At 19 years old, Melissa was referred for FASD assessment by child protective services (CPS) in her community. CPS could only support Melissa up until 20 years of age and requested services within the adult sector to assist in the future. Melissa was born full-term and weighed 5 pounds, 2 ounces. Her mother drank heavily throughout her pregnancy and also smoked cigarettes. Melissa was a small, frail child who had difficulty gaining weight. When she was six years of age, CPS became involved with her Family due to allegations my school personnel that she was being neglected and physically abused at home.
By 8 years of age, Melissa was removed from her mother’s home and put into a series of foster home placement. Each placement began well but would break down ofter a short period, and Melissa would attempt to run away and go back to her mother. By 15 years old, Melissa was made a ward of the state and had been diagnosed with attention deficit hyper activity disorder ADHD, depression, oppositional defiant disorder, and attachment disorder.
Teachers and caregivers believed Melissa was an intelligent but stubborn child who could do better if she would only try harder. At 16 years of age, Melissa was hospitalized for substance-abuse problems and a suicide attempt. She became pregnant at 18 years of age, but the child was apprehended by CPS shortly after birth. Also around the same time, Melissa’s mother died from complications related to liver disease and Melissa became profoundly depressed by these two serious losses in her life.
An assessment found Melissa met criteria for ARND, a form of FASD. Her psychological testing found a scattered profile of skills, with some abilities in the mild range of intellectual disability, some in the borderline range, and some in the low average range.
What Information from Melissa’s family history and her behavioral profile during her infancy and school-age years were missed? How would have that information assisted in an earlier diagnosis?
Considering that children with FASD experience numerous adverse life conditions in addition to alcohol induced brain damage, how would you design an intervention program for a preschool-age child affected by prenatal alcohol exposure?