You love this funny, busy, and spunky kid who has moved into your home. Yes, they keep you on your toes and you feel new levels of tired that you haven’t felt in years. But it’s pure joy when they conquer a new skill or find their voice. You are committed to supporting this child with all they need to succeed while you are helping raise them, but if this young person had prenatal alcohol or drug exposure or has been diagnosed with Fetal Alcohol Spectrum Disorder (FASD), your tools must be different than you might have tried with other kids in your family.
What Are the Impacts of Prenatal Substance Exposure?
Common Behavioral Impacts
Exposure to alcohol and drugs during pregnancy create damage in a developing baby’s brain. That damage results in behaviors that can be challenging to manage and to teach the child new skills. Those behaviors often come in “clusters.” They are magnified when the child enters a school setting where they must behave in the classroom in ways that might be challenging for them. This is a review of some of the common struggles kids have from prenatal alcohol exposure:
Sleep issues – too little, too much, interrupted or fitful sleep- Feeding challenges – suck-and-swallow reflexes, reflux, frequent spitting up
- Sensory issues – over-stimulated or under-responsive to stimuli
- Difficulty with change, transition, or new experiences
- Speech/language delays
- Extremes in “on” days and “off” days
- Memory challenges and difficulty holding on to skills already mastered
- Struggles to hang on to lessons learned from previous mistakes
- Attention differences, hyperactivity, impulsivity, lying, stealing, inappropriate sexual behaviors
- Immature social skills, difficulty making and keeping friendships
- Executive function delays (organizing, planning, understanding abstract concepts, completing tasks)
For additional information on prenatal substance exposure or FASD, review the article on this site titled, “Explaining Prenatal Alcohol or Drug Exposure to Your Grandchild” or listen to this podcast.
Practical Help for Raising This Child with Prenatal Exposure or FASD
1. Start with the ½ their age rule.
Many specialists recommend that you target your parenting to half the child’s age when raising a child with FASD or prenatal exposure.
For example, when a 6-year-old has frequent tantrums before dinner, handle the meltdowns as if they are 3, not 6. Three-year-olds need frequent re-direction. They need to remain close to their primary caregiver and usually need help regulating big emotions. Restructure the hour before dinner to include playtime with toys they are especially fond of, breaks for a quiet reset with a book, and a designated space close to where you are working to prep dinner.
2. Maintain consistent supervision.
In addition to keeping this child close by during challenging times of the day, consistently supervise them across the day. When they sense your presence, even if you aren’t directly interacting with them, you provide guide rails that help them stay on track. Additionally, you can prevent unacceptable or dangerous behaviors from their impulsivity, curiosity, or lack of understanding of consequences.
It’s wise to inform your grandchild’s teachers and support staff at school of the need for supervision too. Many scrapes and struggles at school can be avoided when the team keeps an extra eye out for their impulsive or hyperactive behavior.
3. Catch it low.
Stay tuned in to the child’s behaviors with prevention in mind. It will help to learn their triggers and warning signs for big emotional reactions, boredom, rising curiosity, etc.
For example, this little one always scrunches his nose when he’s trying to figure something out. He’s eyeing that shiny faucet in the tub. You can step in and re-direct him to another activity altogether. But you can also step into that curiosity with him and help him feel and hear what happens when you turn on the faucet. Your supervision and guidance can satisfy his curiosity, help him see cause and effect tangibly, and even have some fun splashing – without the bathroom floor turning into a lake.
Keeping an eye on a child with prenatal substance exposure or FASD can prevent dangerous behaviors. But learning and catching their signals early can also help you tune in to their moods so you can respond quickly. You will build felt-safety and confidence when they feel seen and understood in your presence. Otherwise, they may melt down over an activity they typically enjoy, simply because they crave your attention and don’t know how else to ask. Responding early to their signals teaches them that they matter. When a child feels that their voice counts and you are “with them” for whatever they need, they can thrive in your home.
4. Give them time.
Kids with FASD or prenatal substance exposure struggle to process events, words, and expectations. When you are patient with them and give them time to think and respond, you build life skills they can use to balance their impulsive behaviors.
Use repeated phrases to help them stop and think. When you have a question, please give them a heads up that you’d like to talk about it, but they can take some time to process it before they answer. If you need to leave the house by 7:30 a.m., give them plenty of time (and gentle reminders) for how to do that successfully.
It’s also important to teach them HOW to process the time they’ve been given. Some kids will benefit from a laminated task list of how to do homework. Others will need you to sit with them and walk them through setting up and focusing on the whole task. Offer them a short break between subjects until all the work is done. You can help them think about how to think when you offer them time to process.
5. Spotlight their strengths.
Let’s face it – a child with learning challenges and behavior struggles often gets more negative attention than positive. Try instead to adopt a strengths-based approach for your grandchild with prenatal substance exposure or Fetal Alcohol Spectrum Disorder.
Of course, you should consistently continue your calm, matter-of-fact structures to support their struggles. However, when you notice an accomplishment or see a character trait you admire, shine that spotlight for all it’s worth! You can take it up a notch by providing extra opportunities for those strengths to grow and blossom.
For example, your niece loves animals and is a gentle, nurturing soul. You’ve just heard that the local animal shelter needs sheets, towels, and volunteers to exercise the puppies. That sounds like a win-win! Help her make flyers asking friends and family to donate used towels and sheets. Schedule her to serve once a week at the shelter. Maybe even join her in the fun. You can both have fun and learn a lot by helping the puppies burn off their energy.
6. Set them up for success.
This child will benefit from predictability, structure and consistency. Please support them with a daily schedule, whether in picture form, a checklist, or an app on their phones. When you must change the routine, give them plenty of time and space to process and prepare for the transitions.
If they are always trying to figure out their space or routine, they might respond with challenging behaviors. Keep your physical spaces at home predictable and practical. Clutter-free zones help reduce distractions and sense of inner chaos. Being able to move easily in their spaces and find what they need brings comfort and confidence in their abilities to manage their day.
7. Teach and model self-regulation.
Big moods and big feelings are common for kids with prenatal substance exposure or with FASD. They need help learning how to regulate – and they need to see you practicing it too. This is another situation where reliable phrases you repeat often can be helpful. You can narrate your own emotional state and practice with them.
For example, “I am feeling angry that the clerk overcharged me for this shirt. My face feels hot, and my hands are shaking. I need to take a few deep breaths and plan what to say when I return to the store. I’m going to practice asking nicely for a refund.” Have them be the clerk, and you can role-play the refund process. Try switching roles. Have fun with it, and then talk about what “angry” feels like for your child.
And…
When you see this child’s big emotions rising, be present and offer a choice of the tools you’ve practiced in the past: “I can see you are feeling really frustrated with your brother right now. I’m going to sit with you and help you calm down. Would you rather we do deep breathes or push-ups to calm down?”
8. Make self-care a priority.
The extra effort and intention of learning new tools to support a child with FASD or prenatal substance exposure can be challenging for caregivers. You might feel extra stress or anxiety about meeting this child’s needs. Be intentional to take care of yourself with the same purpose that you are spending on supporting this loved one.
Maintain a regular schedule of doctor appointments, counseling sessions, and other supports that keep you functioning. Take time each day to refresh yourself – even if it’s only 15 minutes to stretch, meditate, or journal. Find small acts every day that refresh you. Plan for more significant events or activities that refuel you, such as a retreat for caregivers or a weekly book club.
If you are married or in a committed partnership, prioritize your relationship with time and attention as regularly as you can manage. If you don’t already have a circle of friends or family who can support you with childcare help, please consider how to create that for yourselves.
Success is Attainable!
As you raise this child, remember that they can achieve their dreams and goals even through their challenges. When you return them to their home or launch them to young adulthood from your meaningful safe presence and practical lessons, they gain the confidence to shine. They can go on to thrive wherever life takes them, in their unique and beautiful way, because they know you’ve got their backs and will support them on the way.