cognitive evals. Especially cognitive evals, if he isn't hearing, seeing, or properly mobile, these won't be of much help. It also takes time and a lot of observation on your part to be able to walk in and give a practitioner the information they need to be of help to the child.

Also really important, I think: Watch for signs of (1) knowing and showing and (2) actually feeling appropriate care and concern for others. If this seems to be lacking even after a good amount of time (6 months, a year) in a stable environment with modeling and training, it may point to higher-level issues.

Other than that, do you have specific ideas of where his greatest struggles lie?