Treatment with Persona with FASD through the lifespan

Treatment with Persona with FASD through the lifespan

Competency VI: Treatment for Individuals with FASD through the lifespan NORTHEAST REGIONAL FAS EDUCATION AND TRAINING CEN We all must row with the oar we are given - old English proverb

FASD is the direct result of maternal consumption of alcohol during pregnancy Core disabilities include: Cognitive Activity and attention Processing Learning and Memory Organization Abstraction Adaptive Social Interaction

FASD involves life-long disabilities Management and care will change, according to the age and presenting disability/problem Protective factors include: Early diagnosis Stable home environment No exposure to violence Early Intervention and services Individuals with prenatal alcohol exposure will need to see various professionals throughout their lifetime. These

include, but are not limited to: Medical Professionals:

Developmental Pediatrician Neurologist Primary Care Physician Immunologist ENT GI Ophthalmologist Endocrinologist Psychiatrist Nurse

Dentist Allied Health Professionals

Audiologist Speech Therapist Nutritionist Psychologist/Therapist Social Worker OT/PT LDTC Alternative therapies practitioners Medical treatment is individualized depending on presenting disability. **Be aware that traditional medicine may not be effective for individuals with

alcohol exposure.** For ADHD, success has been found with: Adderall XR Concerta Stratera Ritalin LA Dexedrine Antipsychotic include: Risperadal Seroquel Geodon

Clozaril Mood Stabilizers: Tegretol Trileptal Depakote (Sometimes) Lamictal SSRIs: Zoloft Prozac Celexa

Wellbutrin Lexapro Paxil Sleep: Melatonin Ambien Desyrel Clonadine Therapeutic Intervention for

Domains Problems with Neuromotor Problems with Executive Functioning: Information processing Storage retrieval Try: Cognitive rehabilitation Concrete learning experiences REPEAT, REPEAT, REPEAT

Functioning: Motor and sensory domains Feeding difficulties ADHD Try: Cue-based feeding Regular schedules Play activities Sensory integration therapy Regulation and relaxation

strategies Problems with Speech and Language: Processing and responding to incoming information Superficial conversational fluency Try: Language stimulation

Target speech production Reduce competing auditory stimuli Problems with Social/ Emotional: Attachment Depression Anxiety Low self-esteem Try:

Therapy Social skills group Anger management Frequent praise General Suggestions: Thorough diagnostic work-up Hands on learning Always check that individual understands directions Use computers Short term consequences Remove tags from clothing, if bothersome

Use literal language Review and REPEAT Limit plans and implementation Multiple system/multi-level/modalities Respite care Address grief of individual and family Family and sibling support Key components to any intervention: STRUCTURE REPETITION

CONSISTENCY BREVITY PERSISTENCE Begin intervention early and continue across lifespan Modify environment to best support childs needs Remember to use non-judgmental wording: a child with FAS, not an FAS child FAS is a disability the person has, NOT what the person is

INFANCY Interventions could include: Parenting techniques and support groups Feeding interventions Medical management of immune problems Early Intervention OTHER: Minimize sensory input (low lights, soft music) Alternate positions Swaddle for calming Consistent feeding/bed times Small mini meals

TODDLERS Interventions could include: Parenting assistance parent support groups Sensory integration activities Early intervention Medical management OTHER: Provide various motor skill opportunities Playful exploration Watch cues for sensory overload Assist with transitions

Make safe play areas Provide structure in daily routines PRESCHOOLERS Interventions could include: Preschool Handicapped classes Parent support and education Medication monitoring Sensory integration activities OTHER: Extra supervision and time to complete tasks Provide consistency

Gradual approach to learning new skills Use of cues visual, auditory, tactile Establish consistent, simple rules Daily routine Encourage self-esteem SCHOOL AGE: Interventions could include: Special education Therapy individual and/or family Medical management Peer counseling

Social skills training Sex education Nutrition Alcohol and drug counseling Parental assistance SCHOOL AGE (cont.) OTHER: Develop rewards and discipline system Use consistent, daily routines LESS IS MORE reduce sensory stimulation

ADOLESCENTS Interventions could include: Special education Therapy Social skills Anger management Family counseling Parent support groups Sex education/birth control Alcohol and drug counseling Probation assistance Vocational rehabilitation

ADOLESCENTS (cont.) OTHER: Allow increased responsibility and decision making Monitor friends Focus on daily living skills Maintain realistic expectations Abilities are probably not at CA, but 2/3 CA Think stage not age ADULTS Interventions could include:

Counseling: individual, family, drug and alcohol Vocational rehabilitation Anger management Support groups SSI/Disability Sex education/birth control Assisted living OTHER: Many adults need 24/7 supervision and the services should be tailored to the adults individual needs and abilities Encourage independence

An external brain is needed ALTERNATIVE THERAPIES Many traditional therapies do not have long-term effects with individuals with prenatal alcohol exposure Alternative therapies and medicines are being investigated for use with FAS Before trying any, please consult your physician or psychologist Some therapies that have been successful include:

Biofeedback/neuro-feedback Vitamins/herbal treatments Recreational therapies Relaxation therapy/visual imagery Creative art and dance therapy Yoga/exercise Always Remember Lifespan assistance may be needed for many families Assistance should include parenting, support groups, respite care and therapeutic interventions, which are culturally sensitive

Medical maintenance may be needed and will need to be adjusted as the individual matures FASD is a lifelong birth defect; brain damage effects will continue through the lifespan The range and severity of effects is very broad and interventions must be individualized And finally. .

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