Fetal Alcohol Spectrum Disorder
A
Alliance Youth Services Inc. has been a leader in the province of Ontario in regards to the provision of residential services, respite and relief, training, consultation and educational partnerships for individuals living with FASD. We have been innovators in the creation of residential programs that address the unique demands and needs of those children and adults that have had diffcult or unsuccessful placements in other settings. Strength and ability focussed approaches that have evolved from over 10 years of extensive training, consultation and the establishment of strong collaborative relationships with community partners, have resulted in unprecedented placement stability and positive outcomes.

AYS was the primary agency providing and coordinating respite and relief services to the largest child welfare agencies in the City of Toronto for their internal foster families, adopted families and community families with children diagnosed with an FASD. We provided this service for 7 years and serviced more than 40 families.

AYS started the first known classroom designed to assist those individuals at the Secondary level in cooperation with the Peel District School Board in 2007. We then partnered with the Toronto District School Board in 2011 and 2013 to create the first FASD primary level class room in the City of Toronto.

Through the programs that we have developed, our clients, who have experienced tremendous placement and education disruption, experience the benefits of stability that allows them to become a part of the community. One such benefit of this stability is to have a consistent educational/day program where clients have the opportunity to develop skills and gain education with supports that are able to understand their strengths and challenges and the chance to become a part of a school/workplace community. Another benefit is the chance to have consistent medical and dental care from practitioners in the community who become familiar with their physical needs and medications, when necessary, and will ensure that those we serve are able to have better medical outcomes as they age. A further benefit is the opportunity to participate in recreational activities in the same community each season which affords them the chance to be able to establish peer connections and become part of a positive peer group where friendships are nurtured and developed. A fourth benefit is that they can become familiar with the services and infrastructure of the community in which they reside so that they can build on life skills that can be utilized while in care or when they have transitioned into their community.

Our programs focus on managing and shaping behaviour through utilizing best practises in FASD, as well as building on the competencies and strengths of those in our care. This is accomplished through the acquisition of as much knowledge about the individual as possible from previous placements, consultation with appropriate professionals, inclusiveness of all previous caregivers when possible, and our vast experience in regards to the impact of FASD in residential settings, schools or the community. We believe that through a cooperative, consistent and unified approach, outcomes for those we serve have a greater chance for success.

It is our commitment to those with FASD, and to our belief that everyone deserves a home that is understanding and stable, that motivates us to continue to do our best to provide services that are informed by the latest research and individualized to meet the needs of those we serve.

Philosophy of Care

Behaviour Management

• Traditional behaviour management interventions often do not work
• Individuals with FASD do not always learn from consequences
• It is more effective to prevent behaviour from occurring than to react to it
• Structure, environmental accommodations and supervision are significant contributors to improved functioning and successful outcomes
• Advocates can help those with FASD maintain emotional control in trying situations
• All non-compliance should be viewed through a lens of non-competence
• We should teach functional skills at every opportunity
• Sensory and physical issues as a result of FASD may impact behaviour and should be recognized
• IQ scores should not be used as a predictor of capabilities
• Individuals with FASD are often unable to ask for help

Individuals with FASD may:

• perseverate
• absorb the emotion in the room
• do not possess the ability to relate the here and now to future events
• have a very big response to very little stimulus
• live in the moment
• often have a wide range between what they can do vs. what they can’t do
• behave in ways that are misunderstood
• confabulate
• have difficulty with the concept of ownership

Developmental Trajectory

We understand:

• that we can support primary disabilities, but we will not expect that our clients have been “fixed” when they are functioning successfully
• that by supporting the primary disabilities, we can reduce, and sometimes prevent the development of secondary disabilities
• that through realistic interventions, based on the developmental trajectory of those aected by FASD, successful outcomes can be achieved
• that children and adults with FASD often appear more capable than they are, and often, are unlikely to recognize their own strengths/needs. They will often require signicant support and advocacy when life planning occurs
• that there needs to be a significant shift in understanding that the supports for some individuals with FASD may increase as they age and as developmental expectations increase

Education:

• The behavioural and learning challenges of students with FASD are often manifestations of primary disabilities
• Stability in the residential placement allows for stability in education
• Supporting the educational environment effectively is a vital to ensure school placement longevity
• Disrupted and problematic school placements are a significant factor in residential placement breakdown
• Informing educational staff and administrators about FASD is the responsibility of our support sta, foster parents, caregivers and agency partners to assist in ensuring that adequate planning and expectations are established in the school setting
• Encouraging a collaborative approach to meet the needs of the student with FASD should be advocated at every opportunity
• The best educational practices require that children with FASD are taught skills that help them to participate fully in the school, the home and in the community

Family Supports

• Parents and caregivers need to feel heard, understood and supported. This will contribute to placement stability
• Parents and caregivers benefit from grief and loss counselling to assist in shifting expectations, accepting support and identifying strengths in the person they care for with FASD
• Families and caregivers require appropriate relief and respite so that they can go the distance with the child or adult with FASD that they care for
• Families and caregivers need to be included as part of a multidisciplinary team that recognizes the value of placement stability and is willing to work through all issues to accomplish this goal
• Families and caregivers require support to ensure that they are able to maintain the levels of structure, routine, supervision and expectations that are appropriate to the developmental abilities of the individual with FASD that they care for

Justice

• We do not utilize the criminal justice system to make plans for or to manage the behaviour of those aected by FASD
• We utilize strategies that include supervision and structure to reduce the incidences of exposure to the criminal justice system
• It is our experience that the youth and adults we assist are unresponsive to traditional legal interventions that very often do not take into account a neurobehavioural disorder
• Those with FASD require dispositions and expectations that will not further criminalize them and protect them from exposure to new criminal behaviour
• Families, caregivers or advocates should to attend all court dates to ensure that the person they care for is fully supported and to ensure dates and relevant information is communicated eectively to lawyers, courts and to the individual with FASD