FASD (foetal alcohol spectrum disorder) is a lifelong condition caused by alcohol reaching a baby before birth, and it affects how the brain handles memory, attention and impulse control. In school it often looks like a behaviour problem: a child who doesn’t do what they’re asked, makes the same mistake every day and panics when the lesson changes. Most children with FASD have no obvious physical signs and many have no diagnosis, so the best support is calm repetition, small steps, visual prompts and a fresh start every day.
Here’s what’s going on underneath, and what helps.
What is FASD?
FASD is an umbrella term. It covers foetal alcohol syndrome (the form most people have heard of) and a range of related conditions, including alcohol-related neurodevelopmental disorder. What they share is damage to the developing brain from alcohol in pregnancy. That damage can’t be undone. FASD doesn’t go away with age, and adults still face the difficulties they had as children, though with good support many learn to manage them.
FASD is thought to be far more common than most people realise, and most people with it have never been diagnosed. The course points out that the rate among looked-after children is higher still. Many children with FASD are adopted, fostered or living with kinship carers.
A word on mothers, because it changes how you talk to families. Almost every mother wants a healthy baby, and where alcohol was involved it was very rarely deliberate. Not knowing the risks, a hard home situation or not yet knowing about the pregnancy are far more likely. Families have usually been judged plenty already. They don’t need it from school.
What are the signs of FASD in the classroom?
Every child with FASD is different, because so much depends on when in pregnancy the alcohol was drunk and how much. Some have physical features, such as a smaller head, a thin upper lip or being small for their age, but many have none at all. So look at how the child learns and behaves.
Things school staff tend to notice:
- forgetting today what they clearly understood yesterday
- being very easily distracted, by a flickering light or a blind moving in the breeze
- struggling with abstract ideas: money, time, much of maths, creative writing
- distress at changes to routine, new tasks or new places
- poor balance and coordination, so more trips and falls
- trouble with body signals like hunger, temperature and sleep
- trusting everyone, with little sense of boundaries or danger
- saying they’ve understood when they haven’t, to fit in with friends
Alcohol can also affect the eyes, ears, heart and kidneys, so some pupils miss school for medical appointments. Many children with FASD are also creative, sociable and very likeable, which is worth remembering when the list above is all you’re hearing about.
One caution. A child who falls over a lot will have more bruises, but injuries never stop being a safeguarding matter. If you’re worried about any child, with FASD or without, follow your school’s safeguarding procedures and talk to your DSL. It’s far better to find out it really was a run of accidents.
Why doesn’t a child with FASD do what they’re asked?
Usually because the instruction didn’t land. Their attention may have been split between you and five other things in the room, or they heard it and lost it again. It’s rarely defiance. The fix is unglamorous: give instructions in short, simple chunks, repeat them calmly as often as you need to, and back them up with something written or visual.
The same goes for repeated mistakes. FASD affects the parts of the brain that store and retrieve learning, so something secure on Tuesday may have gone by Wednesday. The child isn’t being careless. They just need teaching things many more times than their classmates do.
The panic when a lesson changes? For some, it’s anxiety about not being able to remember what comes next.
How can teachers and TAs support pupils with FASD?
Most of what works is good practice for lots of children, and our FASD course covers it in more depth. It just matters more here. Keep the room as free of distractions as you can. Break tasks into small steps, like stepping stones, and keep activities short so the child can give each one their full attention. Give older pupils a clear, well laid-out vocabulary list before a new topic.
Use visual prompts to show what you expect. Where you can, use photographs of the child themselves rather than symbols or cartoons, so they see straight away it’s about them. Social stories and short scripts help with situations they find hard to read, especially if you go over them again and again.
Praise progress, every bit of it. A child who keeps finding things hard gets frustrated quickly, and warmth is what keeps the relationship working. End the day on a positive note: tomorrow’s a fresh start, whatever happened today. For a child who can’t easily let go of a bad morning, that line does a lot of work.
A calm space can help too, as long as everyone (the child included) understands it’s a safe place to go and settle, not a time-out or a naughty corner.
There should be a team around a child with FASD. Use any plans or advice from other professionals, and talk to your SENCO about what’s already in place. Your school’s wider SEND support applies here too.
What changes in the teenage years?
Trust is the big one. Young people with FASD tend to believe everyone is a friend, and the safer school feels, the more they assume everywhere is safe. That leaves them open to being exploited. Relationships, consent, trust and staying safe need teaching directly, clearly and more than once. Don’t leave them to be picked up. Impulsivity comes from the brain differences too, so expect it and plan for it.
Transitions are hard, especially the move from primary to secondary. Good handover notes and involving parents and carers early make a real difference. Later on, many students do well in practical areas such as art and gardening, but they’ll usually need extra help choosing realistic courses or work, and with everyday skills like handling money.
Working with parents and carers
Parents and carers know their child best. When school and home use the same approach and the same language, learning sticks. Be patient and honest, and tell them about progress, however small.
Many families have met blame or disbelief from professionals in the past, so a warm, open welcome counts for a lot. Simple things travel well between school and home: visual timetables, social stories, a quiet corner for homework, games with real money. Some schools swap a note of what’s happening after school, so staff can remind the child what’s coming before they go home.
Is there FASD training for school staff?
Yes. There’s less UK material on teaching children with FASD than there should be, which is part of why so many go unrecognised. Our online course, Spot and Support Foetal Alcohol Spectrum Disorders, is short CPD you can do at your own pace, aimed at classroom staff.
Jessica Parker presents it. She covers what FASD is and how it affects the brain, the signs to look for with or without a diagnosis, practical classroom strategies, the teenage years, working with families and looking after yourself. It suits teachers, teaching assistants, SENCOs and pastoral staff in primary, secondary and further education.