Changing Attitudes and Shifting Behaviours Towards People with FASD
In this section
Since FASD is a spectrum disorder, the range and severity of symptoms will differ from one person to the next and will remain apparent at varying degrees throughout the person’s life.
Some people who have been exposed to alcohol before birth may present with various types of difficulties and intellectual impairments. Others can present with very few difficulties and have above average intelligence. Due to the diversity of FASD presentations, you may be working alongside someone with the condition without knowing it.
Just like anyone else, people with FASD have a range of strengths that make them excellent employees:
People with FASD can be as bright as other persons without FASD. Many have normal intelligence.
People with FASD can be very practically minded and be very successful with hands-on, visual and physical activities. They can also be very insightful.
People with FASD enjoy interacting with others and are often very chatty, outgoing, engaging and bubbly. They also tend to be very forgiving and non-judgmental towards others.
People with FASD display a range of positive and desirable attributes that make them great workers, friends and companions including (but not limited to) loyalty, devotion, generosity, friendliness, care for others and helpfulness. They are also perseverant, hardworking, demonstrate resilience and take great pride in their successes.
People with FASD tend to be particularly creative including when it comes to music and arts.
And just like anyone else, people with FASD may need support in the following areas:
They may find it difficult to focus for long, sit still, think clearly and complete tasks. Due to problems with focus, they can be prone to making careless mistakes. In fact, due to these difficulties with attention, many people with FASD also get a diagnosis for attention deficit hyperactivity disorder (ADHD).
Memory and learning
They may struggle to recall details, events or instructions. They may also misplace items, become easily confused or overwhelmed when learning new things.
They may have difficulties understanding information and meaning and may struggle with expressing themselves.
Social and interpersonal functioning
In some cases, people with FASD may display social immaturity and ineptness. They may have difficulties maintaining boundaries, as well as forming and maintaining relationships.
Decision making, abstract thinking and organisation
They may have difficulties thinking ahead, understanding consequences, planning and organizing tasks, and dealing with concepts such as time, money and math.
They may find it difficult to control their impulses. They may also be restless and easily become frustrated. Many people with FASD can also struggle with social cues and therefore misunderstand body language, social etiquette and gestures and tend to cross personal boundaries when interacting with others.
Shifting Perspectives On FASD
FASD is a diverse condition and should not be characterised by deficits alone.
Shifting perception about FASD is an important first step towards creating positive, productive, safe and long-lasting relationships where people with the condition feel valued and can perform at their best.
Consider ways in which you might challenge your perspectives on people with FASD:
FASD means deficits and impairments only
FASD has diverse characteristics and should not be considered a limitation
People with FASD are broken and need to be ‘fixed’
People with FASD have unique talents, skills and challenges, just like everyone else
Seeing everyone with FASD as the same
Recognise and acknowledge everyone has different and unique characteristics
Applying consequences for challenges
Acknowledging and finding solutions for challenges
We need to change the person with FASD
We need to change the environment so that it supports the person with FASD
The person is the problem
Finding solutions is our challenge
Focusing on problems and limitations
Focusing on strengths and needs and building support strategies
Setting the Right Conditions to Support Work Readiness
With the right supports and guidance, a person with FASD can gain a better understanding of what employment entails and be enabled to thrive.
Employment professionals and employers can adopt two complimentary sets of principles that will cultivate supportive interactions:
The FASD-informed approach
Being FASD-informed is based on principles around nurturing successful interactions thus promoting the success of any programs targeting people with FASD.
The Eight Key Principles
Well-known principles for teaching new skills and supporting people with FASD in the workplace.
The FASD-informed approach
Adopting a FASD-Informed approach underpins all successful interactions and can therefore ensure the success and sustainability of employment.
These principles should be kept in mind during interactions as well as when designing programs to support people with FASD.
General principles for interacting with people with FASD:
Maintain a strong understanding of FASD and embrace ongoing training
In order to enhance interactions with people with FASD, it is important to keep up-to-date with knowledge about FASD. This can be achieved by completing online or face-to-face professional development opportunities and engaging in reflective discussions, including debriefing, brainstorming solutions and seeking support from community agencies and employment providers.
Avoid making judgments and assumptions
It is important to foster a safe and trusting relationship in which people with FASD do not feel judged, misunderstood, labelled and stigmatised. A relationship founded on trust and lack of judgment sets the right conditions to motivate, set new goals and make positive changes within their lives.
Use person-first language
FASD should be considered as secondary, or a characteristic that is associated with the person, rather than a key feature of the person. Use language that emphasises that they are valued as an individual, and not someone who is defined by disability. Avoid phrases such as “my FASD employee, Andy” or “Andy has FASD” and use phrases such as “Andy is a person who has FASD…” or “My employee Andy, who/has FASD”.
Use clear, concrete and concise language
People with FASD can have difficulties processing and understanding information. They may also struggle to understand abstract concepts, ideas or figurative language. It is important to accommodate their communication needs and styles. To achieve this use clear and concise language, short sentences and allow time for them to process what is being communicated.
Check for understanding
Do not assume the level of comprehension when communicating. Politely check their understanding rather than relying on overt verbal acknowledgement of their understanding. Ask them to demonstrate their understanding in an active way, for example, by asking them to repeat the information which allows you to clarify any misunderstanding in a gentle and respectful manner.
Set goals, objectives and tasks
Break tasks into smaller, concrete and more manageable chunks and align your expectations with what can be achieved. Provide ongoing support and check in regularly for progress. Work with them to identify challenges that may be getting in the way of success. Maintain a safe, nurturing and trusting relationship which will allow them to feel comfortable in reporting their setbacks and to seek the clarity they need to move forward with their work.
Poor punctuality or poor attendance does not automatically reflect lack of interest or an unwillingness to work. These may stem from brain and cognitive deficits. Minimise forgetfulness and poor grasp of time by providing reminders for work-related activities, appointments and meetings. Reminders may be visual reminders such as calendars, photo and picture cues, checklists or text reminders.
Provide coaching and demonstrate hands-on learning
Using hand-on approaches when teaching new skills, like showing them how to do the task, modelling, role playing, and coaching are all beneficial strategies that support learning. These practices should be employed on an ongoing basis to support applying this new knowledge from one situation to the next.
When meeting with people with FASD ensure the physical environment is appropriate by:
- Adjusting lighting and if possible reduce fluorescent and bright lights
- Minimising visual and auditory distractions
- Using visual aids where necessary such as drawings and photos
- Holding meetings and interviews in a calm and quiet space
- Ensuring that the physical space is non-confining, and the person can identify a clear way out, for example, by keeping the door slightly open.
When tailoring work programs for people with FASD ensure to:
Adopt an individualised and flexible approach
Given the degree of variability amongst people with FASD, employment programs and strategies should steer away from adopting a one-size-fits-all approach, and instead embrace an individualised approach aiming to meet the individual needs of persons seeking employment. Maintain flexibility by demonstrating an understanding of individual challenges and adapting to those. Be flexible with regards to lateness, poor punctuality or a missed appointment. Refrain from punishing the individual, recognizing that lateness or missed appointments does not reflect a lack of motivation but instead a brain-based deficit, leading to difficulties with planning and organisation.
Be consistent when scheduling activities
Provide structure, routine and predictability in the workplace given that they may experience memory-related difficulties. Work-related tasks and activities, meetings and appointments can be scheduled on consistent days and times.
Offer one-on-one and outreach supports
One-on-one and outreach based support provides an individualised approach to employment programs. This relationship based process empowers individuals to identify challenges and needs which enables strategies and supports to be acknowledged and developed. These supports may include transportation to meetings or work, accompanying to meetings, interviews or appointments or providing access to work-related training.
Programs geared towards supporting people with FASD, are most beneficial when they take into account the needs of the person as a whole. This approach recognises that people often require support in multiple areas of life. Coordination and integration of services benefit improved social and wellbeing outcomes. As an example, as individuals transition out of the justice system they require a collaborative approach between the Department of Justice, organisations working within the reintegration space, allied health professionals, community services and employment agencies to enable successful transition and to limit the possibility of re-offending.
Include family and support networks
The family and support network play a critical role when someone is seeking employment. Programs that capitalise on intergenerational and family-based approaches in supporting people with FASD, have positive benefits such as a greater likelihood of maintaining a job, (through the provision of supports such as transportation, baby-sitting duties), advocacy and emotional wellbeing.
Eight Key Principles
When teaching new skills to a person with FASD, adopt the Eight Key Principles:
1. Use concrete language
Concrete words are those that are exact, specific and rely directly on our senses (what we see, hear, touch, taste and smell). Avoid words with double meanings.
People with FASD may experience difficulties applying knowledge gained in one situation to another new situation. They do best in environments with few changes therefore create a consistent environment with minimal changes. Use the same words and same strategies.
Minimize risk of forgetfulness and memory difficulties by teaching and re-teaching to help the consolidation of information into long-term memory.
Provide and encourage stable routines that do not change from day to day. This will reduce anxiety and enable them to settle, learn and perform better.
People with FASD are easily overstimulated and may shut down. When this occurs, no more information can be assimilated. When providing tasks, activities and instructions, Keep It Short and Sweet (KISS Method) and provide a simple environment that minimizes distraction.
Say exactly what you mean and provide step-by-step directions, either verbally or in writing. Remember that people with FASD can have difficulties dealing with abstract concepts, generalizations and can find it difficult “filling in the gaps”.
Structure is the “glue” that creates a world that make sense to a person with FASD. They thrive best and achieve more when their environment is structured, and they have a strong foundation. Therefore, say exactly what you mean, provide step-by-step directions and provide them with the right tools to complete their tasks.
Provide continued supervision for teaching appropriate behaviour and promote independence.