Strategies and Advice

Fetal Alcohol Spectrum Disorder (FASD) Strategies and Advice. All information in this section has been supplied by NHS Ayrshire and Arran. For full documents please see further information.

Information supplied by NHS Ayrshire & Arran.


6 Guiding Principles to Helping Children with FASD Reach Their Potential

Adapt the Environment

Children with FASD have an invisible brain-based condition. This means the best strategies are ones that change the child’s environment rather than focusing on changing the child. Creating a calming physical space, having clear and consistent schedules and routines, and communicating appropriately can be helpful. Being supported and supervised by people who understand and have adapted their expectations of the child will create the best environment for children to reach their potential.


Think Younger

Children with FASD develop differently than their peers. It can be helpful to think about our expectations and adapt these to ‘think younger.’ Children with FASD may be socially immature and need more support and supervision than what is expected of their chronological age. Using simple language and concepts will help.


Build on Strengths

Every child with FASD is unique and will have their own strengths and difficulties. Identifying their strengths and using these when planning daily-living, learning and leisure activities will enable children to grow in self-esteem and be successful in their learning. Praise children when they make even small achievements - they have often worked hard to get there.

Keep it Simple

Children with FASD can become overwhelmed easily. Therefore, it is important to keep things simple. Break down more complex tasks into simple steps so that children don’t need to “fill in the blanks.” Allow time for breaks and be aware of spending too long on a task. It can help to do only one task at a time, give one instruction at a time and say exactly what you mean. Keep the environment uncluttered and focused on the task at hand.

Be Patient

It can take many tries for a child with FASD to learn and sometimes they can forget even once you think they’ve got it! You will often have to repeat instructions again and again. It’s important to be patient and calm. Finding someone to talk to, ways you can be supported and what helps you cope will help you to achieve this.


Work as a Team

Children with FASD may have many family, friends and professionals helping them to achieve their potential. These people are often important for providing the extra supervision and structure that children with FASD need. Children will learn best if there is consistency in language, routine, rules and expectations from all these people. This means communication between everyone, including the child, should be open and clear.

FASD and Sleep

Sleep issues are common amongst children with FASD. Sleep can be affected by a number of different factors. These include brain differences (structural and chemical), physical and emotional health and sensory issues. It may also be the case that children do not have an awareness of time and routine. Common issues may be trouble falling asleep, staying asleep and waking early, or having restless sleep. The first step to helping with poor sleep is to promote good sleep habits. This is called sleep hygiene. It may be useful to consider:

Sleep Environment

It is important to create a calming environment for sleep

  • If possible, make the bedroom for sleep only. Avoid TV, electronic games, computers and phones in the bedroom because these devices create blue wave length light that keeps you awake. Make sure the space is uncluttered and comfortable.
  • Reduce noise and light (to total darkness, if possible). Black-out blinds can be really useful.
  • Be aware of sensitivities to touch and ensure that pyjamas and bedding are comfortable. Find out what your child’s preferences are for different materials, temperature, tight or loose fitting, and the weight of blankets and duvets. Please note “weighted blankets” are no longer recommended.

Sleep Routine

It is important to create a clear and consistent routine before bedtime

  • Establish bedtime routines. A visual schedule may help reinforce expectations and sequences.
  • Include a scheduled wind-down time for about 30-60 minutes before bedtime. Calming activities include eating a low sugar snack and/or drink, a warm bath, stories, massage or quiet time together, or listening to calming music.
  • Avoid screen time (e.g. TV, computer or video games) at least an hour before bedtime.
  • Limit activities that increase stress or excitement including homework or stimulating story books. Be aware that a busy household can be over stimulating for some children.
  • Avoid exercise such as running or trampolining which stimulates the hormones that keep us awake.
  • Avoid food and drinks containing caffeine or high sugar.

Some children and young people with FASD may continue to struggle with sleep despite good sleep promoting environments and routines. In such cases, talk to your doctor or other health care professional to see what further supports or options are available in your area. It may also be helpful to complete a sleep diary for your child, which may support you and your doctor to consider your child’s needs.