Dysmaturity

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Introduction

This factsheet will assist school teaching and support staff to better understand dysmaturity in young people with Fetal Alcohol Spectrum Disorder (FASD). Dysmaturity refers to a misalignment between a person’s chronological age and their level of developmental maturity across various cognitive, emotional and social domains.

Each young person with FASD is different, often in significant ways, and will have their own strengths and challenges. Additionally, FASD is so prevalent many educators may not realise they are interacting daily with students who have undiagnosed or misdiagnosed FASD. The information in this factsheet will be useful for all students who display patterns of dysmaturity, even if a young person does not have a formal FASD diagnosis. As the pathway to a FASD diagnosis can be lengthy, it’s important that support strategies are implemented as soon as possible.

What is Dysmaturity?

Dysmaturity is common among individuals with FASD. It is characterised by an uneven developmental profile in which cognitive, emotional, and social skills develop at varying rates depending on an individual’s unique pattern of brain impairment. For example, a 15-year-old adolescent with FASD may display the communication skills typical of a 16-year-old, the emotion regulation skills of a 12-year-old, but the social skills of a 10-year-old. This uneven development can make it difficult for young people with FASD to consistently meet age-based expectations for academic, social, emotional, and cognitive functioning. This explains why young people with FASD appear capable in certain domains, while simultaneously being unable to meet age-based expectations in others. Occasionally, relative strengths in certain domains can mask difficulties in others. Dysmaturity may also become more pronounced during adolescence, where age-based expectations increase in complexity and require greater independence. For example, peer-relationships increase in importance during adolescence. Young people with FASD may struggle with complex peer relationships as dysmaturity can result in inappropriate social behaviours such as being overly friendly or misunderstanding social boundaries, which can lead to peer-rejection, teasing, and bullying.

It is important to note that dysmaturity does not mean immaturity. Difficulties in meeting age-based expectations are due to the neurodevelopmental impairments associated with FASD. Behaviours should be understood as the result of brain injury, rather than immaturity or an unwillingness to ‘act their age’. Teaching and learning strategies should therefore be adapted to a child’s developmental age and their individual strengths, rather than their chronological age. As different skills may develop unevenly throughout childhood and adolescence, ongoing assessment and a flexible, responsive approach should also be used to tailor supports to a young person’s changing needs.

References

Hanlon-Dearman, A. C. (2021). How FASD presents across the lifespan. In Mukherjee, R.A.S & Aiton, N. Prevention, Recognition and Management of Fetal Alcohol Spectrum Disorders (pp. 85–102). https://doi.org/10.1007/978-3-030-73966-9_8

Hanlon-Dearman, A. C., & Longstaffe, S. (2023). Clinical perspectives on the diagnostic assessment of individuals with FASD. In Neurodevelopmental Pediatrics (pp. 353–369). https://doi.org/10.1007/978-3-031-20792-1_22

Kodituwakku, P. W. (2009). Neurocognitive profile in children with fetal alcohol spectrum disorders. Developmental Disabilities Research Reviews, 15(3), 218–224. https://doi.org/10.1002/ddrr.73

Koren, G., & Ornoy, A. (2020). Searching for the fetal alcohol behavioral phenotype. Global Pediatric Health, 7, 2333794X20941337. https://doi.org/10.1177/2333794×20941337

Malbin, D. V. (2004). Fetal Alcohol Spectrum Disorder (FASD) and the role of family court judges in improving outcomes for children and families. Juvenile and Family Court Journal, 55(2), 53–63. https://doi.org/10.1111/j.1755-6988.2004.tb00161.x

McDougall, S., Finlay-Jones, A., Arney, F., & Gordon, A. (2020). A qualitative examination of the cognitive and behavioural challenges experienced by children with fetal alcohol spectrum disorder. Research in Developmental Disabilities, 104, 103683. https://doi.org/10.1016/j.ridd.2020.103683

Temple, V., Shewfelt, L., Tao, L., Casati, J., & Klevnick, L. (2018). Comparing daily living skills in adults with Fetal Alcohol Spectrum Disorder (FASD) to an IQ matched clinical sample. Journal of Population Therapeutics and Clinical Pharmacology, 18(2). https://jptcp.com/index.php/jptcp/article/view/486