Strategies and Accommodations to Support Employment in People with FASD
In this section
- Specific strategies to accommodate for the cognitive difficulties of people with FASD in the workplace.
Cognitive Supports for Employees with FASD
This section provides a list of types of accommodations and adjustments an employer may need to consider implementing for their employees with FASD.
Each type of accommodation and adjustment is specific to each type of difficulty that is commonly seen in FASD.
Consistent and repeated use of the techniques can improve the chances of creating a work environment that supports successful employment outcomes.
We will address supports for 9 cognitive challenges of employees with FASD.
- Attention
- Generalising
- Memory
- Language and Communication
- Decision Making and Judgement
- Difficulties Initiating Tasks
- Difficulties Carrying out a Plan of Action
- Impulsivity (including poor inhibition and lack of self-control)
- Self-awareness and insight
Cognitive support 1 of 9
Attention
Attention is an important aspect of our daily work and promotes thoroughness, accuracy and consistency when accomplishing our tasks.
Being able to attend to our work ensures that we complete it to a high standard, minimises the likelihood of errors and reduces the amount of supervision needed.
Paying attention, particularly for long periods of time, can be challenging to a person with FASD. These difficulties with attention may be misinterpreted by employers as carelessness or a lack of motivation.
Difficulties with attention can present as:
- A proneness to being easily distracted by irrelevant things
- Short attention span
- Zoning out
- Difficulties multi-tasking or attending to more than one thing at a time
- Difficulties with shifting attention between tasks
- Difficulties understanding information
Dr Richard Cash: 360Edge
Cognitive support 2 of 9
Generalising
Generalisation means having the ability to transfer skills and knowledge learnt in one setting to other settings.
This is an important skill to have in the workplace as it ensures flexibility and ease when learning new tasks and activities.
Generalising can be challenging for people with FASD.
Difficulties with generalisation can present as:
- Difficulties taking previously-learnt information and skills to the current work
- Slowness when it comes to learning tasks despite similarities to previously learnt tasks
Strategies to support generalisation:
- Do not assume the employee is able to jump right into a role simply because they have done a similar job in the past
- Point out similar elements of the new and old task to build confidence
- Only add in new tasks when the first one or two tasks have been successfully completed or understood
Cognitive support 3 of 9
Memory
Moments of forgetfulness are commonplace.
It is not useful nor efficient for our brain to remember everything!
With moments of forgetfulness come mistakes, such as forgetting to show up to a meeting or forgetting to do a task.
These can be embarrassing and frustrating and can potentially impact our efficiency and goals. Difficulties with memory can be a common challenge for people with FASD.
Difficulties with memory can present as:
- Problems with learning and remembering new information
- Difficulties with remembering tasks and how to conduct them
- Difficulties remembering instructions
- Misplacing items
Strategies to support memory:
- Assign jobs that are in line with capabilities.
- Provide information both verbally and visually.
- Establish and maintain a structured routine of daily tasks.
- Provide and encourage use of memory aids such as notebooks, calendars, task checklists, calculators, pictures, etc.
- Color code checklists to help identify items.
- Encourage frequent review of notes in memory notebook throughout the day.
- Encourage co-workers to write down any information
- Limit verbal instructions to shorter, manageable chunks of information.
- Promote opportunities for the rehearsal of new information and practice of new skills after initial learning.
- Pair new information with items the individual is already familiar with.
- Provide cues to assist recall and when necessary; directly help the individual to fill in gaps in their memory.
- Allow audio-recording where possible.
- Provide typed minutes for meetings.
Cognitive support 4 of 9
Language and Communication
Good communication is the key to any successful relationship.
Good communication amongst employees, the management and consumers lead to a more productive outcome for all. Communication also promotes a healthier and less stressful workplace.
Communication is often challenging for the individual with FASD due to difficulties with language.
Difficulties with language and communication can present as:
- Difficulties paying attention to what is being said
- Misinterpreting or not understanding information
- Difficulties initiating conversations
- Not responding to others’ communication attempts
- Leaving long pauses
- Difficulties with communicating information and meaning (finding it difficult to explain things)
- Difficulties with etiquette such as taking turns, giving others the opportunity to talk, adjusting communication style to suit the situation and maintaining appropriate physical distance
- Difficulties selecting topics of conversation
- Difficulties keeping up with changes in topics of discussion
- Introducing new topics abruptly
- Difficulties staying on topic
- Difficulties understanding non-verbal cues such as facial expressions and body language
- Problems maintaining an appropriate physical boundary
- Giving excessive or poor eye contact
Dr Annabelle Nankoo: University of Western Australia
Cognitive support 5 of 9
Decision Making and Judgement
The ability to make decisions and exercise sound judgement are valuable skills in the workplace as this helps employees to make mindful choices that improve outcomes.
Difficulties with decision-making and judgment can present as:
- Vulnerabilities to social and interpersonal issues (e.g., being easily led by others)
- Difficulties considering all alternatives and selecting the appropriate ones
- Difficulties applying commonsense, etc.
- Making inappropriate or potentially harmful decisions
- Frequently hesitating when making decisions
- Poor reasoning
- Poor/ineffective problem solving
Strategies to support decision-making and judgment:
- Encourage the individual to adopt a Stop-Think-Do approach when problem-solving.
- Work with the individual to explore alternative options to the problem
- Encourage the individual to talk through options with colleagues or manager, including the advantages and disadvantages of each option.
- Encourage the individual to jot down potential options, if possible.
- Brainstorm or role-play courses of action for various scenarios, situations and problems.
- Provide picture diagrams of problem-solving techniques.
- Restructure the work to only include essential functions.
- Assign a supervisor, mentor, manager or buddy.
Cognitive support 6 of 9
Difficulties Initiating Tasks
Task initiation refers to one’s ability to get started on a task and to overcome procrastination.
When someone struggles with initiation, they take longer to do the task and require more effort.
Difficulties with task initiation can present as:
- Struggling to get started on tasks
- Procrastination
- Seeming overwhelmed by tasks
- Appearing uninterested or unmotivated
Strategies to support task initiation:
- Help develop a structured daily routine with specific goals and set specific timeframes
- Provide choices for daily tasks. For example, “would you like to start with A or B today?”
- Simplify tasks by breaking them down into simple steps and encouraging completing one step before another
- Praise and encourage for starting a task without being prompted
Cognitive support 7 of 9
Difficulties Completing Tasks
Problems with successfully completing tasks independently can occur due to difficulties with organisation, planning or coping with the difficulty of the task.
Difficulties completing tasks can present as:
- Poor follow through of a task from start to finish
- Unable to plan a sequence of tasks
- Appearing disorganised
Strategies to support task completion:
- Provide small, realistic projects to begin with.
- Involve the individual in planning the activity and its completion.
- Provide a clear, detailed explanation of the task or activity, prior to starting.
- Break down new or more complex tasks into smaller, more manageable steps.
- Encourage them to write down the steps to conduct the task.
- Ask them to repeat back to you the steps, to ensure understanding.
- Encourage them to frequently check their plan and cross off tasks as they are achieved.
- Repeat the sequence of activities as needed.
- Provide extra time to complete the tasks.
Cognitive support 8 of 9
Impulsivity (including inhibition and self control)
Being able to inhibit one’s behaviour is crucial in putting a brake on any undesirable or unwanted behaviour.
An example of such an unwanted behaviour is checking one’s phone rather than focusing on a task at hand.
People who are impulsive can act before thinking things through adequately. People with FASD can have problems with impulsivity, including in the workplace.
Difficulties with impulsivity can present as:
- Acting or speaking without considering all information or without considering the consequences.
- Engaging in impulsive or inappropriate behavior or demonstrating lack of judgement.
- Making inappropriate or undesirable comments to, or about others.
Dr Kirsten Panton: University of Western Australia
Cognitive support 9 of 9
Self-Awareness and Insight
Self awareness is the ability to keep track of yourself, your actions, thoughts and emotions and consider how they fit with the situation.
Self-awareness in the workplace allows the employee to take in what is going on around them and to consider them more thoroughly.
Challenges with self-awareness can present as:
- Lack of awareness of one’s difficulties and limitations.
- Inaccurate self-image or self-perception.
Strategies to support self-awareness and insight:
- Anticipate lack of self-awareness and/or insight.
- Prompt accurate self-statements.
- Provide generous, supportive and positive feedback when possible.
- Provide realistic feedback about behaviors you observe.
Employment Professionals and Employers: Reflections
You play an important role in supporting the person with FASD in your employment journey.
This places you at the centre of the client’s employment experience. Your ability to reflect on your practice can help you grow, learn and, in turn, better support people with FASD as they transition out of the justice system and engage in more positive and fulfilling life experiences, such as work.
Below is a reflective practice exercise that will assist you to support someone on their employment journey.
| Need to Know/Reflect on… | Need to be Able To… |
|---|---|
| Your own understanding of FASD and that of the community. | Access and keep abreast of information regarding FASD. |
| Your own biases towards people with FASD and those of the community. | Challenge your ways of thinking about FASD, for example, by seeking alternative ways of thinking about FASD or interacting with people with FASD. |
| FASD is a brain injury. | Integrate and apply knowledge of FASD into your workplace by adopting suitable practices and accommodations. |
| FASD is permanent and irreversible. | Not seek to change the person but adapt the environment to suit their needs. |
| Employers’ values and business considerations. | Understand and negotiate with the employer to create situations of mutual benefit. |
| The level of comfort your clients feels at work and what additional supports they might need. | Engage in conversations with the client and encourage collaborative conversations between the client and yourself as their employer. |
| The presence of support workers at work. | Encourage blending in and being discrete. |
| The balance between the person with FASD's level of autonomy with their need for supports. | Provide supports as needed and requested for the client; seek advice as to when to phase in these supports. |
| There will be good days and bad days at work (e.g., two steps forward and three steps back). | Be flexible and stay positive. |
| Who is in the person’s support network and who can be called if needed. | Collaborate with the client’s support network. |
| Your own boundaries, tolerances and well-being. | Practice self-care and utilise your own support network. |
Summary
Thank you for taking the time and effort to use this Resource.
We hope that it provides you with the necessary tips and tools to enhance interactions and improve employment outcomes for people with FASD.
Thank you to all those that have been involved. Your support and dedication has been so very much appreciated.
Quiz
Wesley Citizen is a 23-year-old man who was diagnosed with FASD as a child.
He is a very outgoing person of normal intelligence, however, makes poor decisions, acts impulsively and does not appear to learn from his mistakes. He has spent much of his time in and out of prison for committing illegal acts, some petty and some more serious than others.
Due to his history of illegal behavior, Wesley has missed significant periods of schooling and ceased school after Year 9.
In fact, he has always struggled at school with teachers commenting that he did not pay attention in class, was lazy and careless, disturbed his classmates and was behind his peers in developing his numeracy and literacy skills.
In prison, however, he has participated in educational and vocational programs.
He has developed excellent culinary skills which he is proud of.
Wesley has recently been released from prison and his parents have welcomed him back home.
Wesley feels like he’s found a new lease on life and is determined to change his ways.
His goals are now to join a sports club, make new friends, find work in a restaurant, and hopefully have a family of his own.
Wesley’s family home is located in a neighborhood that has a notoriously high rate of crimes.
His childhood friends who are his neighbors, have themselves been in prison for several crimes, some of them more serious than the ones committed by Wesley have heard of his recent release from prison.
They decide to visit Wesley to see if he will hang out.