In the first part of this series, Fetal Alcohol Spectrum Disorders (FASD) 101, we explore what FASD is, how it’s diagnosed (and misdiagnosed), and how it affects learning, behavior, and development. As we explain in that article, FASD is often misunderstood or overlooked, and many children go without consistent recognition or appropriate supports for their disability. This lack of understanding can compound challenges over time, especially when expectations don’t match a child’s neurological needs.
Beyond understanding the diagnosis itself comes the real day-to-day work: supporting your child at home and at school, making sense of brain-based differences, and advocating for an FASD-informed IEP that helps them succeed.
To learn more about supporting children with FASD, we spoke with Roxanne Chang, MD, pediatrician at Harbor-UCLA Medical Center and assistant clinical professor at David Geffen School of Medicine at UCLA; Kelly Rain Collin, EdM, educational consultant and founder and director of Healthy Minds Consulting; Nate Sheets, behavior consultant specializing in FASD and author of Essential FASD Supports; Shannon Iacobacci, MPsych, FASD specialist, non-attorney special education consultant, founder of Embracing the Brain, and parent advocate; and Eileen Devine, LCSW, therapist, parent coach, consultant, and trainer.
Supporting a child with FASD is so important, and it can also feel incredibly hard when schools don’t fully understand brain-based differences or aren’t sure how FASD fits into special education categories.
To recap from FASD 101, brain-based differences refer to differences in how the brain developed during pregnancy — meaning any diagnosis connected to how the brain is structured or functions. FASD is a physical disability because it’s a brain-based disability and the brain is a physical organ, even if it’s “hidden,” Collin tells us. “It primarily impacts the brain, the nervous system, and any other part of the body that was developing during the time the infant was exposed to alcohol during gestation — the liver, the heart, the ears, the eyes, etc. Any part of the body can be affected, and it will vary from individual to individual, but everybody with FASD, their brain and nervous system are impacted.”
So, when an IEP is truly FASD-informed, it can be a game changer. The earlier a child’s needs are recognized and the more educators understand how FASD impacts learning and behavior, the better the long-term outcomes for that child.
While we’ve already talked about signs of FASD to look for, here are a few school- and learning-related patterns that parents often notice over time:
Now that you have a clearer picture of how FASD can show up at school, the next question is an important one: where do schools often get it wrong when creating an IEP? Collin shares some of the biggest red flags parents should watch for — and then we’ll walk through what to do when you see them and how to troubleshoot when an IEP isn’t working the way it should.
To be eligible for an IEP, a student must fall into one of 13 eligibility categories. Collin tells us that parents might find this process challenging because FASD is so misunderstood and misdiagnosed. Kids with FASD might come in with multiple health and mental health diagnoses, making finding the right category difficult.
However, “in California, we now have it listed as one of the examples under OHI, under Other Health Impairment,” Collin says. This is due to California Education Code 56332, effective January 2023. And federally, while FASD is not language used specifically in the law, it can fall under the umbrella of IDEA’s eligibility category of Other Health Impairment (OHI): “In general, the federal law actually supports that, and it’s not written into the law, but it’s in the regulations and the discussion around the regulations,” Collin says.
For help crafting a letter requesting an FASD-specific special education assessment, Collin and her team have created this template for parents.
Because FASD is so complex and can potentially impact all bodily systems, evaluations should be done by informed assessors who know what to look for and how to interpret the results. Here are some areas of suspected need that assessments should look at:
Dr. Chang explains that assessments for kids with FASD need to go beyond what’s typically done for, say, ADHD. These kids often have learning disabilities in multiple areas. For example, struggles with visual-spatial skills can make things like math especially hard. Their executive functioning challenges can look like ADHD — but are often more intense — and while medication may help, it’s never the whole solution. These kids need lots of “external brain” support: help with organization, planning, and getting through the day.
“It’s really looking at: where is this child struggling?” she says.
She also emphasizes that assessments should look at the whole child, including sensory processing, visual-motor skills, and how the child functions in real environments. Occupational therapy should be part of the evaluation, and if behavior is a concern, schools should use functional behavioral assessments that dig deeper than surface-level explanations like “avoids unpreferred task” The goal is to understand why the behavior is happening and to build a behavior plan that focuses on co-regulation, accommodations, and support — not on punishment, and that does not place regulation responsibilities entirely on the child. punishment.
Collin tells us that one of the unique pieces for FASD that’s really common is receptive language being more impacted than expressive language. “The students will talk well. They seem like they’re able to converse fine. And so it typically gets missed. But the receptive language — their ability to interpret the language that they’re pulling in through their ears — is often a much bigger challenge for these students.”
As kids get older and approach transition age, Dr. Chang recommends planning early and using multiple systems of support, which in California would include the school district, the Regional Center, and the California Department of Rehabilitation. Many kids with FASD are very verbal, social, and motivated to connect with others, so supported work experiences, internships, and job coaching can be a great fit during the transition to adulthood, she says.
Key parent tip: pay close attention to scattered results in assessments
Iacobacci reminds parents that uneven test scores — where a child does really well in one area and struggles a lot in another — are a core part of the FASD profile and should never be brushed off. Unfortunately, in many IEP evaluations, this kind of “scatter” is often dismissed as inconsistency or test error.
But those outliers actually tell an important story. They show which parts of your child’s brain are working well and which areas need more support. For kids with FASD, scattered data isn’t a problem to ignore — it’s a clue. When schools pay attention to it, assessments become more accurate and IEPs become more helpful.
We explore everything behavior in our main article, Fetal Alcohol Spectrum Disorders (FASD) 101, so head there to get the basics. Now, let’s turn toward how behavior could be addressed at school and in the IEP. Iacobacci tells us that a functional behavioral assessment (FBA) is very important when there are behavioral challenges, but it is so crucial that the individual doing the FBA looks at those patterns of behavior through a brain-based lens and not solely through a behavior lens.
“Typically, FBAs utilize the ABA approach, but we need to look deeper than that. And so it’s really important that it’s extremely objective and that it’s about the brain function versus the rewards or the consequences. . . . And an FASD-informed BCBA (board-certified behavior analyst) would be very helpful,” she says.
Collin agrees, telling us that many school behavior plans are based on the ABC (antecedent, behavior, consequence) model, which comes from behaviorism. While behavior specialists are supposed to consider underlying medical and brain-based needs, that part often gets mentioned in reports but not truly used in the analysis, from Collin’s experience. That means the plan misses the most important piece: how a child’s disability is actually affecting their behavior and responses. “There’s frequently a lack of translation of, ‘Hey, there’s this underlying disability. What does that mean with regard to how this student is functioning? Why do they react to certain things?’ The type of response that they have to certain interventions — why are some working and why are some not?”
Sheets explains that FBAs can look very different from school to school and they are highly subjective. In most FBAs, behaviors are usually labeled as being a “function” of one of four things:
To make them more useful for kids with FASD, he’s adapted the traditional “functions of behavior” to better reflect what’s really going on for these kids. His list includes FASD/trauma -informed behavior functions that he filters through as he assesses a child’s behaviors:
Other “functions” of a child’s behavior could include:
Dr. Chang tells us, “This is where we end up doing a lot of advocacy at the schools: the behavior intervention plan (BIP). They must understand co-regulation and how to do accommodations in the classroom to scaffold that child and set them up for success, rather than behavior-consequence, behavior-consequence,” she explains.
When you’re looking at your child’s evaluation, ask yourself (and the team):
Now, let’s get into all the supports that can help our children at school. Collin tells us that one of the biggest components of IEPs for students with FASD is accommodations. “We make accommodations to support that physical disability, that brain-based disability, and adjust the environment as much as possible,” she explains.
Flexible but specific accommodations
One of the most important things to understand about FASD is that learning isn’t consistent, and that’s not a child’s fault, so flexible goals and accommodations are a great way to support them. Collin tells us that instead of requiring a skill to be shown “eight out of ten times,” teams should look for evidence that the child has learned the concept, even if they can’t show it consistently. She explains more about this:
Iacobacci reminds parents that executive functioning challenges are very common in FASD, along with memory, learning, sensory processing, and adaptive skills. These differences are a big reason why learning can look so inconsistent from day to day. For example, a child might fully understand something early in the week, but by the time a test or an assignment comes, that information just isn’t accessible anymore. As Iacobacci explains, “They knew it on Tuesday, but they didn’t know it on Friday.” The same thing can happen with social skills; a child may handle an interaction well one day and struggle with it the next.
This is where generalization becomes difficult. Kids with FASD often need more support on “off” days, even if they did the same task successfully a few days prior. Iacobacci points out how important it is for adults to respond with support instead of frustration. She also emphasizes that repetition and scaffolding are essential. Kids may need directions repeated, help starting a task, or support finishing it — not because they aren’t capable, but because their brains need extra structure to access what they know.
And finally, Iacobacci highlights why accommodations must be specific and individualized: “Common interventions or common supports are not usually effective. Saying preferential seating — what does that look like? It’s not necessarily in front of the teacher. It could be that the teacher sounds super loud to me, and I need to actually sit toward the back because otherwise I think they’re yelling.” The key takeaway is that the accommodations need to be very specific instead of a general “preferential seating,” because there’s too much left to interpretation.
Collin agrees, adding that one of the big things with FASD is looking at the root causes that need to be addressed. “What are the brain processes that this student needs in order to do this math problem effectively or to be able to read this text effectively or comprehend it effectively? They are not able to do those brain processes effectively because of the way that their brain has developed and the unique ways that the connections are made. Neuronal connections are different — many of them don’t exist the way they should, or they’re confused and attached differently. They have fewer connections. And so, the more we can understand how they think and what processes are effective for them and which processes are not, then the more we can tailor their educational supports to those needs,” she tells us.
Here are some examples of accommodations from our experts.
Give kids time to think
We’ve mentioned this one before, but it’s important to address it in the IEP as well as at home. As Sheets explains, this could look like, “Adults will give John two minutes to think.” If there’s a behavior plan for the child, there could be something similar: that adults are not going to respond if the child is oppositional. Instead, they will give the child two or three minutes to be oppositional without trying to address it, to see if the child processes what is going on and whether or not they want to move forward. Overtime we want to track if there is a benefit to this.
Shorter school days
“If a kid can’t handle six hours at school, let’s try them on two, if that works for the family and their situation,” Sheets says. “A lot of people are resistant to doing that, but oftentimes when a kid is really struggling at school, that’s the first thing I’m looking at. For some kids, difficulties may be less about what the adults are doing and more that, as soon as they step into the school, their nervous system is feeling unsafe. So even if the adults are very kind and supportive, we might have to start slow and short, eventually build up just to make sure that they can actually do the learning and the regulation that we want them to do.”
Reminders for regulation from teachers and staff
Sheets points out that many IEPs will have accommodations that include the child asking for help, such as, “The student will ask for help,” or, “The student will take a break.” These are red flags for Sheets because that assumes that the child has the skills to identify when they need help and to ask for it.
“There needs to be a reminder because, most likely, somebody’s not going to think in the middle of an escalation, ‘Oh, I have these tools that I could use right now.’ That usually isn’t how it works. So then the teachers, or whoever’s working with them, needs to be willing to have a system in place where we remind them what those options are, and then give them time and expect that they’re probably going to reject all of them instantly. Then, as time goes on, hopefully they will pick one of them and start the regulation process.”
Universal Design for Learning (UDL)
Collin explains that one of the best ways to support students with FASD is through Universal Design for Learning (UDL) because it’s built to be flexible from the start. UDL focuses on understanding how a child learns best and how they can show what they know, instead of forcing every student to learn and demonstrate knowledge in the same way.
As Collin puts it, “You’re opening up to how this individual learns and how they’re able to demonstrate what they learn — and the teaching approach accommodates all of that by default.” When UDL is used, the classroom is already set up to support different brains, different strengths, and different needs. Unfortunately, UDL is still hard to find in many schools, which is why Collin encourages parents to request it as part of their child’s IEP. For students with FASD, UDL isn’t just a nice idea, it’s often what makes learning possible. It gives them a fair way to access instruction, show their understanding, and succeed in the classroom.
Math supports
Collin tells us that almost all students with FASD struggle with math. What can supports look like? Some students might need manipulatives to help with math, others might need hands-on or kinesthetic support where they can move their bodies and interact in some ways. She shares a program called the Math Interactive Learning Experience (MILE), which is evidence-based for FASD and has a social-emotional parenting component mixed in with the math component. The creators of MILE explain this as “a collection of teaching tools and resources that provides interactive, engaging, and adaptable education for learners of all ages and neurodevelopmental diversities.”
Speech and occupational therapy
When it comes to related services for kids with FASD, speech and occupational therapy are often key supports. Collin explains that speech and language therapy is important because many kids with FASD struggle with receptive language (understanding what’s being said), pragmatic language (social communication), and generalizing concepts from one situation to another. Memory also plays a big role here. In fact, nearly all individuals with FASD have some type of memory challenge, though it can look very different from child to child.
Occupational therapy (OT) can also be incredibly helpful, especially for sensory sensitivities and executive functioning. OT can provide sensory strategies and tools that help kids stay regulated, organized, and ready to learn. That said, not every child responds to the same sensory supports, so OT needs to be individualized; what works for one child may not work for another.
For a list of more examples of supportive school interventions, check out this pdf from FASDNow!
Placement: it’s not the setting — it’s the approach
Families often find themselves trying multiple school settings and still feeling like none of them truly fit. Collin explains why kids with FASD can struggle across placements, why traditional strategies often fall short, and what a brain- and nervous system–based approach really looks like in practice at school.
All of our experts want parents to remember that, more often than not, schools are not informed about FASD. This gets harder as kids get older, which is why parent advocacy is key.
Iacobacci tells us, “Once middle school and high school comes and those supports start to leave, or there are changes in environment or expectations, then instead of supporting, they’re labeled as a behavior problem, and we’re punishing now versus supporting, and that’s very common. As the student gets older, now they’re labeled, which is unfortunate, and that’s where you have where parents have to advocate more intentionally than before, [and] it’s harder.”
Parents may also have to provide information and training to the school staff. Collin explains that that piece often falls on families who have become experts on FASD. “Sometimes it’s hard for schools to see parents as experts in an area that they’re not familiar with, and so that can be a challenge, but I think providing resources, providing recommendations for training, asking for training in IEPs is a huge piece so that the school can learn more about FASD.”
Something to note: Collin tells us that in California, FASDNow! has a training specifically designed for educators that is all about FASD and how to incorporate it into school settings. These trainings can also be done virtually anywhere, even outside of California. Get more information and share the link with your school team.
With all this in mind, here are some expert tips for parents on supporting your child with FASD.
Use the 8 Magic Keys
The 8 Magic Keys are simple, practical guidelines for supporting kids with all kinds of learning differences — especially FASD. Developed by Deb Evenson and Jan Lutke, these keys help adults create environments where kids can actually succeed, instead of constantly feeling overwhelmed. The 8 Magic Keys are:
Structure. Structure is the glue that holds everything together. When it’s missing, things fall apart. Visual schedules, checklists, routines, and clear expectations help kids with FASD function and succeed — not just sometimes, but consistently.
Concrete. Kids with FASD do best when language is clear and literal. Avoid idioms, sarcasm, or words with double meanings. Because social and emotional understanding is often younger than their age, it helps to “think younger” when giving instructions or support.
Consistency. Generalizing skills is hard for kids with FASD, so consistency matters — in routines, expectations, and even wording. When parents and teachers use the same phrases and directions, it reduces confusion and helps learning stick.
Repetition. Memory challenges are part of FASD, which means kids may forget things they already learned. This isn’t stubbornness — it’s brain-based. Re-teaching and reviewing again and again is often what helps information move into long-term memory.
Routine. Predictable routines help kids feel safe, reduce anxiety, and free up brain energy for learning. The more stable the day feels, the easier it is for your child to know what’s coming next.
Simplicity. Less really is more. Kids with FASD can get overstimulated quickly, leading to shutdown. Keep directions short, environments calm, and choices limited. Simple supports make learning possible.
Specific. Say exactly what you mean. Kids with FASD often can’t fill in the blanks or infer steps. Break down directions step by step and model what success looks like.
Supervision. Because of challenges with judgment and cause-and-effect, kids with FASD need more supervision — often similar to much younger children. Ongoing adult support helps them build safe, healthy habits over time.
And when something isn’t working? The 8 Magic Keys advises parents to stop all action, observe, listen carefully to find out where the child is stuck, and ask, “What is hard? What would help?”
Find providers who get it
Devine tells us that when working with providers, the most important thing is to ask questions so you can figure out that the person “gets” your child. To determine whether a provider really “gets” FASD, you might ask questions such as:
In short, parents need to “feel confident that that person at least has the openness and curiosity to understand their child from this different lens,” Devine says.
Treat the child’s functional needs, not the label
For younger kids especially, the focus is on what the child is struggling with right now. “If they’re having speech or language delays, send them to speech and language therapy and early intervention. If we are seeing some more difficulties with tantrums and behaviors, that’s a great place for specialty mental health to step in,” Dr. Chang says. The goal is meeting real, everyday needs as they show up.
Use parent-focused supports that help with regulation and connection
Parenting programs don’t have to be FASD-specific to be helpful. What matters is that they help parents tune into their child’s needs, support regulation, and respond more productively to challenging behavior. Dr. Chang says, “Parent-child interaction therapy is something that’s commonly used because we have that resource for some of the younger kids who may not have been diagnosed but have a lot of these outward sorts of behavioral symptoms.”
Use a brain-based (neurobehavioral) approach
This approach starts with the assumption that there’s a reason behind the behavior. Instead of seeing a child as lazy, defiant, or noncompliant, adults ask: what brain-based challenge might be showing up here? Many kids don’t learn effectively from consequences due to challenges with memory, impulse control, and linking cause and effect, and repeated failure can be emotionally damaging. Dr. Chang explains that supports have to start with reframing: “It’s all about reframing: thinking differently about their behaviors. Really thinking about what are the brain challenges of what I’m seeing in front of me, and how can I support that?”
Prioritize co-regulation over punishment
Instead of reacting after a meltdown or behavior, the focus is on prevention: helping adults interact in ways that keep kids more regulated and emotionally steady in the first place. “Our strategy with FASD around behaviors is much more around a principle called co-regulation,” Dr. Chang says. “It’s more about prevention, rather than teaching through response.”
Use cognitive supports
One helpful way to support children with FASD is through cognitive supports, a concept introduced by Sheets. Cognitive supports happen when adults make decisions with a specific cognitive skill in mind. Instead of expecting a child to “try harder,” we adjust expectations or the environment based on how their brain is functioning in that moment. For example, if your child is struggling to focus, the barrier may not be motivation — it may be attention itself. A cognitive support might mean delaying homework, breaking it into smaller pieces, or changing when the task happens.
Give time to think and transition
Processing time is one of the most powerful supports for kids with FASD. All our experts agree that many kids need extra time for their brain to shift gears — especially in high-sensory or high-emotion situations. Devine explains that kids with FASD often have a much slower processing pace than a typical child has. An accommodation would be to give them more time or, instead of expecting independence before the brain is ready, prompting, guiding, and supporting in real time so the child can succeed.
Rely heavily on visual supports
Visual schedules, checklists, and step-by-step visuals (even for older, very verbal kids) help take pressure off memory and organization. Visuals support multiple cognitive skills at once and make expectations clearer.
Adjust your expectations
Iacobacci reminds parents that sometimes the most helpful accommodation is simply adjusting what we expect, especially at home. For example, if a child struggles to sit still, expecting them to sit through a full family dinner may not be a good fit for their brain right now. “If they can’t sit still, expecting them to sit at the table and eat dinner with the family is not a good idea, it’s not a good fit for them. So the change is, I have to come to the point of allowing my child to graze — to come up, take their bite of whatever it is that they’re going to eat, and then let them walk into the living room, spin around for a little bit, come back to the table, take another bite. Maybe they can engage in a conversation, like a little brief one, maybe they cannot. But the change doesn't come with the expectation of making the child do what I want them to do. The accommodation is the fact that I change what I expect of my child. ”
Hear the rest of this tip and more in this clip:
Recognize asynchronous development
While asynchronous development happens with all kids with brain-based differences, it’s especially significant in FASD, Devine explains. It means that a child’s skills don’t develop evenly — their age on paper may not match how their brain functions in daily life. Asynchronous development can show up in many areas — executive functioning, attention, working memory, and more — and each child’s profile will look different. Recognizing this gap is the first step to setting expectations that are fair, supportive, and actually helpful.
For example, to help others understand her daughter’s needs, Devine often explains it this way: “She’s sixteen, and the way that I will describe her to some people who are supporting her so that they get it is that she is like a mature eight-year-old in terms of where society expects her to be. There’s nothing wrong with my daughter and the way that she functions; what’s wrong is that society has this very ableist view that’s based on chronological age, and in their framework she is much more like an eight-year-old. That instantly helps people understand her differently: ‘Oh, that’s why she acts the way she does. That’s why she’s in a relationship with people in this way, etc.’”
Talk about the brain
Many parents feel unsure about when — or how — to talk to their child about their diagnosis and challenges. That discomfort is completely understandable. But Iacobacci encourages families to think about it the way we think about adoption: there shouldn’t be one big moment where a child suddenly finds out.
Instead, she shares that she has talked with her children about their FASD from a very young age, in small, ongoing, age-appropriate ways. This helps kids grow up with an understanding of their brain, rather than feeling confused or blindsided later on. “We speak brain in my house,” she says. Here are a few examples she shares:
Here's what our experts recommend for continuing to support kids with FASD as they move through school and prepare for adulthood.
Start transition planning early
Collin recommends beginning the Individual Transition Plan (ITP) well before age 16. The goal isn’t to just write reports about future careers or fill out paperwork, it’s to teach real-life skills directly and intentionally.
For students with FASD, transition planning should focus on what will actually help them in adulthood, like learning how to ask for help, use supports, and navigate daily life. “One of the biggies with transition planning for students with FASD is looking at interdependence as well as independence. So not expecting that they’re going to be independent in all of these areas, but supporting them and how to access supports and services,” Collin says. That might mean helping your child identify:
Collin also stresses that health care planning is a critical part of transition. Health challenges often increase with age, and many adults with FASD struggle to find providers who understand their needs, especially because most physicians who know about FASD are pediatricians. Transition plans should include teaching students how to understand their bodies, ask questions, advocate for care, and find professionals who can support them once they’re no longer seeing pediatric providers.
Talk about FASD early and gradually, not as a one-time reveal
Iacobacci recommends treating it similarly to how most families talk about adoption or autism — using simple “brain talk” from a young age, naming differences over time, and helping kids understand that their brain works differently and needs different supports, not that something is wrong with them. “‘Everybody’s brains work differently. Everybody’s brain is different, right? How you see something, it’s going to be different than how I see it. How you experience it, it’s going to be different from how I experience it. So let’s talk brain.’ I think that’s what’s been helpful in the beginning because there’s a process that they have to go through in understanding why their brain works differently.”
Expect and normalize grief — without blame
Iacobacci adds that learning about FASD can bring up grief for both families and individuals, especially because there’s a known cause. That grief is valid, but it’s important to avoid shame or blame toward the pregnant person. Naming FASD can ultimately be empowering and help kids grow into self-advocacy and confidence.
“There could also be that additional grieving process because it wasn’t just something that happened neurodevelopmentally, it was the cause of something that happened. And it’s important not to put the blame or shame on the pregnant person that you know consumed alcohol. It’s not their fault. There are multiple reasons why alcohol is consumed during pregnancy, but allowing that individual to have that grief process, that this happened to them because it was the alcohol that did it. It was the alcohol that created this. Then the beauty of it, seeing the ability to come through that and advocate. There are so many individuals living with FASD that are advocating for change and sharing their story, which is so important, because that’s how change happens.”
Talk about alcohol
This can be a sticky subject, and you’re not alone in wondering how to handle it. Talking with your child about alcohol can feel complicated, especially when FASD is part of the picture. Iacobacci shares that this is a conversation she’s had many times with her own adult children with FASD, and it’s one she approaches with honesty, care, and ongoing support.
Research shows that prenatal alcohol exposure affects how the brain and body develop, and for some individuals, alcohol can feel “familiar” in a way that’s hard to explain. Iacobacci avoids framing this as an “allergy,” because that’s not quite accurate. Instead, she helps her children understand that alcohol can unlock cravings or reactions more quickly — and that’s something to be aware of as they grow into adulthood.
Rather than using fear or shame, she focuses on awareness and safety. Her kids know they’re legally allowed to make their own choices, but they also understand their risks and limits. And yes, those conversations also include pregnancy and alcohol. “Do we talk about alcohol consumption during pregnancy? Absolutely, we do. We talk about it for pre- and post- and all of the things: ‘If you are thinking of becoming pregnant, just avoid it.’ It’s so ingrained in our society, though. So we talk about that, too,” she says.
She also offers reassurance to parents who may feel overwhelmed: “I want to offer some encouragement because it may be challenging, but when you start to see the behaviors that you’re experiencing through the lens of brain function, it’s very enlightening. And it’s very life-giving because we know our kids the best. You can be less stressed. You can have less frustration. You can have a better understanding of your child when you look at these behaviors differently and you support them. Because you can also be proactive in avoiding those behaviors from happening and knowing what your child needs before they even know they need it. So I just want to encourage parents because it can feel difficult, but you’re not alone. There are supports out there. Just connect with your community.”
It can feel like a lot, but here's what our experts recommend most for supporting your child at home and school.
Shift your mindset from won’ts to can’ts
One of the most powerful shifts Dr. Chang encourages families to make starts even before a formal diagnosis. As soon as FASD is suspected, she says it’s important to reframe how we understand a child’s behavior. “Once I’m even suspecting FASD — maybe even before I’ve fully done the diagnostic — I start that conversation around brain-based differences. These are can’ts and not won’ts. And if parents can start to understand that, the whole lens shifts, and it can go a really long way.”
Dr. Chang often uses analogies to help this click. She explains that a child with cerebral palsy has an obvious brain injury, and no one would say, “Why don’t you just run faster?” With FASD, the brain injury is just harder to see. “We end up asking them to do things that they can’t do,” she says, “but if we’re mindful of the can’ts, that shifts our expectations and helps us provide more scaffolding instead of blaming the child for not meeting unrealistic expectations.”
Sheets agrees, telling us, “Even if you don’t know the reason for a struggle in the moment, you’re probably best off just assuming there’s a brain thing going on. A lot of our intuitions, or how we were raised, or even what the systems are telling us, lead us to think that this child is choosing not to be successful right now. And so then all the responses respond to that interpretation. But if it’s not as simple as the child choosing and there are other factors involved, then you’re probably going to want to do something different.”
For parents, this “brain, not behavior” mindset can be a relief. It opens the door to practical supports — using more concrete language, breaking tasks into smaller steps, adding visuals, and adjusting expectations — while also reminding families that connection, education, and peer support matter just as much as any strategy.
Focus on strengths
As Dr. Chang adds, “The other huge part of treatment or management is really to look at strengths and build on strengths, because all these kids can have some incredible strengths, and if we can tap into that and grow, that . . . would really help these kids to thrive.” She shares strengths she sees often: “Their social motivation is usually very high, so they’re very friendly, they’re fun. Many are also visually creative, like they love art, some love music.”
Sheets adds that often, somebody’s strengths are a synonym for what they like to do, whether that’s video games, crafts, etc. — those interests can open the door to connection, conversation, and skill-building without forcing it.
He explains that direct conversations don’t always work, especially with teens. Instead of sitting down to talk about social/interaction challenges, those moments often happen more naturally when you’re doing something together. He shared an example of a parent who worked on motorcycles and dirt bikes with his son. While fixing things side by side, the parent was able to use the mechanics they were working on as a way to talk about bigger topics, like relationships and social situations, without it feeling overwhelming or confrontational.
Sheets also points out that a child’s strengths offer clues about what their brain needs to connect, learn, and participate in other parts of life. Attention span challenges in kids with FASD aren’t constant. While focus can be difficult at times, it’s not usually absent all of the time. If a child can spend an hour on the playground or deeply engaged in a game or an activity, that tells us something important about how their brain works. Those moments show us what helps their brain stay engaged, and that information can be incredibly useful.
Give children time to think (more than you might think)
Sheets tells us that one of his biggest tips for parents is in this question: how much time to think are we giving this child, this teenager, or this adult with FASD? And this is across all situations — even when they’re doing well and especially when they’re starting to struggle. “Oftentimes, when you give them time to think, they have the ability to do what you’re asking them to do, and now they can actually do it – versus continuing to talk, power struggling, interrupting the thinking processes that we want to have happen. So giving time to think is what I’m constantly thinking about and encouraging adults to incorporate into daily interactions and learning.”
Restructure your conversations and demands
Sheets tells us that the amount of adjusting will depend on the person, and it should all be individualized and person-centered. For example, he shares that some children need a lot of structure and others are the opposite. Some children struggle with too much consistent structure — their brains just don’t work that way — and they prefer more go-with-the-flow, figuring things out, and negotiating in the moment.
Sheets explains that a lot of the real work happens in the moment — right during the interaction. “For example, if I’m going to ask a child to do something and, based on what I know of this child, 1) might be oppositional and 2) may not want to do it the instant I ask them to do it, then, before I even ask them, I’m going to stop myself and I’m going to ask, ‘Okay, is this really necessary right now, given all the information?’ Maybe the answer is yes. So then the restructuring of the interaction might be, ‘Hey, I’ve got a question for you, but you don’t have to answer right away. Just think about it.’ And then give that a few moments, and then ask my question.”
For some kids, especially those who struggle with opposition or feeling controlled, it can also help to give a heads-up. That might look like, “I’m going to ask you to do something in one minute,” or, “In five minutes, I’ll have a request,” or even, “I have a request — can you tell me when you’re ready to hear it?”
The key, Sheets says, is paying attention to what actually helps your child. If giving them time to think or a warning before a request makes things go more smoothly — even half the time — that’s valuable information. Those are the strategies you want to remember and keep using because they’re helping your child’s brain engage instead of react.
Model, model, model
Sheets explains that modeling is a good, proactive way to help kids learn how to self-advocate or use language when they have needs they’d like expressed. He adds a caveat, saying that it’s often hard for kids with FASD to stay regulated enough to even identify what the issue is and then tell a trusted adult. “Kids don’t necessarily process things in that way. They’re having responses, and so it’s the adults that need to do the adjustments of understanding,” Sheets says. But parents can work on modeling certain responses bit by bit.
“One way that I suggest that we start to teach kids self-advocacy skills is us, as the adults, modeling those supports for ourselves in situations that have nothing to do with the child, but when they’re nearby. So maybe I’m talking to my spouse about some drama that I’ve had at work and the kid’s in the other room. I might say something like, ‘Yeah, I was getting really angry with my coworker, and I noticed that when I feel angry, my ears get hot and my heart beats.’ And then you just move on.The skill in there is associating dysregulation with a certain body sensation as we’re living our lives. You might say, ‘You know what? Let me think about that,’ if you get asked a question. Even if you already know the answer, the idea is to model. ‘I feel like I’m getting a little bit frustrated. Let me take a break.’”
Create fifteen minutes of connection during the day
Sheets explains that one of the most important things parents can do is intentionally carve out five, ten, or even fifteen minutes a day for focused connection with their child. That might look like talking about your child’s interests and truly leaning into them, doing sensory activities together, or simply rubbing their back for a few minutes. The goal is to choose activities that soothe you both and help you feel safe and regulated together — what Dr. Mona Delahooke describes as being on the “green pathway.” Sheets emphasizes that this isn’t just hanging out. It’s about intentionally creating moments where both you and your child feel settled, supported, and emotionally safe.
In this clip, Sheets dives deeper into the idea of the green pathway and why these small daily moments of connection matter so much:
Know that it’s a process
Devine reminds parents of something many don’t hear often enough: it’s possible to have a child who is challenging, complex, and still deeply joyous to parent — all things can be true at the same time. Much of the work, she explains, is about helping parents shift how they see their child and giving parents space to process the grief and loss that can come with letting go of expectations they once held.
This emotional work is hard and necessary. It’s not just about learning strategies or supports, but about slowly moving toward acceptance of who your child is and who they are becoming.
Devine also offers reassurance that this is a process, not a destination: “There is no finish line. It’s not ‘I’m going to learn this and then we’ll be done.’ It’s ‘I’m going to learn this, and every day I will deepen my understanding of my child through this lens.’ At first that can feel really heavy for parents, but over time there’s often relief — a sense of ‘Okay, this is the way it is, and I can keep getting better at this.’”
And while the journey looks different than many parents expected, she reminds families of something hopeful: kids with FASD do grow and develop skills, just on a different timeline. “All of our kids can grow in their skills. The pace is different. The progress is different than you would expect with a child of their age. It just happens on a different timeline,” she says.
Find a community
Parenting a child with FASD can feel overwhelming, isolating, and exhausting — which is why finding support early matters so much. Devine reminds parents not to wait until they’re completely burned out to reach out for help: “Get support early and often. For yourself — don’t wait until you’re in crisis mode or in the depths of burnout before you reach out for help. If things are starting to feel tricky, reach out then. Getting information about your child’s unique neurobiology early can help you shift your parenting now, and that can prevent a lot of the escalation families often hear about later. There are shifts that can be made early that really do make a difference, matching the intensity of your supports with the intensity of your child’s needs whenever you can — I think that would be my overarching piece. Get curious about how the prenatal alcohol exposure has impacted their brain and results in them experiencing the world drastically differently than you probably imagine.”
Iacobacci adds that community isn’t just helpful, it’s essential, especially when parenting feels lonely and heavy: “Finding your community is so important because it can feel very [lonely] and isolating, like you’re on this island in the trenches. There have been times where I’ve been in a ball on the ground crying because I didn’t know what to do. You need to find your people who get it and you can talk about it and understand each other and come up with other ideas based on experiences.”
In December 2025, the FASD Respect Act was officially signed into law, marking a major milestone for individuals and families impacted by FASD. This is the first time in nearly 20 years that federal programs for FASD have been updated and reauthorized — and it happened because families and self-advocates across the country pushed for change. So what does this mean for parents?
FASD-informed educational consultation and advocacy:
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