Over 1 million babies born annually in the United States are exposed to some type of drug, alcohol or tobacco use while in utero. While scientists have long espoused the negative impacts of substance use during pregnancy on infants, a 2008 study found that cocaine, alcohol, marijuana, or tobacco use, either alone or in combination, can have effects on the brain structure that persist into early adolescence.

For those babies exposed to alcohol consumption in utero, studies have shown devastating impacts academically, behaviorally, socially, and emotionally for adolescents. A 2017 study found that alcohol-exposed children performed significantly worse than their peers in all academic areas, with particular weaknesses in mathematics performance. A 2016 study discovered that adolescents with fetal alcohol spectrum disorders struggle with both internalizing behaviors such as anxiety and depression and externalizing behavior such as aggression and delinquency. Another study in 2014 found that those with FASD also experience negative physical impacts such as higher rates of weight gain and obesity.

Despite these challenges, there is growing evidence that early detection of Fetal Alcohol Syndrome and positive environmental factors such as a stable and nurturing environment can help individuals escape social and relationship problems later on in life. The associated challenges of FAS and the possibility of mitigating these challenges with knowledge and interventions presents a strong case for learning about how FAS can impact teenagers and what strategies parents can use to help their child gain independence and be successful.

What is Fetal Alcohol Syndrome?

Research has shown that alcohol exposure during pregnancy has a more powerful impact on the fetus than any other drug. When a pregnant woman consumes alcohol, the blood alcohol level of the developing child reaches the same concentration as her own. Anything that is being developed at the time of alcohol consumption is at risk for damage, and since the brain is developing throughout a pregnancy, brain functioning is at the highest risk for being affected. How much a child is affected depends on the level of drinking, the fetus’s resistance, and when alcohol exposure occurs.

The resulting effect from alcohol exposure during pregnancy is referred to as Fetal Alcohol Spectrum Disorders (FASD). FASD includes all of the effects that are related to prenatal exposure to alcohol and includes the medical diagnosis of Fetal Alcohol Syndrome, which is a birth defect syndrome. In order to make a medical diagnosis of FAS the following symptoms must be present:

1. Pre- and/or postnatal growth retardation – this can include weight, length, or head circumference below the 10th percentile for gestational age

2. Evidence of central nervous system involvement – this can include signs of neurological abnormality, developmental delay, or intellectual impairment

3. Facial dysmorphology – at least 3 of the following need to be present: head circumference below 3rd percentile, short eye openings, vertical groove between upper lip and nose, thin upper lip, or flattening of the midface

4. History of maternal drinking during pregnancy

Children with FAS can experience a range of challenges both physical and mental that can carry over into adolescence and impact their ability to function in daily life.

Common struggles for teens with Fetal Alcohol Syndrome

Teens can experience myriad challenges associated with Fetal Alcohol Syndrome during their adolescent years including problems with executive functioning, memory, social cues, risk taking, behavior, and attachment.

Executive functioning refers to the cognitive functions in our brain that are used to plan ahead and behave appropriately when trying to reach a goal. Executive functioning also impacts skills such as self-motivation, organizing thoughts, setting priorities, suppressing impulses, and the ability to weigh the consequences of our decisions and actions. Teenagers are already predisposed to making risky decisions, and this is exacerbated for those who have deficits related to cognitive and emotion-based functions due to FAS. They struggle to weigh the pros and cons of decision-making and can miscalculate the odds of having successful outcomes, resulting in harm to themselves or others.

Impairment of the hippocampus also frequently occurs in adolescents with FAS and this impacts a teen’s memory. Much of the time, memory struggles occur in the short-term memory, which can make it hard for adolescents to keep a train of thought or stay on task with school and homework assignments. Forgetfulness can also lead to some behavioral issues if teens struggle to remember rules and consequences.

An important part of being a teenager is social interaction with peers, and teens with FAS can struggle to respond properly to others due to amygdala and frontal lobe impairment. These parts of the brain teach us how to read facial expressions and social cues and respond appropriately. For example a teen with FAS may misunderstand an expression of fear as anger or hostility, or misunderstand a friendly conversation as flirting. These misinterpretations of emotions can lead teens with FAS to have inappropriate reactions or exchanges with others and can hinder further social development. Adolescents with FAS can also have difficulty creating healthy bonds and attachment. Many teens tend to create social attachments very quickly and just as quickly break them.

For teens struggling with FAS there are many interventions and strategies parents can put into place to help their teens on their path toward independence.

Strategies for helping teens with Fetal Alcohol Syndrome gain independence and be successful

All adolescents with FAS are struggling with a unique set of challenges and rather than trying to make a teen behave, it can be helpful to focus on utilizing strategies and setting up situations so these teens have the best chance of success. Repetition, rehearsal, and practice of appropriate behaviors can help teens through daily living, social, and self-care skills.

Research shows that teens with FAS do best with rule governed behavior meaning they need explicit rules about behavior that are reinforced with repeating, reteaching, and visually demonstrating to help keep them on track. Parents can provide specific support in numerous areas such as sexuality, education, social skills, and transition to adulthood.

Conversations around sexuality can be difficult for all parents and teens, but especially for those with FAS. Teens with FAS often have the same needs, desires, and pressures as neurotypical teens, but they can lack the coping skills needed to deal with these changes. In particular, developmental delays combined with hormonal urges can result in inappropriate sexual behavior. In order to prevent these occurrences and promote healthy sexuality, parents need to provide concrete information about responsible relationships, reproduction, sexuality, and values. Engaging in repetitive conversations with concrete examples of appropriate interactions and practicing possible scenarios are great ways to help your child with this type of development.

To help teens thrive in school environments, work with your teen’s school to undergo realistic assessments of your child’s abilities and styles of learning to see how they can fit within the school system. Communicate with teachers to gather as much information as possible about your child’s academic and learning history so you can better assist them at home with school work. If you feel more support is needed, request a special education evaluation and an individualized education plan that specifies in writing what services will be provided, and then schedule regular follow ups to make sure the accommodations are being followed.

Adolescence is a period of wanting to spend with friends and engage in social activities, and parents can help their teens through perceptual and judgment problems that can interfere with successful social interactions. You can start with teaching your children as soon as possible basic skills about how to relate to others such as how to start a conversation and how to disagree with someone appropriately, remembering repetition of these skills is key. It can also help to discuss with adolescents how to cope with the world around them when not everyone is kind to them, what strategies they can put in place to protect themselves, and how to select positive role models as friends.

Lastly, parents can help their teens with FAS prepare for the transition into adulthood. This may look different than with neurotypical teens and may extend later into life, with research showing a realistic timeline of 25-30 years of age. Parents can help with this transition by working with their teen to develop both internal and external skills and resources. To develop internal adult skills, practice hygiene, cooking, and cleaning skills with repetition. To find external resources for support, help your teen identify job training programs, transitional housing, and recreational activities.

If your teen is struggling with FAS and needs additional support, New Focus Academy can provide him the care he needs to work toward independence

How New Focus Academy can support your teen

New Focus Academy is a therapeutic residential program with academic support for adolescent boys ages 12-18. We specialize in helping students with a variety of cognitive, social, and emotional struggles including FAS that affect their ability to manage their interpersonal and daily life. Our mission is to use positive reinforcement to increase our students’ self esteem and independence.

We meet with students and their families to identify each child’s unique needs and abilities and then create a plan with evidence-based techniques to help students utilize their strengths in addressing their challenges. We help teens discover how their distinctive gifts can be used to build skills and develop a purpose-filled life. Our ultimate goal for each student at New Focus is gaining independence and our dedicated team empowers each student to develop important life skills that help build confidence and motivation for lifelong growth. Call (435) 383-4369 for more information on how New Focus Academy can help.

• FAS
• Fetal Alcohol Syndrome