Fetal Alcohol Spectrum Disorder and transitions during adolescence

Secondary School Resources
The purpose of this factsheet

This factsheet will assist secondary school teaching and support staff understand the challenges that may arise for adolescents with Fetal Alcohol Spectrum Disorder (FASD) during common school transitions. The most common transitions that are experienced during adolescence include moving from primary to secondary school, transitions between classrooms throughout the school day, and transitions out of secondary school and into adult roles. This factsheet provides practical advice and strategies to help educators support young people with FASD during these transitions. It’s important to note that every individual with FASD is different, and these strategies may not be effective every time. Additionally, it’s important that educators are aware FASD is so prevalent, many educators may not realise they are interacting daily with students who have undiagnosed FASD or FASD that has been misdiagnosed as another neurodevelopmental disorder. The information in this factsheet will be useful to support all students through transitions, 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.

1 Why are transitions important?

The transitions that occur during adolescence can be both exciting and challenging for all young people. These transitions are especially difficult for young people with FASD due to the unique cognitive, physical and behavioural impacts of FASD. Difficulties with cognitive flexibility, memory, planning, and executive functioning make day-to-day transitions much more demanding for young people with FASD. This might include difficulty with remembering what class they need to go to and how to get there, switching between subjects or topics, and generalising information and behavioural expectations from one context to another. These cognitive challenges often hinder their ability to meet age-based expectations related to education, employment, as well as general adaptive functioning as they approach adulthood.  

General adaptive functioning – that is, how well someone is able to meet the demands of daily life, taking into account their age and societal norms – is often impaired in young people with FASD. Adolescents with FASD typically show a pattern of dysmaturity, that is, varying levels of maturity in different areas of development. For example, a 16-year-old adolescent with FASD may have the emotional regulation skills of a 10-year-old. Consequently, when transitioning into adolescence and adulthood, the emotional, social and adaptive skills of a young person with FASD may not align with the typical expectations of someone their age. 

There are general principles that are best practice in supporting young people with FASD. These include things like routine, repetition and consistency, and you can read about them on our What is FASD page. These principles should always underpin approaches to working with students with FASD and be used in conjunction with the specific strategies to support students through transitions that are described below. 

2 Transitioning into secondary education

Moving from primary to secondary education introduces a host of new people, environments and challenges for all young people. For young people with FASD, the transition into secondary education can be distressing, as they often struggle with adapting to new routines.

Strategies for teaching and support staff to support this transition include:

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Collaborate early with caregivers, learning support staff, and other professional supports (if available) to plan out the transition. Consider using a shared observational diary among teaching and support staff and caregivers. Collectively working to address the young person’s concerns can ensure they feel more supported and optimistic.

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Familiarise with new environments: Provide a tour of the classroom(s) and nearby facilities (e.g. location of bathroom, reception area/office, first aid room). Reinforce this information using visual supports (e.g., images in the young person’s visual schedule, signage with directions, or lines on walkways). Maps can also be a useful visual aid but may need to be specifically taught and reinforced. If possible, work with caregivers to organise practice tours where the young person can gradually be exposed to the school environment before the first day of school.

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Build strong, trusting relationships: Spend time introducing yourself and getting to know the student. Consider using visual cues such as name badges, or photos in the young person’s visual schedule. Facilitate meetings with other teaching and support staff to ensure the student is familiar with a wide range of staff members.

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Foster peer connections: Encouraging collaboration in class can help build social bonds inside and outside of the classroom. A buddy system can be mutually beneficial for all new students.

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Provide opportunities for engagement: Encourage the student to take on roles (e.g. ‘class leader’) or tasks that promote agency, success and collaboration with peers. Some students may find these expectations challenging or stressful, so allow time for a period of adjustment, and provide scaffolding and support for students who may have difficulty.

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Develop a tailored plan: Create an individualised plan that aligns with the young person’s unique level of adaptive functioning. This might mean adjusting assessment plans to focus on areas of strength, while acknowledging difficulty or dysmaturity in other areas. A strengthbased learning approach will encourage engagement and provide a higher chance of success.

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Scaffold the plan throughout the term or year, adding time-sensitive goals to build upon the skills they develop.

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Involve the young person in setting goals that are in line with their abilities and incorporate their interests to help keep them engaged and motivated during the transition period.

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Provide supervision and attention: Young people with FASD may require 1:1 supervision in every class. If this is not available through learning support plans, ensure that you check in with the student regularly and allow extra opportunities for questions.

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Embed inclusive practices into the classroom environment to support students’ needs. For students who struggle with expressive and receptive language, try using multiple formats for lesson content (e.g., visual, verbal written), use simple language, and check for understanding often. For students with sensory processing challenges (e.g., sensitivity to noise, light or touch), adjustment strategies include flexible seating options, quiet zones, noise-cancelling headphones, fidget toys, mindfulness and meditation activities and regular movement breaks.

3 Transitions at school:

As young people with FASD often benefit from familiarity and routine, the structure of secondary education can feel overwhelming and disruptive. Transitioning between classrooms and having different teachers and classmates each period is likely to be challenging.

Strategies for teaching and support staff to support this transition include:

Use a visual schedule: Create a physical visual schedule that includes photos of classrooms, teachers, and detailed directions to help a young person find their way between classes.

Establish a peer-support plan: Partner the young person with a peer to walk with between classes and to sit with at break times.

Plan accommodations: Create a plan for accommodations in classes (e.g., adapted worksheets or digital versions) and ensure all teachers are aware of the supports that the young person requires.

Set up a quiet or alternative learning space: Transitions can increase emotional dysregulation and anxiety, which may lead to schoolavoidance or school-refusal. Morning check-ins, designated calming spaces, alternative learning spaces, and break passes can provide opportunities to retreat and regulate emotions and reduce avoidance.

Familiarise with different environments: Practical classrooms (such as food technology or science laboratories) might be overwhelming and cause distraction. Taking time to go through the demonstration of equipment and safety practices and continually reinforcing this information can help a young person with FASD engage during class.

4 Transitions out of secondary education:

Leaving secondary education brings an exciting new set of opportunities, as well as challenges for young people with FASD. Common adult responsibilities such as problem-solving, managing finances, and independent housing can become significant obstacles.

Young people with FASD or other neurodevelopmental disabilities will need extra support when navigating the transition into post-secondary pathways. Some post-secondary paths might include entering vocational training, higher education, supported or open employment, or other community programs.

Leaving secondary education may also mean that some financial and structural supports cease for young people with a confirmed diagnosis of FASD, such as learning support staff who assist them with daily tasks at school. This another important consideration when planning for the transition out of secondary education.

Strategies for teaching and support staff to support this transition include:

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Plan early: Best practice suggests that individualised planning for transitions out of school should begin by 14 (age 16 at the latest) to allow time to plan the best course for the young person.

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Be optimistic and realistic: Research has shown that having positive, yet realistic, expectations can improve outcomes for young people with disabilities and developmental delays. Working within a student’s strengths and abilities encourages them to work towards goals and avoids limiting post-school options. Create an atmosphere of encouragement by providing praise and recognition for progress made towards these goals.

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Collaborate with other supports: Develop a plan alongside caregivers, and consider if medical, mental health, social services or legal advice should be involved. This is particularly important if there are existing support systems provided that may cease after age 18, such as foster care. As many young people with FASD will need lifelong assistance with daily living, promoting interdependence (i.e. with caregivers, carers and professionals), rather than complete independence may be more practical.

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Develop a personalised pathway: Work with the young person to map out their goals. Ensure goals align with their strengths and highlight which areas might need further development to achieve their goals.

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Set clear goals that can be tracked: Goals should be clearly defined, and frequently reviewed and adjusted to promote learning and personal development. Ensure that each goal is concrete and measurable so that the young person can monitor their progress.

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Model post-secondary roles: Where possible, engage with mentors, graduation coaches, visit career fairs, or organise in-school career talks that display the range of pathways available. Social stories and scripts focusing on different post-secondary pathways are useful in demonstrating examples of abstract concepts to young people with FASD. Work experience in areas related to the individual’s identified strengths and taking account of their ongoing challenges, can also provide a practical opportunity to engage with different career options.

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Build academic and personal skills: While educators will have a focus on building academic skills, building life skills, self-determination and self-efficacy will also support a young person’s transition into adult roles. This might include lessons on managing finances, transportation, shopping, cooking, and social skills.

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Promote social development: Provide information about social activities and peer groups that can be utilised to ensure that young people remain socially engaged following secondary education.

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Support self-advocacy: As young people with FASD move into adult roles, they may need to adopt a more active role in advocating for their needs. This might include arranging support in post-secondary education, or workplace accommodations. Using role-play scenarios can help them identify what they need, where to find support, and how to broach the conversation.

References

Australian Education Research Organisation. (2023) Transitions to school for children with disability or developmental delay: Research summary. https://www.edresearch.edu.au/summaries-explainers/research-summaries/transitions-school-children-disability-or-developmental-delay-evidence-summary

Avellone, L. E., & Taylor, J. (2017). Transitioning Students with Low-Incidence Disabilities to Community Living. In Routledge eBooks (pp. 758–770). https://doi.org/10.4324/9781315517698-59

Blackburn, C. (2021a). Identifying the Child with FASD in Educational Settings. In Springer eBooks (pp. 103–117). https://doi.org/10.1007/978-3-030-73966-9_9

Blackburn, C. (2021b). Supporting a Child with FASD in the Classroom. In Springer eBooks (pp. 395–406). https://doi.org/10.1007/978-3-030-73966-9_29

Coons-Harding, K. D., Azulai, A., & McFarlane, A. (2019). State-of-the-art review of transition planning tools for youth with fetal alcohol Spectrum disorder in Canada. Journal on Developmental Disabilities, 24(1), 81-98.

Effective transition from school to work and post-secondary education for people with intellectual disability – Everyone Can Work. (n.d.). https://www.everyonecanwork.org.au/resources/evidence/8-effective-transition-from-school-to-work-and-post-secondary-education-for-people-with-intellectual-disability/

Gault, S., McGarrity, M., Star, J., Chaves, D., MacDonald, R., Lee, F., Gilbert, O., Badry, D., Huber, K., Fischer, M., Stefanon, B., & Ninomiya, M. E. M. (2023). Transitions into adulthood for people with fetal alcohol spectrum disorder: A scoping review of promising practices. Children and Youth Services Review, 155, 107239. https://doi.org/10.1016/j.childyouth.2023.107239

Løhaugen, G. C. C., Tveiten, A. C., & Skranes, J. (2022). Interventions for Children and Adolescents with Fetal Alcohol Spectrum Disorders (FASD). In Springer eBooks (pp. 1177–1203). https://doi.org/10.1007/978-3-030-92392-1_63

McLachlan, K., Flannigan, K., Temple, V., Unsworth, K., & Cook, J. L. (2020). Difficulties in daily living experienced by adolescents, Transition‐Aged youth, and adults with fetal alcohol spectrum disorder. Alcoholism Clinical and Experimental Research, 44(8), 1609–1624. https://doi.org/10.1111/acer.14385

Millians, M. N. (2023). Educating School-Aged Children with FASD. In Springer eBooks (pp. 405–445). https://doi.org/10.1007/978-3-031-32386-7_16

Mukherjee, R. a. S. (2021). Transition into Adulthood and Avoiding Secondary Disabilities. In Springer eBooks (pp. 359–367). https://doi.org/10.1007/978-3-030-73966-9_26

Pitt, F., Dixon, R., & Vialle, W. (2019). The transition experiences of students with disabilities moving from primary to secondary schools in NSW, Australia. International Journal of Inclusive Education, 25(7), 779–794. https://doi.org/10.1080/13603116.2019.1572797

Redgrove, F. J., Jewell, P., & Ellison, C. (2016). Mind the gap between school and adulthood for people with intellectual disabilities. Research and Practice in Intellectual and Developmental Disabilities, 3(2), 182–190. https://doi.org/10.1080/23297018.2016.1188671