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About Fetal Alcohol Syndrome
Fetal alcohol syndrome (FAS) is a common, yet preventable condition that results from prenatal alcohol exposure. The impairments that are part of fetal alcohol syndrome are irreversible and can include serious physical, mental, and behavioral problems with possible life-long implications. The severity of the impairments varies, with some individuals experiencing them to a far greater degree than others. As many as 40,000 babies are born with some type of alcohol-related impairment each year in the United States.
FAS is not a single birth defect; it is a cluster of related problems, the most severe of a group of consequences of prenatal alcohol exposure. Collectively, the range of disorders is known as fetal alcohol spectrum disorders (FASD). Signs of FAS may include distinctive facial features; heart, kidney, and bone defects; slow physical growth before and after birth; vision and/or hearing difficulties; small head circumference and brain size; poor coordination; sleep problems; intellectual impairments, delayed development, and learning disorders. Behavioral issues associated with FAS include short attention span; hyperactivity; extreme nervousness and anxiety; and poor impulse control, reasoning, and judgment skills.
JAN's Accommodation Solutions: Executive Functioning Deficits is a publication detailing accommodations for individuals with limitations related to executive functioning. These ideas may be helpful in determining accommodations.
Fetal Alcohol Syndrome and the Americans with Disabilities Act
The ADA does not contain a definitive list of medical conditions that constitute disabilities. Instead, the ADA defines a person with a disability as someone who (1) has a physical or mental impairment that substantially limits one or more "major life activities," (2) has a record of such an impairment, or (3) is regarded as having such an impairment. For more information about how to determine whether a person has a disability under the ADA, see How to Determine Whether a Person Has a Disability under the Americans with Disabilities Act Amendments Act (ADAAA).
Accommodating Employees with Fetal Alcohol Syndrome
People with FAS may develop some of the limitations discussed below, but seldom develop all of them. Also, the degree of limitation will vary among individuals. Be aware that not all people with FAS will need accommodations to perform their jobs and many others may only need a few accommodations. The following is only a sample of the possibilities available. Numerous other accommodation solutions may exist.
Questions to Consider:
- What limitations is the employee experiencing?
- How do these limitations affect the employee and the employee’s job performance?
- What specific job tasks are problematic as a result of these limitations?
- What accommodations are available to reduce or eliminate these problems? Are all possible resources being used to determine possible accommodations?
- Once accommodations are in place, would it be useful to meet with the employee to evaluate the effectiveness of the accommodations and to determine whether additional accommodations are needed?
- Do supervisory personnel and employees need training?
Situations and Solutions:
The following situations and solutions are real-life examples of accommodations that were made by JAN customers. Because accommodations are made on a case-by-case basis, these examples may not be effective for every workplace but give you an idea about the types of accommodations that are possible.
A grocery store bagger named Wanda had fetal alcohol syndrome.
She wanted to hug everyone who came into the store, as well as her coworkers. Some customers were open to it, but many were not. The employer hired a job coach to help Wanda understand the inappropriateness of hugging customers and coworkers alike. The coach worked successfully with her, and was able to fade out her direct involvement, but remained available to support Wanda as needed.
Luis is an automotive repair technician with fetal alcohol syndrome who is highly distractible and inattentive to his tasks.
As an accommodation, he was provided with a mechanic’s stool with color-coded shelves. Luis’ supervisor helped him “load” the stool with regularly used tools. He was also given a daily checklist.
James is production worker with motor difficulties as a result of fetal alcohol syndrome.
He found it nearly impossible to stuff plastic bags with the required craft materials for each kit he assembled. His employer provided a small wooden box with a clip to hold the bag upright so James could assemble the complete kits more effectively.
Isaiah is a janitorial employee with fetal alcohol syndrome who had difficulty organizing his supplies and knowing what to do differently in various areas.
To accommodate him, the employer color-coded the rooms and the lists of needed supplies for each of the different areas. Isaiah was also provided with a color-coded flip chart for the varied tasks.
Trinity, a new employee with fetal alcohol syndrome passed her probationary period with flying colors.
She started to experience the gradual withdrawal of the job coach who had been instrumental in the her success. The supervisor began to see a few issues resurface. The employer recruited a co-worker that had formed a positive relationship with Trinity to function as a natural support to her after the job coach was gone, providing the same type of support.
A country club employee named Sean had fetal alcohol syndrome and was having difficulty getting motivated in the mornings to begin his work tasks.
Extended training on how to do the tasks, along with a task list in picture form were not successful motivators. The employer noticed that a friendship had developed between Sean and a pro shop employee. The pro shop employee described the relationship as a grandfatherly one. He began to mentor Sean by doing periodic “checks” on him during the mornings. The response was very positive, and Sean worked successfully, seemingly eager to please his new friend.
Darius, an individual with fetal alcohol syndrome, works in a noisy warehouse environment and has difficulty understanding verbal communication from his supervisor.
Unsure of exactly what the issue was, JAN suggested she consider the environment and what is going on around Darius first to determine if the background noises and voices were a distraction to him. Other ideas to enhance communication included speaking slowly and pausing while talking to allow more time for the information to be processed, speaking directly to and making eye contact with Darius to make sure that she had his attention. Speaking in clear short sentences, avoiding words or terms that are complicated, technical, and difficult to understand may also be effective.
JAN Publications & Articles Regarding Fetal Alcohol Syndrome
Consultants' Corner Articles
- Accommodations Beyond Job Performance = Compliance and Inclusion
- Cognitive Impairment and the Interactive Process
- Job Coaches and Support People for Individuals with Intellectual Disabilities
- Making Shared Workspace More Accessible for Employees with Disabilities
- When Support Persons Hamper the Process They were Brought in to Facilitate