Breaking through the Barriers: Supporting Youth with FASD who have Substance Use Challenges

Background. Fetal Alcohol Spectrum Disorder (FASD) describes the range of disabilities resulting from prenatal alcohol exposure. FASD is associated with various cognitive impairments which, coupled with other challenges, can... [ view full abstract ]

Background. Fetal Alcohol Spectrum Disorder (FASD) describes the range of disabilities resulting from prenatal alcohol exposure. FASD is associated with various cognitive impairments which, coupled with other challenges, can increase the likelihood of youth with FASD becoming involved in crime, substance use, and other risk behaviours. This study included the voices of youth with FASD to gain a better understanding of their needs and of promising practices in reducing their substance use and supporting their healthy development.

Method. This project emerged from a community-research partnership in British Columbia, Canada. A mixed-methods approach was used, including interviews (50 youth with FASD; 55 service providers) and analyses from three youth surveys (youth in mainstream schools; custody; alternative-to-custody programs; n=260 youth with FASD).

Results. Youth with FASD experienced a number of risks and challenges, including an unstable home life, difficulties at school, abuse victimization, mental health issues, substance use, and criminal justice involvement. For example, 17% of youth with FASD aged 12-19 in mainstream schools had stayed in a custody centre (vs. 1% without FASD). Also, 27% of those with FASD had their first drink of alcohol at age 9 or younger (vs. 5% of youth without FASD). Protective factors and promising practices were identified that were linked to reduced substance use and other benefits. These included FASD-informed and trauma-informed approaches, individualized support and program flexibility, structure and consistency, a strengths-based approach, focus on concrete skill-development, and youth involvement in their own treatment planning.

Discussion. Youth’s suggestions were consistent with past research on promising practices for this group of young people. Substance-use programming should take into account youth’s cognitive challenges and unique needs, as well as their strengths, to create an individualized and integrated plan of care for each youth with FASD.