FEAR: FASD Interactions with Authorities

By Ann Yurcek, guest editor

“What if society doesn’t understand them?”

(That’s where we come in as their biggest advocates)

Caregivers of individuals with Fetal Alcohol Spectrum Disorder (FASD) often face significant concerns regarding interactions with professionals and people in authority. These concerns are rooted in the cognitive and behavioral challenges associated with FASD, which can lead to difficulties understanding and responding to authority figures.

Challenges Faced by Individuals with FASD

• Memory and Cognitive Deficits: Individuals with FASD often experience memory lapses and difficulty with executive functioning, which includes planning, impulse control, and understanding the consequences of actions. This can make it challenging for them to follow instructions or understand complex situations presented by professionals and increase the need to confabulate and fill in the memory gaps without understanding the consequences for themselves and the effect on others.
• Vulnerability to Influence: People with FASD are highly suggestible and can be easily influenced by others, including professionals and peers. This suggestibility can lead to compliance with requests or demands without fully understanding the implications, increasing the risk of victimization or involvement in inappropriate or illegal activities.
• Fear of Authority: The combination of cognitive challenges and past negative experiences can lead to a fear of authority figures. Individuals with FASD may have difficulty interpreting social cues and understanding the intentions of others, which can exacerbate anxiety in interactions with professionals. Adding in the auditory processing disorders, which is a challenge for the majority of those with FASD, causes huge challenges with questioning and not being able to understand even what is being said.

Concerns for Caregivers

Caregivers worry about the potential for adverse interactions with authority figures due to these vulnerabilities.

• They may fear their loved ones being unfairly judged or misunderstood, leading to legal issues or victimization.
• The risk of their loved ones being manipulated or coerced into actions that have serious consequences is a significant concern. 
• Questioning about home situations and care can often be misinterpreted due to concrete language and the individual with FASD wanting to please the authorities or to get out of the situation by agreeing with whatever they say. 
• Our kids with FASD want to please, and some will want to escape the situation by pleasing the interviewer, which can have significant ramifications for the family.
• Social service investigations, removal of the child during investigations, and abuse and neglect charges are real fears faced by caregivers.

Strategies for Caregivers

• Advocacy and Education: Caregivers can advocate for their loved ones by educating professionals about FASD and the specific needs of individuals affected by it. This includes explaining the cognitive and behavioral challenges, suggesting clear and concrete communication strategies, and educating about confabulation and memory lapses. 
• Support Networks: Engaging with support networks, such as other families dealing with FASD, can provide caregivers with strategies and resources to better manage interactions with professionals. These networks can also offer emotional support and practical advice.  Keeping a day-to-day chronological notebook about key events can be protective. Make sure you know your rights in these situations and have documentation of FASD and confabulation for the interviewer.
• Preparation and Role-Playing: Having a card in their wallet or on their phone that they can share with interactions with professionals.  Explain FASD and ask to call for someone before questioning. Preparing individuals with FASD for interactions with authority figures through role-playing and rehearsing scenarios can help them navigate these situations more effectively. This preparation can include teaching them to appropriately recognize and respond to different social cues and authority figures.

Real-life example: With one of my children with FASD, when stressed, he’d go to school and tell the school that there was no food in the house.  He would not eat anything we put before him and then steal food instead of eat meals with the family.  He wanted McDonalds instead of dinner.  And he would go to school and say we refused to feed him dinner.  We made a plate for each meal, and he would get up in the night and eat it. He would eat all the other kids’ packed lunches or special diet foods and say we were starving him.  He had limited access to food during his first three years, and when school was hard and causing him stress, he began allegations. Drawings showed that he and his brother had been eating grass to fill their empty stomachs. When his older brother filled us in on what they experienced, it was painful.   With his caseworker, his therapist, and the counselor, we added to his IEP that he had a history of allegations.  Before reporting to child services, the school would call the house or caseworker for a chance to explain or investigate what happened. The principal called the house, and I put the PCA on the phone. She explained that the boy was offered food, but he refused, and the plate was empty in the morning, and we had found 13 boxes of empty cereal in his room this week when cleaning.  No CPS investigation, we could, as a team, figure out what was the trigger that may be bothering him, and the school quit giving him control over Mom.

By understanding these challenges and employing supportive strategies, caregivers can help mitigate the fear and potential negative consequences of interactions with professionals and authority figures for their loved ones with FASD.