Interventions That Work in 2008
From the FASD Wisdom of Practice
Reprinted from FAS Times, Spring 2008
By Jocie DeVries
Before any program or service can be successful, FASD must be diagnosed or at least acknowledged as highly likely and then taken into account as modifications are made. Assessments need to be made as to whether or not more than one “T” issue is involved.
1. Traumatized Teens with FASD
When a youth has problems that severely interfere with daily life or they repeatedly display disruptive behavior without any obvious predatory intent, a complete mental health evaluation needs to be made to determine the cause of the presenting issues, whether it be abandonment, current or past abuse, and/or some other trauma. Standard approaches to healing these memories may work. Some parents report excellent results with alternative/complimentary approaches that work through the subconscious.
2. Tipsy Teens with FASD
Outpatient treatment programs may work for a few teens with substance abuse problems, as long as they are cognitively able to understand it and willing to cooperate with changes in their environments, activities and friends that have contributed to the situation. If not, or if withdrawal is a concern, inpatient treatment program may be necessary. Either way, long term supports, like supervision and accountability will be needed. 12-Step programs can be helpful, if they connect with a trained mentor.
3. Truant Teens with FASD
Diversion programs can be very effective with realistic requirements, good supervision and accountability, with the understanding that if they violate the terms, they will go to jail for a few days. If school truancy is involved, then their academic and school-based social issues also need to be addressed. Many times the reason teens with FASD fail in school is more social/behavioral than academic.
4. Troubled Teens with FASD
When co-occurring mental health disorders are suspected, we recommend a full neuropsych evaluation, done by a neuropsychologist who understands FASD. Follow-up therapy can be provided by any mental health professional who understands FASD and co-occurring disorders. It works best when professionals gather information from and consult with the family in this process. Based on the evaluation and consultation results, professionals can recommend the type and length of medical treatment and/or psychiatric therapy with specific timelines and goals, not to just “stabilize them” and send them home with more medications and no behavioral supports.
5. Treacherous Teens with FASD
Since violence and predatory behavior are not core FASD traits, if this type of pattern exists, a secured facility will be needed to keep themselves and others safe until the co-occurring disorders can be addressed and treated. The most important things to remember are (1) just because they are violent at this time, it doesn’t automatically mean they can’t change with appropriate treatment and (2) it is critical that a family member or someone continues to love them through this process. Unconditional love makes miracles possible!
Riding the Wave of FAS Awareness
By Delinda McCann
Last weekend my family went to the ocean. On the only sunny afternoon we sat on the beach and watched the surfers. I noticed they rode in front of the crest of the wave. As I watched I thought about my life and realized that much of my angst has come from surfing the wave of FAS.
I was raising my daughter before there were parent support groups. She was 15 before Ann Streisguth invited parents to a conference about FAS for the first time. She is a settled adult now with issues that most of the parents I know are not yet facing. The side of this coin that I keep forgetting is that I am a wee bit older than most of my friends who are raising kids and young adults with FAS. I am surfing the wave of knowledge about parents my age with middle aged kids with FAS. (Hint: If you thought FAS with puberty was bad…FAS with menopause is coming.)
This age thing is one of the reasons I love Linda LaFever who is a couple years older than me and Jocie DeVries who is some months older. . It was at Jocie’s “no more chemo” party that the shock of surfing that wave hit me. Linda mentioned something about her stay in the hospital when she stopped breathing. This was Jocie’s party so I was really really downplaying the fact that this was my first trip away from home after having a stroke.
Hey! We are not that old! We sound like a group of octogenarians. We are not ready to retire yet. It will be years before I am eligible for Social Security.* What is going on here?
I found part of my answer to what is happening to me in the office of my stress management doc. The first step in my stress management program was a lesson in biofeedback. For those unfamiliar with biofeedback, the machinery is similar to a complicated computerized polygraph. I was supposed to try to lower the little green lines on the computer monitor by relaxing. I was actually pretty good at this exercise. I kept working at relaxing and the lines went lower.
The doc asked me about my gardens and the lines went lower. I talked about my dogs, poodles, and the lines went lower. The doc asked about my daughters and the lines made a little blip then went lower as I talked about my birth daughters. Then the horrible rat of a meany doctor asked me about my foster daughter. He fully deserved what happened next. The little green lines shot straight up to the top of his monitor and his whole system crashed. Ha!
Can we say I have a huge load of stress from years of 24/7 supervision of my foster daughter with FAS? Yes, I am learning to consciously relax and my blood pressure is not nearly so volatile but it is taking huge sums of money for doctors and a challenging level of self awareness for me to gain a fragile level of health.
Looking at my experience and that of those who were raising kids the same age as mine, the topic of “Family Preservation” takes on a very fundamental meaning. Like Jocie’s and Linda’s families mine came very very close to loosing their mother.
Will the earlier support available to families today help alleviate some of the stress? I am not sure. Support is good but parents are still working 24/7. It is the constant pounding stress of thinking you have solved a problem only to find a new bigger uglier problem take its place. It is the grieving over and over for who the child could have been. It is the battering of our hopes that are raised with one success only to have them dashed again and again by this disability and the wall of ignorance and discrimination our kids face.
My question is whether or not we can intervene at this fundamental level of family preservation so that parents raising children with FAS can live out their full lives with some level of health. What will this intervention involve? Perhaps some research to document that what I am seeing is real. It will involve the collective family experience in finding interventions that work to relieve stress while keeping your eyes on your teenager. Ugh.
It will involve documenting realistic expectations so we do not have our hopes destroyed over and over. It will take community education and awareness to eliminate the barriers of ignorance and prejudice. I think together we can preserve our families at this most basic level. I at least am willing to take on the challenge as long as I can take breaks for my breathing expercises.
*Okay maybe I exagerated a bit on how long it is before I’m eligible for Social Security,