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Module 4: FASD Signs and Symptoms

Secondary Disabilities

Primary disabilities are characteristics or behaviors that reflect differences in brain structure and function, such as mental retardation, attention deficits, and sensory integration dysfunction. Secondary disabilities are disabilities that the individual is not born with. These disabilities and behaviors develop over time because of a poor fit between the person and the environment.

Many secondary disabilities can be lessened or avoided if those working with the child understand FASD. They need to modify their approach to support the way the child learns academics and social behavior. More research is needed to identify specific effects of prenatal alcohol exposure in terms of behavior and development and related effect on school performance and behavior. Findings may lead to the development of practical teaching methods to support the education of children with an FASD and prevent secondary disabilities.7

Examples of secondary disabilities include mental health problems (although some persons with an FASD are born with mental health problems), substance abuse problems, academic problems, and trouble with the law.

Chart showing secondary disabilities among individuals with an FASD (age 6+). Categories for age 6+ are mental health problems–93%, disrupted school experience–42%, trouble with the law–41%, confinement–32%, inappropriate sexual behavior–45%. Category for age 12+ is alcohol and drug problems–38%. Categories for ages 21+ include dependent living–82% and problems with employment–79%.
Click to enlarge

Source: Streissguth, A.P.; Barr, H.M.; Kogan, J.; et al. 1996. Final Report: Understanding the Occurrence of Secondary Disabilities in Clients With Fetal Alcohol Syndrome (FAS) and Fetal Alcohol Effects (FAE). Seattle: University of Washington Publication Services.

Difficulties stemming from primary disabilities may lead to secondary disabilities. For example, negative behaviors may result from cognitive deficits, as shown in the table.

Primary and Secondary Disabilities

Primary Disability

Secondary Disability

Possible Reason for Behavior

Memory problems

Lying

Making things up to fill in the blanks

Failure to understand ownership

Stealing

Attempt to buy friends

Little understanding of value of objects

Destructive behavior

Anger and frustration

Slow cognitive or auditory pace

Defiance

Avoidance as a result of frequent failure, inability to process instructions

 

 

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