The November and December Shared Solutions issues spotlight lesser-known disabilities that create challenges for job seekers. While the average vocational rehabilitation counselor or employment services professional may not come across a Fetal Alcohol Syndrome (FAS), Williams Syndrome (WS), or Fragile X Syndrome (FXS) diagnosis often, we encourage proactive self-learning regarding each so that you can empower these individuals to gain and retain fulfilling employment.
Fetal Alcohol Spectrum Disorder (FASD) results from the chronic over-consumption of alcohol during embryonic fetal development. FASD impacts fall into four broad areas including growth deficits, a unique cluster of facial features, cognitive and behavioral deficits, and skeletal abnormalities. Deficits carry to adulthood, and although it’s often referred to as an invisible disorder, the resultant lifelong disability features physical, cognitive, behavioral, and social deficits.
By the numbers
The Centers for Disease Control notes fluctuations in FASD diagnosis across the U.S. Despite these geographic differences, the number of school-aged children eventually diagnosed with FASD may reach as high as 5% of all students.
If that isn’t enough to raise your eyebrows, consider the $2 million lifetime cost associated for an individual diagnosed with FASD. The National Institute on Alcohol Abuse and Alcoholism, in a study published in the Journal of the American Medical Association, estimates a prevalence of 1 to 5% across community samples in the U.S. They consider FASD to be a “significant public health problem.”
The diagnosis
As the word spectrum implies, FASD comprises a range of disorders and they include Fetal Alcohol Syndrome, Partial Fetal Alcohol Syndrome (pFAS), Alcohol-Related Birth Defects (ARBD), and Alcohol-Related Neurodevelopmental Disorder (ARND). FAS is the most severe end of the spectrum.
Experts agree alcohol causes severe and long-lasting neurobehavioral damage. But because FASD features are not easily recognized, diagnosis generally occurs after a child enters school and may never be diagnosed at all.
Prenatal alcohol exposure crosses the blood-brain barrier in utero and poses challenges to:
- Communication between brain lobes.
- Regulating emotional responses (fear, stress, anxiety, anger, or aggression).
- Expressive and receptive language (discrepancy between verbal and nonverbal skills).
- Abstract thinking.
- Decision-making.
- Academic achievement (as a result).
- Executive functioning (inhibition, judgment, inattention, memory problems, hyperactivity).
- Balance, dexterity, tremors.
- Empathy.
What’s more, FASD often occurs alongside other disorders, according to Grant et al. (2013) in “The Impact of Prenatal Alcohol Exposure on Addiction Treatment.” These co-occurring disorders include sensory integration disorder, reactive attachment disorder, attention deficit disorder, traumatic brain injury, borderline personality disorder, depression, and substance use disorders. According to Martyniuk and Melrose (2018), adults experiencing the impacts of FASD have significant cognitive, behavioral, and executive functioning challenges. Research from Flannigan et al. (2020) also indicates mental health problems are “one of the most prevalent adverse outcomes associated with FASD.”
Supporting someone with FASD
Supporting a job seeker with FASD necessarily involves a holistic practice and may best be accomplished through a collaborative team approach. If you are a vocational rehabilitation counselor or an employment services professional supporting an individual with FASD, it is important to become familiarized with an individual’s support network (family, doctor, counselor, nutritionist, etc.). According to the Center for Disease Control and Prevention, potential treatment for people with FASD may include biofeedback, auditory training, relaxation techniques, acupuncture, herbal therapy, or animal-assisted therapy.
As a person transitions to employment, it is important to understand specific strategies that may be helpful in supporting that individual. Identifying those support needs should occur during Discovery and be recorded on VR’s Employment Supports and Retention Plan form. It may be necessary for you to provide pre-employment and post-employment support, both at the worksite and away from the worksite.
The National Organization on Fetal Alcohol Syndrome suggests considering the following strategies as you work with job seekers diagnosed with a disorder under the FASD umbrella.
- Picking jobs that match an individual’s skills, abilities, and interests.
- Emphasizing strengths, not weaknesses.
- Using volunteering positions and trial periods to learn about a variety of jobs.
- Finding jobs which follow a daily routine and have consistent, regular hours.
- Finding jobs that do not have a very stimulating environment or using noise-blocking headphones to reduce distractions.
- Utilizing job training.
- Educating employers about FASD and talking about possible accommodations.
- Providing a digital watch and a written schedule.
- Using text messages and alarms as cues.
Learn More
You can learn more information by visiting the Center for Disease Control and Prevention web page about FASD. The National Organization on Fetal Alcohol Syndrome has some excellent guides including this tip sheet on what the business community should know about FASD. You’ll find more strategies you can employ for helping job seekers with FASD in this resource from Community Living, an organization in British Columbia.