An Accurate FASD Diagnosis Matters

Description

The wrong diagnosis for people with Fetal Alcohol Spectrum Disorder can lead to poor outcomes, like homelessness, educational failure, unemployment, and more. Shannon Dingle explains.

We tend to look at behaviors rather than people.

All of us: teachers, parents, people in general.

When there's a diagnosis in the picture, sometimes we swing the other way: focusing on the diagnosis instead of the person.

Both are wrong.

People matter.

And that's why an accurate diagnosis of FASD matters.

Wait, what?

Let me explain: if we want to consider the needs of a person, we have to consider them holistically. To do so, the underlying causes of behaviors must be examined. In the case of behaviors related to FASD, an accurate diagnosis can help pinpoint the origin of the issues at hand.

Dan Dubovsky, who is the Fetal Alcohol Spectrum Disorders (FASD) specialist for the Substance Abuse and Mental Health Services Administration (SAMHSA) FASD Center for Excellence and who led the most recent MOFAS webinar, shared a story of a man with violent behaviors. Doctors discovered a lesion on his brain and subsequently removed it surgically. The violent behaviors disappeared. Prison or rehab or other negative outcomes wouldn't have worked for him. Any of those outcomes would have failed to address the cause of his behavior and would have failed him as a person.

Thankfully, his doctor saw him as a person first, not just a set of poor choices and violent behaviors.

FASD can often be misdiagnosed as adolescent depression, bipolar disorder, intermittent explosive disorder, autism (especially in cases in which verbal skills are average or advanced), reactive attachment disorder, traumatic brain injury, antisocial personality disorder, or borderline personality disorder. All of these misdiagnoses have a host of research behind them, detailing practice-proven interventions that can be beneficial for each diagnosis.

The problem is, though, that if the wrong diagnosis is assigned to a person, then the wrong underlying causes are assumed, which usually leads to the wrong interventions being applied.

In other words, misdiagnosing FASD can be just like putting a man with a lesion on his brain in jail to address his behavior instead of dealing with the lesion to address the cause. The wrong diagnosis for people with FASD can likewise lead to poor outcomes, like homelessness, educational failure, unemployment, addiction, broken relationships, drinking during their own pregnancies, and so on.

In preventing FASD, we tend to focus on a list of dos and don'ts, a list of behaviors to emulate and ones to avoid. But it's not about those lists: it's about babies who can be profoundly impacted by their mothers' drinking habits, who then become children who can struggle with sensory integration and attention and mental illness and medical disorders, when then become adults who - if never diagnosed correctly - have trouble fitting in with the rest of the world because they were never given the tools to do so.

But the good news? When prenatal exposure to alcohol is avoided, FASD can be prevent 100% of the time. When prenatal exposure to alcohol is known (or hypothesized, in cases of adoption - for example - when full medical history isn't available), then parents and professionals can look holistically at the individual and ask, "What does this person need to be successful?"

Because FASD is about the person, not the diagnosis.

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