Managing hyperactivity, having sleepless nights, breaking up fights, and visiting the principal’s office are all a part of the deal when caring for a child with Fetal Alcohol Spectrum Disorder (FASD). Foster or adoptive parents may feel hopeless, overwhelmed, or like a bad parent, and these feelings are not uncommon. However, nothing could be further from the truth. The fact that you are reading this article and reaching out for help is proof positive that you care. Fetal Alcohol Syndrome (FAS) affects between one and three of every 1,000 babies born and is the leading preventable cause of mental developmental delay in the U.S. The fact that FASD is a lifelong disease may not be very encouraging, but don’t lose hope!


Simply put, FASD is caused when a woman drinks alcohol while pregnant. Whether it’s wine, beer, vodka, or champagne, the alcohol makes its way down to the baby. The alcohol has a detrimental effect on the unborn baby. It causes birth defects that are irreversible. The more alcohol or the stronger the alcohol the woman drinks, the worse the effects.


One way to determine whether your child has FASD is by his or her physical characteristics. Children with FASD may have eyes that are far apart and appear to have small eye openings. Their heads might appear smaller. They may have a smooth philtrum (which is the divot or groove between the nose and upper lip) and a smooth upper lip. These children may also be smaller in development than their peers. Many foster children are smaller to begin with due to a lack of healthy nutrition or a lack of a healthy environment. While any one of these things alone may not be a cause for concern, all these traits taken together may be evidence of FASD. You should consult with your doctor. Please note that these traits are not universal for every child with FASD. But if they are present, your doctor should be able to easily diagnose it.


One of the biggest frustrations for foster and adoptive parents of children with FASD is responding to their behaviors. The biggest behavior is a seeming lack of conscience. Things that would appall or scare an unaffected child has the opposite effect on a child with FASD. For example, laughing at a horror movie on TV, having no compassion when a friend or sibling gets hurt, or not feeling remorse when hitting a peer are not uncommon. Stealing or lying comes naturally to many kids with FASD. Teaching the child right from wrong may be exhausting because it seems like they have no moral center. That may also be environmental, especially if they are foster children or adopted children that spent any amount of time in orphanage care. But in the case of a child with FASD, it is more biochemical than anything.

Another behavior is aggression. Children with FASD are usually more aggressive than their peers. They are quicker to lash out in anger. They are more easily frustrated and more prone to meltdowns. Fights and bullying are not uncommon. Ending up in the principal’s office more than once per year should be expected. This can be incredibly frustrating to foster/adoptive parents who thought they would be protecting their child from the class bully, not raising the class bully.

Lying is a behavior that may shock well-meaning foster and adoptive parents. But for many kids in care, not just kids with FASD, lying is a way of life. What parents need to determine is, is this lying “crazy lying,” or is it “survival” lying? Crazy lying is when a child makes up stories about her birth family or past, like how they visited Disneyland every week or how she met the President personally. That may be attention-getting behavior. Survival lying is when the child knows she has done something that is not socially acceptable and is trying to protect herself from harm. Would you ever harm her? Of course not. But her previous caregivers may have. It might take months or years to gain her trust. Parents will do well to assure these kiddos that they will not get into trouble if they tell the truth.

Impulsivity and lack of logic is a classic trait in kids with FASD. Running out into the street, taking another child’s toy out of pure curiosity, telling crude jokes, jumping off a balcony because it was the quickest way to get downstairs, or simply accepting dangerous dares from his peers is the rule of the day. The child may feel like he is the hero or the class clown but such attention easily turns negative. Some of these behaviors are purely survival-oriented. For example, the child may be stealing because he is hungry or lying to protect himself from getting into trouble. Once you, the adult, create a consistently safe space for him and provide for his every need, day in and day out, some of these behaviors should subside.

Lack of attention is not uncommon for most kids but is especially prevalent in kids with FASD. Difficulty concentrating, fidgeting, leaving work incomplete, repeated complaints of “I’m bored” is the norm in a household with an FASD child/youth. Because of this, many medical professionals may misdiagnose their behaviors as Attention Deficit Hyperactivity Disorder (ADHD). As a result, a child with FASD may be prescribed ADHD medication such as Adderall to treat the symptoms. This may or may not be effective for kids with FASD. Consultation with a number of professionals is warranted.

An additional symptom of FASD is sleeping difficulties. From difficulty falling asleep to difficulty staying asleep to night terrors, sleeping issues are a challenge with these kiddos. Melatonin is a natural supplement that aids in sleep and could help resolve these issues. However, as with all solutions, you should consult with your doctor before starting a regimen. Your local pediatrician will guide you in terms of possible side effects, interactions with other medications, and the dosage needed for your little one.

Many children with FASD have learning difficulties, delays, or disabilities. Many foster or adopted children have school Individual Education Plans (IEPs) to help them through those tough school years. An IEP is a special plan, set by the school district, that makes modifications to the learning environment for children with learning disabilities. An IEP adjusts many of the requirements in the day-to-day education of the child, such as reduced or no homework, a reduced school week, untimed tests, or reduced minimum passing grades, for example. An IEP may also recommend a teacher’s aide in the classroom or a self-contained class for the child. An IEP team may include the teacher, the teacher’s aide, the school nurse, the guidance counselor, and of course, the parent. A good IEP team should meet monthly or quarterly to discuss the child’s progress and discuss any changes that need to be made.


I would be neglectful if I didn’t mention the sense of humor many FASD children have. They are funny, goofy, love being the center of attention and love making other people laugh. However, their humor can sometimes be crude due to their determination to be more and more shocking. They don’t intend to be rude, they merely crave attention. In their need to be the class clown, they may become the focus of much negative behavior.

Other FASD kiddos are very strong-willed, seeing things a certain way and insisting other people see things their way. Being strong-willed is not necessarily a bad thing. It is our job as parents to mold our strong-will children into leaders that will one day be in charge of a Fortune 500 company rather than in charge of a biker gang!

Your child may also have an intense sense of curiosity. That’s not necessarily a bad thing. For example, a child may simply want to know how a toy works; in her curiosity, she will take that toy apart. What we see as a streak of destructiveness is really a streak of curiosity. Enhance that curiosity by turning off the TV and supplying the child with games such as puzzles, Jenga, Legos, or other hands-on toys that motivate her creative juices rather than her destructive ones.

Lastly, the older your child gets as he nears adolescence, the more you may see a victim mentality become a part of his personality. Because his actions may sometimes be viewed as antisocial, he may get in trouble a lot or be disciplined more than other kids at home and at school. After a while, he may tend to get defensive, overreacting when is name is called, or constantly yelling, “I didn’t do it!” when he feels he is getting the blame for something. “It’s not fair!” or “it’s not my fault!” are other phrases you may hear often. A victim mentality is feeling that the entire world is out to get you and no one likes you. In some respects, these children have been victims. Whether it was abuse, neglect, abandonment, or something else, your child has undergone tremendous trauma. Your child has been victimized. The goal is to model for your child how not to victimize others while enhancing his self-concept; he does not have to stay a victim for the rest of his life.


So, how can you help your little one who is suffering? First of all, a simple change in environment may work wonders! If your child was ever in an orphanage overseas, in a group home, or was neglected by his primary caregiver, that change in scenery is therapeutic in and of itself. Be patient and give change time to work its magic!

Secondly, a change in diet could be just what the doctor ordered! Many neglected children came from homes that merely had soda, chips, and foods full of artificial colors and flavors for breakfast, lunch, and dinner. Some children came from homes where they were under- or malnourished. Having three square meals a day will help a child with FASD.

Next, counseling may help a child with FASD. Be sure you find a counselor with experience with FASD. Also, interview your counselor to make sure his methodology aligns with your beliefs and value system.

Lastly, use medication as a last resort. Consult with your doctor regarding natural supplements before you start a regimen of intense medications that are meant for adults.


Does that sound selfish? Consider this. When preparing for an airplane trip, flight attendants always give instructions on proper procedures in case of an emergency. Without fail, they give instructions to make sure you place the oxygen mask over your face before you place the oxygen mask over your child’s face. Why? Because you can’t help someone else if you can’t breathe yourself! The same logic applies in child-rearing, especially when caring for kids with FASD. You can’t care for a special needs child when you are in crisis! What should you do?

First, get counseling for yourself. Counseling is no longer a stigma. It is simply talking through some of the issues that come with caring for a special needs child. In many states, if a child is a ward of the state, the caregiver may be eligible for counseling as well as the child. Take advantage of it!

Another source of strength you can tap into is support groups. Sometimes foster or adoptive parents feel isolated. Yes, it is good to be alone at times to just recharge your batteries. But isolation is not good! Sharing common challenges and joys with other foster and adoptive parents, or parents of special needs children works wonders. The feeling that “I’m not alone” works wonders. It is not good for man to be alone. Search for an appropriate support group in your area.

Lastly, request respite! Respite is a short time away from your child to take a break. Whether it’s hiring a babysitter for a couple of hours for a date night, an overnight trip, or it’s something that has to be done every weekend, use this time to get a better perspective, to catch up with an old friend, or simply to sleep. You cannot give to a special needs child with FASD if you have nothing to give.

Living with FASD is not a death sentence. With patient, supportive families, these children can be very productive members of society! Do not be disappointed if this is your first experience caring for a child with FASD. Surround yourself with experienced, positive people who will support you and not judge you. Take advantage of the opportunity to nudge that child in the right direction and help him to reach his full potential!

Derek Williams is an adoption social worker and has been in the field of child welfare and behavioral health since 2006, where he has assisted families in their adoption journey. He and his wife started their adoption journey in 1993 and have 8 children: 6 of which are adopted. His adoption children are all different ethnicities including East Indian, Jamaican, and Native American. He loves traveling with his family, especially to the East Coast and to the West Coast and is an avid NY Mets fan! Foster care and adoption is a passion and calling for Derek, and he is pleased to share his experiences with others who are like-minded.