Developmental age and FASD
Children with FASD are much younger in their “developmental age” than they should be for their actual age. This means that as they grow and develop, they do it much more slowly than other children do. Plus it gets more complicated because they will grow more slowly or more quickly in different areas of development. Here’s an example. The chart shows the development of a teenager who is 18 years old. His physical development is on time for his age. But his emotional maturity and social skills lag far behind. This obviously can cause a lot of difficulties.

A phrase that is often used with people who are affected by FASD is to “think younger” or to “think stage, not age”. You adjust your expectations of them, depending on their skill level in various areas. And you make changes in their environment to accommodate them. Then, a good fit is created and they are more likely to do well as they get older.

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Ages and stages of people affected by FASD

People affected by FASD will go through different stages and behaviours, depending on their age. Service providers can provide different supports to those affected by FASD and their parents or caregivers depending on the person’s stage. There are six different stages that people affected by FASD go through.
These are:

1. Infancy (approximately up to 1 to 1 ½ years old)—some of the issues you can expect in this age group are:

  • a lot of crying—babies are often irritable and can quiver or be shaky
  • it’s difficult for them to suck and they have a weak muscle tone
  • they are more likely to get sick
  • they can have a lot of feeding difficulties—they may not be very interested in eating or feeding can take hours and a lot of patience
  • their sleep patterns are unpredictable, so you can’t predict when they will be asleep or awake
  • they are very sensitive to sights, sounds, and touch
  • they are slow to achieve “developmental milestones” like walking, talking, or imitating sounds
  • they have problems with bonding (or “attachment” ) with their parents or caregivers
  • they have a general “failure to thrive” which means that, overall, these babies can be sickly and weak

 

2. Pre-School (up to approximately 5 or 6 years old)—some of the issues you can expect in this age group are:

  • they still aren’t very interested in food and the disrupted sleep cycles continue
  • they have poor “motor coordination,” which means they can have trouble controlling their hand, arm, and leg movements
  • they are likely to have outbursts, meltdowns, or temper tantrums and don’t follow instructions
  • they have a short attention span
  • their speech (especially what’s called “expressive” speech) may be delayed—this means their language might be less in-depth than their peers’ OR they can be super talkative and interrupt a lot, so people think their speech is not impaired when, in fact, it is
  • they are distracted easily and tend to be hyperactive
  • change and transitions can be difficult and they prefer routines
  • they can flit from one thing to another—this is sometimes called “butterflylike’ movements because they go from thing to thing and place to place without staying put
  • they might be more interested in people than in things or objects
  • they can be overly friendly and highly social
  • they have difficulty understanding danger and they don’t respond well to verbal warnings

 

3. Early School (up to approximately 10 years old)—some of the issues you can expect in this age group are:

  • their reading and writing skills during the couple of years in school might not be noticeably delayed
  • arithmetic is likely to be more of a problem than spelling and reading
  • they have problems paying attention to what’s going on around them
  • they have poor memories
  • they have poor control over their impulses so they can act inappropriately in a lot of situations
  • it’s hard for them to “transfer learning” from one situation to another, which means that they don’t learn from experience very easily
  • they are likely to need constant reminders for basic activities at home and school
  • they can learn information but it is retained only for a short time and then it’s lost (called “flow through phenomena”)—other people might think these children are deliberately forgetting because they seemed to learn a task or lesson at first
  • they can have problems with “gross motor control”, which means they appear to be clumsy
  • they can have problems with “fine motor control” which means they have trouble with thinks like holding a pencil or pen, colouring or handwriting, and doing up buttons, zippers, and shoe laces
  • they can have a lot of difficulty with social skills and relationships—with their peers, for example, they might be unable to share, wait for their turn, follow the rules or cooperate, and with everyone they can interrupt a lot and be inappropriately intrusive
  • they often prefer to play with younger children or adults rather than with kids their own age or in their peer group
  • they often live only in the moment or “here and now” without thinking ahead or learning from past experiences

 

4. Middle School (up to approximately 13 years old)—some of the issues you can expect in this age group are:

  • Delayed physical and cognitive development
  • Reading and spelling skills usually reach peak
  • Increased difficulty maintaining attention, completing assignments and mastering new academic skills
  • Usually a very concrete thinker, may have trouble working with ideas — tends to fall further behind peers as world becomes increasingly abstract and concept base
  • Continuing fine motor problems may make volume work production impossible
  • Good verbal skills, superficially friendly social manner and good intentions often mask the
  • seriousness of the problem
  • Psychological evaluation and remedial placement may be necessary
  • A pattern of school suspensions may start

5. Adolescence (up to approximately 18 years old)—some of the issues you can expect in this age group are:

  • they skip school a lot, refuse to go to school, or actually drop out of school
  • when in school, they can be very disruptive and find it difficult to manage classroom rules, norms, and expectations
  • they can recognize words when they are reading, but their comprehension of what they are reading is poor  
  • they have difficulty with logical thinking, which means their judgement is poor and they don’t have basic “critical thinking” which is the ability to think clearly, rationally, and independently—this makes it difficult for them to understand the logical connections between ideas
  • math tends to be really difficult for them and they can have problems with abstract thinking and with basic problem solving
  • they can be really impulsive, have a total lack of inhibitions, and are easily influenced, which means their peers can manipulate and exploit them
  • they have difficulty showing remorse or taking responsibility for their actions
  • they can have problems managing time and money
  • this is the time when they are at high risk for the “secondary disabilities” that go along with FASD, like problems with the law. For more information about this topic, go to the Strategies section of this site, here.
  • they can have difficulty identifying and labeling their feelings
  • they can have low motivation and low self-esteem
  • they might start showing signs of depression (sometimes called “clinical” depression)
  • they can have sexual boundary issues and sexual activity might begin at an earlier age

 

6. Adulthood (over approximately 18 years old)—some of the issues you can expect in this age group are:

  • they can seem to be obsessive or compulsive (“OCD”) which means they repeat certain responses over and over and can seem to be compulsive and rigid in their ideas or activities
  • they have difficulty holding down jobs
  • their social skills are weak and they have difficulty getting into relationships that are equal and fulfilling
  • they might be unable to live independently or to parent their own children effectively
  • their behaviour can be really unpredictable
  • they can have problems managing money
  • they can show increasing signs of depression or thoughts of suicide and might withdraw and isolate themselves from other people
  • they might have alcohol or drug problems

 

And let’s talk about strengths!

Although living with FASD can present many challenges, it also important to always focus on strengths. Here are some of the many ways children and adults affected by FASD show their positive energy, power, and strengths:

  • they are often creative, artistic, and have a love of music
  • they can have very strong verbal and writing skills
  • they can have a very good mechanical ability or are good with computers
  • they have a good sense of humour
  • they are kind, friendly, and outgoing
  • they are hard working
  • they can have a rich fantasy life which makes them good story tellers
  • they can be very loyal and trusting
  • they can be spontaneous and curious about life around them, which makes them a lot of fun to be with

Here is a quote from a parent from the Picture This video project about the joy her child has brought her:

Audio Transcription:

“Had it not been for my child with FASD, I would not have learned how to create safe spaces in a chaotic world, use imagination without limits, dream without boundaries (ANYTHING is possible!). And he wrapped all these gifts in his unconditional LOVE.”


Want more information about understanding the different stages of children, teens, and adults affected by FASD? Check this out:

FASD Tips for Parents and Caregivers