Article Summary #8: Community-based interventions for adults with FASD

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This Article Summary is part of our new CanFASD Connect Top Articles Summary Series. Over the next several months, we will be bringing you summaries of all the recent research papers from our list of the Top FASD Articles of 2019. This is an overview of a recent research paper called Elements for developing community-based interventions for adults with fetal alcohol spectrum disorder: a scoping review.


Developing community-based intervention programs for adults with FASD is challenging, but necessary. Current intervention programs assume a certain level of cognitive skills among individuals with FASD, which can result in low levels of success among adults with FASD. For example, failing the program often leads to the perception of adults with FASD as uncooperative, unmotivated, or lazy.

The authors of the current review completed a thematic analysis to identify common elements used in interventions for adults with FASD. With this information, interventions can include more support to address the needs of adults with FASD with the overall goal of improving individuals’ experiences of adverse outcomes and living more successful lives.

Main Findings:
  • In their database search, which occurred from September 2016 to July 2017, the authors found 7 studies that explored successful interventions for adults with FASD.
  • 5 of the seven articles were published by researchers/service providers in Canada and 2 were from the U.S.
  • The authors generated 6 themes from their findings:
    1. Inclusion of functional context: Focuses on the roles of adults and develops everyday living skills, including the practical aspects of day-to-day life. For example, the functional context may include developing vocational skills, attaining employment or housing, and managing finances.
    2. Individualized support: This form of support may include family, friends, and professionals who provide individualized help. Specific support helps individuals to feel autonomous and in control of their lives.
    3. Education for service providers: The more formal training professionals received, the more prepared they felt to work with these individuals. Education may include basic professional education or continuing education through webinars and conferences.
    4. Structure and routine: Routines and structure help individuals create patterns in their days and weeks, which can increase success.
    5. Utilizing a strengths-based approach: A strengths-based approach focuses on the unique strengths that people with FASD have, instead of their challenges.
    6. Environmental adaptions: Adapting the environment to overcome challenges can be beneficial, as environmental changes can enhance their potential for success, decrease frustration, and maximize support. 
  • Involve occupational therapists in supporting adults with FASD in different functional needs. The holistic treatment approach to occupational therapy is helpful because it addresses the whole person with FASD and provides individualized support.
  • Provide support and education to assist people with FASD with planning and using schedules, signs, checklists, calendars, and alarms, as well as helping them to incorporate these strategies into their everyday routines.
  • The use of strengths-based approaches is needed. Professionals who work with individuals with FASD should be encouraged to operate from a strengths-based model.
Take-home message:

Connecting individual experience with the six elements identified in this study may contribute to the development of more successful interventions for adults with FASD. Individualized services will provide greater support opportunities and enable adults with FASD to achieve success and live meaningful lives.

Authors: Ryan Quan, E Sharon Brintnell and Ada WS Leung

Journal: British Journal of Occupational Therapy

Date: April 1, 2019

Read the full article (available open access)

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