Ages and Stages of Development

In children with FASD

© 2007 NOFAS Connecticut

Early Childhood (Birth to Age 5)

• Sometimes medically fragile
• Often have speech, language and/or fine and gross motor delays
• Extreme tactile sensitivity or insensitivity (sensory integration and/or modulation)
• Limited ability for abstract thinking
• Poor or inconsistent memory
• Usually require high maintenance, keeping parents alert and on duty 24 hours a day
• Extremely distractible, maybe be hyperactive
• Often exhausted and irritable from uneven sleep patterns
• Highly manipulative
• Danger to self and others due to difficulty understanding cause and effect
• Void of the normal sequential learning abilities in reasoning, judgment and memory
• Very difficult to manage when out in public
• No natural fear of danger, e.g., lacking in the normal abilities to distinguish between friend and  enemy
• Misunderstood by service providers because their IQ’s appear to be developing normally

Elementary Years (Ages 6 to 12)

• Can have normal IQ (or borderline, or high) but acts very immature
• Overlooked as permanently disabled because their IQ’s are normal
• School becoming increasingly difficult
• Language deficits (receptive/expressive, social language)
• Information processing deficits
• Extremely distractible, sometimes hyperactive
• May have behavior or emotional disorder
• Difficulty with abstract concepts (time and money)
• Impulsive, unpredictable and mischievous, creating ongoing safety hazards, such as setting fires and running away
• Often exhausted and irritable from uneven sleep patterns
• Extreme tactile sensitivity or insensitivity (sensory integration or modulation)
• Innately skilled in manipulative tactics
• Void of normal sense of justice
• Blames others for all problems
• Perseveration problems (repetitive thoughts, persistent repetition of verbal or motor response)
• Desperate for stimulation and excitement to keep them entertained and happy
• Emotionally volatile and often exhibit wide mood swings throughout the day
• Often disconnected from their own feelings and are unable to identify or express logical reasons behind their volatile outbursts
• Impaired social skills  
• Isolated and lonely because the desire to be included can remain intact while the reasoning skill to figure out why they are excluded is lacking
• Angry and resentful toward more structure and supervision than their peers need
• Void of natural empathy for others

Adolescent Years (13 to 18)

• Moral chameleons (despite consistent loving care, family values and even general rules of social behavior are not being internalized)
• No personal or property boundaries
• Naïve, suggestible, a follower
• Poor judgment, reasoning, memory
• Difficulties with school continue, at risk for school failure
• Language deficits, information processing deficits, complex learning disabilities
• Difficulty with abstract concepts (time and money----may be able to “tell time” but has no “sense” of time, difficulty (often extreme) managing money
• Often exhausted and irritable from uneven sleep pattern
• At high risk for being drawn into anti-social behavior: stealing, lying, running away, etc.
• Continuing to be a safety menace to themselves and others
• Still in need of limits and protection like a three year old
• Often obsessed by primal impulses such as sexual activity and fire setting
• Able to recognize and will submit to raw power, making them vulnerable to gangs.
• Seriously impaired when it comes to making decisions (not having the judgment or reasoning skills to make decisions)
• Terrified of major transition or change, e.g., middle school, moving, etc.
• Extremely vulnerable to ideas in movies, videos, music, TV and advertisements
• Unaware of normal hygiene needs
• Unable to take responsibility for their actions                                      

Adults (18 years and over)

• Moral chameleons
• Often exhausted and irritable from uneven sleep patterns
• Extremely vulnerable to anti-social behavior and at great risk for finding the structure and supervision they need in the criminal justice system
• Unlikely to follow safety rules concerning fire hazards, safe meal preparation, vehicle operation, infectious diseases, basic life needs, etc.
• Notably lacking in the ability to manage money
• Volatile if pushed too far to do something they see as unreasonable, such as asking them for money to pay their rent or groceries.
• Quite vulnerable to co-dependent relationships, which can turn violent
• Incapable of taking daily medication or birth control pills on a regular and effective basis
• Vulnerable to panic attacks, depression, suicide ideation, mental and emotional overload, and sometimes psychotic breaks
• Very impaired as to entertaining themselves and keeping out of mischief
• Not nearly as capable as they appear to be
• In desperate need of appropriate sheltered employment opportunities

Note: These characteristics may appear to be typical behavior in a normal person, but in individuals who have been disabled by prenatal exposure to alcohol, these traits occur in grossly exaggerated form and do not respond to typical interventions.

Adapted from the ARC Northland, Duluth, MN and the FAS Family Resource Institute