How should we talk about FASD?

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In June, I wrote a post summarizing a Manitoba report on the overlaps and gaps between expert and public understandings about FASD. Today, I’m sharing the researcher’s recommendations for changing the FASD conversation.

The authors identified two key issues that make it challenging for policymakers and service providers to cultivate public support for FASD initiatives:

  1. The narrow understanding of FASD as a problem that results from a woman’s lack of willpower and selfish decisions limits people’s thinking on what the province can do to make meaningful progress on the issue of FASD.
  2. The public’s understanding of people with FASD as having Forever Damaged Minds blocks productive thinking about how wraparound social services could help people lead more fulfilling lives.

The report suggests some intentional communication strategies for helping to reframe the way the public thinks about FASD. Here are some of their recommendations:

Reframe FASD as a contextual, not individual, issue by promoting 3 values: interdependence, ingenuity, and pragmatism: 

  • The public tends to blame women for causing FASD and sees people with FASD as “other” and separate from society. Framing the issue with interdependence can encourage thinking about the connections among us. If we are going to make progress on preventing and addressing a challenge like FASD, we need to recognize that when FASD affects one person in our province, it affects us all. We need to develop policies and programs that enhance everyone’s wellbeing across every phase of life, because we all benefit when everyone in the province is well supported. The impacts of FASD matter to our whole community, and we need to work together to find solutions to it.
  • With some ingenuity, even complex social issues can be addressed with innovative problem-solving – there are things society can, and should, do to prevent and address FASD.
  • Promoting pragmatism – that problems are solvable through realistic, step-by-step, practical, and commonsense actions—can counter fatalism by reframing the role of solutions like community-based social programs.

Communicators should put forward a definition of FASD—in educational materials, in schools, in doctors’ offices, on websites—that describes FASD as a disorder whose causes are biological and social. For example: 

  • Fetal alcohol spectrum disorder (FASD) can result from exposure to alcohol during pregnancy. Whether or not alcohol exposure leads to FASD depends on a complex set of biological and social factors that interact in different ways for each person. Biological factors can include a woman’s sensitivity to alcohol, metabolism, and size. Social factors like chronic stress, violence, trauma, or poverty can increase the chances that a baby might be born with FASD.

Communicators should clearly explain how FASD is directly related to the social environment by using explanatory chains: Screenshot 2017-08-16 13.03.19Always tell “wide-angle” stories:

  • Social science research has found that stories that are narrowly and exclusively about individuals reinforce individualistic thinking and focus people’s attention on “character flaws” as the explanations for poor outcomes. This is particularly concerning for stories about FASD issues, because people’s foundational cultural models of women and pregnancy already focus thinking on individual willpower and character and obscure the relevant contextual factors.
  • Instead, programs, social factors, and systems must also be characters in stories about FASD. Framing systems and contextual factors as key characters can help correct the public’s tendency to focus on individual women and their individual choices to the exclusion of social determinants.

Cue and expand productive cultural models to shift thinking away from individual blame and towards contextual factors:

  • Keep the public’s thinking focused on social inequity and systemic discrimination rather than individual will and choice.
  • If addiction can be clearly positioned as a cause of FASD, and the need for support in addressing addiction made explicit, public support for FASD prevention measures should increase.

Counter fatalism with detailed descriptions of effective solutions:

  • Communicators should reinforce the idea that positive change is possible by explaining the details of how programs and policies lead to better outcomes.
  • Be specific and highlight solutions, for example:


People with FASD may have an “invisible disability” that can include difficulties with memory and cognition, organization, and sensory overload. But the brain is always growing and changing, and innovative programs can help people with FASD manage their challenges with excellent results. For example, when young children with FASD are coached in cognitive skills like self-regulation and memory, and trained in coping with a variety of sensory experiences, their behaviour can improve tremendously over time. When these services are provided routinely and children and their families are given support and encouragement by therapists and behaviour specialists, children with FASD can learn to adapt to classroom environments and participate in a range of activities. Programs like these work for children with FASD, and it’s important that all children in Manitoba be able to access the support they need.

Explain how trauma experienced by Indigenous communities contributes to FASD:

  • Use the recognition that Indigenous communities face particular challenges to explain how the history of trauma in these communities is linked to FASD and can begin to be addressed with the right solutions.

Explain how not addressing FASD on a large scale stunts society’s growth:

  • People are aware that there are costs, but they need help seeing the full range of people and institutions affected. Making this information clear should increase support for public solutions. Pair cost information with solutions examples for optimally effective messages.


Remember to take a look at the full report here. It’s full of helpful examples and metaphors. The communication strategies start on page 39.


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Hello! I’m Dr. Marnie Makela and I’m one of the voices behind the CanFASD blog. I’m also a researcher with CanFASD and a Registered Psychologist in Edmonton, AB. I received my PhD in School and Clinical Child Psychology from the University of Alberta.  I work with individuals with FASD and other complex disabilities, their families, and their service providers to complete assessments and develop effective intervention plans that will create meaningful and positive life experiences. 

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