Trainee Series: An Interview About Engaging with Individuals with FASD in Your Practice

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Written by Kathleen Holmstrom, a member of the 2023 CanFASD Trainee Program

Hi everyone! My name is Kathleen Holmstrom, I am a first year Master of Education student in the University of Alberta’s School and Clinical Child Psychology program. I was presented with the unique opportunity of interviewing someone who historically worked with individuals who have Fetal Alcohol Spectrum Disorder (FASD). I felt this would be an interesting learning experience to hear the acquired knowledge of someone who engaged in Social Work with individuals with FASD, particularly because I currently work in an educational setting where we have on-site Social Workers and also students who have been diagnosed with FASD.

Kathleen: What kind of work do you do? How long have you worked in this field?

Interviewee: I have been doing this role for 30 plus years, but I’ve been with Children’s Services for 45 years. In past experiences, I’ve certainly dealt with clients where FASD was a concern or an issue that we were having to work with. In terms of actual job type or qualifications, I have a Master’s in Social Work. So, as a Social Worker, I was working with clients.

Kathleen: What kinds of activities, tasks, or responsibilities have you engaged in when working with individuals with confirmed (i.e., diagnosed) or possible FASD?

Interviewee: Back when, I mean – it’s been 30 plus years since I’ve actively worked with clients – I’m going say that FASD was somewhat in its infancy in terms of the field, knowing and understanding the impacts and implications. I was more in a learning phase at that time in terms of how FASD would impact our clients’ ability to work on issues. Most of the work I’ve done is more with parents who have FASD and working with them to try and develop their skills and abilities to be parents, or ultimately coming to the conclusion that the FASD diagnosis would prevent them from being able to care for themselves, let alone a child… So, that’s probably where the activities were involved. Getting that assessment, in thinking about this interview, I thought back to, “When did I first hear about FASD?” It was basically 40 years or more ago. When I was at a hospital with a doctor and a newborn, and the doctor was explaining to me some of the obvious signs of a “Fetal Alcohol Child,” which – you know, FASD itself – that it was just “Fetal Alcohol,” and then it became “Fetal Alcohol Spectrum,” and it’s changed and morphed over the years. I’m sure you know that.

Kathleen: Yes, it definitely has. What are some of the positive experiences (i.e., successes) that you’ve had when working with individuals with FASD?

Interviewee: The successes are probably going to be with the children, and in terms of being able to identify supports that they will need as they grow and helping caregivers provide for their children. Caregivers would be foster parents, kinship parents, adoptive parents… Knowing that they’re dealing with a child and the child’s disability is not going to change. That they may be stuck at a stage, and that may be as far as they had advanced. But, providing the information and the supports necessary to be successful. More often than not, with parents who have FASD, that’s a more challenging issue. That’s probably where your next question is going to come in, on the negative experiences.

Kathleen: Yes, that is my next question! What are some of the negative experiences (i.e., struggles) that you’ve had when working with individuals with FASD? These could be interactions, systemic, structural, really anything that comes to mind.

Interviewee: Yeah, you know, I think the biggest issue is having others recognize that this person is someone with FASD, and that’s not going to change. You hear the constant feedback as well, “They’re doing this again,” and it’s yes, they are doing that again. That’s all part of the diagnosis. That’s not going to change. I look at kids that we place in secure services… We are able to take away a child’s freedoms and liberties because they are a danger to themselves or others. Part of the assessment process with that is, “What has to happen for the child to be stable enough to leave?” And here’s where the frustration is, is that the facility is going to say this child is as stable as they’re ever going to be. Stability for this child may be continued acting-out behaviours because they don’t understand, and because the child is as stable as they can be, they really don’t qualify to remain in secure services settings… That would be up to even current day. That’s one of the biggest challenges, what do we do with this child who’s acting out and it’s all part of the diagnosis? We can’t change the diagnosis. Sometimes we get the child too late in the process where – had we known earlier on – we could have provided the supports to at least get them to adulthood. Now, it’s almost too late in the process… So, that’s one of the negatives I would see.

Kathleen: I guess that leads to my next question. So, I work at a high school where I and other educational staff support students who are diagnosed with or have possible FASD. Through your experiences, what could you recommend for us as staff to implement in our daily practice to be more FASD-informed when working with these students?

Interviewee: Well, my first suggestion would be to learn as much as you can about FASD. Learn how it impacts the client who is affected by FASD and be aware and understand that this is who they are, and because of the diagnosis they’re unlikely to be able to change. We have to provide them the supports at the level that they are at, and as a person providing supports you need to be at their level as well.

This interview was conducted with the explicit request for anonymity by the interviewee, which is respected and upheld to ensure the protection of the individual’s privacy and confidentiality. The content of this interview is based on their personal experiences, opinions, and insights gained from working with individuals with FASD. The interviewee’s decision to remain anonymous serves to facilitate open and honest discourse, and readers are encouraged to focus on the content of the interview, evaluating the ideas and perspectives shared rather than speculating on the identity of the interviewee. While every effort has been made to accurately transcribe and represent the interviewee’s words, please be aware that minor modifications may have been made to preserve anonymity and improve readability.

Kathleen smiles at the camera wearing a striped sweater and standing in front of a white wallKathleen Holmstrom is a first year graduate student in the School and Clinical Psychology program at the University of Alberta. She spent her undergraduate years researching cognitive and behavioural development in childhood, and is currently aiding in research related to FASD and the justice system. Kathleen is interested in learning about ways to facilitate strength-based and person-centered intervention strategies in educational settings when working with students who have FASD.

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