Working with The Towards Healthy Outcomes Framework: Lessons from a Graduate Research Assistant

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Written by Vanessa Joly, M. Ed., Graduate Student and Research Assistant


My name is Vannesa Joly, and I just finished my second year in the School and Clinical Child Psychology PhD program at the University of Alberta. Since 2018, I have worked on several research projects related to the Towards Healthy Outcomes (THO) framework. This framework focuses on promoting healthy living and quality of life to support intervention planning throughout the lifespan for individuals with FASD.

THO provides individuals with FASD and those who support them with a shared understanding, language, and philosophy. It acts as a roadmap to support intervention planning and healthy development. At the centre of the THO framework is the idea that all behaviour is functional. This idea grounds the other guiding philosophies focused on development, interactive systems, and strengths-based approaches.

Through my work on various THO projects, I have learned a lot about these guiding philosophies. I would like to share some of what I have learned with you here.

All Behavior is Functional

The need for shared understanding of the individual with FASD is at the core of this framework. Each person has their own unique strengths and needs that are constantly evolving. THO assumes that all behavior is functional. That is, behaviors all serve a purpose for the individual. This assumption encourages us to think about what the reason for a behavior might be.

For example, a grade 4 student might have a hard time sitting at her desk when doing her work. Instead, she walks around the room, which other students find distracting. When the teacher asks the student why she walks around, the student says she is bothered by the sounds in class and it makes her nervous. Walking around is serving the purpose of helping her regulate her emotions. After this conversation, the teacher agrees to let the student use noise blocking headphones or listen to music during work time.

Through this teamwork and shared understanding, we can identify other ways to meet these goals. Rather than assuming, we should seek to understand what people are trying to achieve with their behaviours. In short, shared understanding helps us collaborate to meet goals.

Developmental Lifespan Perspective

People grow and change over time, as do our strengths, needs, and goals. We all move through developmental stages as we get older. All the while, we are being influenced by our past and planning for our future. Support services and interventions also need to be responsive to unique strengths and needs while considering the impacts of our experiences.

Intervention is a lifelong process that evolves as the individual continues to grow. When implementing interventions, we need to consider what we know about the person from a holistic perspective across time. These considerations will in turn shape goals. The THO framework captures these changes across different ages and stages. 

Interactive Systems

As individuals with FASD develop, they may connect with many interactive systems (such as schools, hospitals, etc.). Each system’s influence is additive. That is, each system influences an individual’s experiences, including those within other systems.

Different systems need to collaborate, communicate, and cooperate to best foster strengths and meet the needs of each individual with FASD. To work together successfully, systems must engage in meaningful teamwork and be responsive to the individual and other service providers. Support systems must be fluid and flexible to work together and respond to evolving strengths and needs across the lifespan. 

Strength-based, Empowered, and Goal Oriented Approaches

The THO framework is strength-based and empowered. Everyone has unique strengths and needs that evolve over the lifespan. Intervention is not only helpful to address challenges; it can also promote and use individuals’ existing strengths. Interventions and supports for individuals with FASD that build on strengths can address challenges and achieve healthy outcomes.

Strength-based interventions empower the individual with FASD and their families, and set service providers as partners. Success is co-created as support systems walk with, not for, individuals with FASD. Combining individual strengths and meaningful partnership with support systems creates conditions for success.


The THO framework encourages a growth mindset, which is the belief that the abilities and skills of everyone, including individuals with FASD, do not stay the same. That is, strengths and needs continue to evolve over the lifespan as we develop and grow.

These guiding philosophies have helped me work effectively with many people, including individuals with FASD. I believe that they can do the same for other practitioners and service providers working with similar populations.

Vanessa Joly is a Graduate Student and Research Assistant at the University of Alberta and a member of the CanFASD Trainee Program.

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