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How can I help my grandson overcome FAS?

 The term Fetal Alcohol Syndrome (FAS) was first used nearly 30 years ago by doctors to describe a pattern of birth defects in children of mothers who drank too much alcohol in pregnancy. Even today FAS is still the main preventable cause of mental retardation in children.

Not all children with FAS suffer with mental retardation. Some suffer with neurological problems whilst others, as in the case of your grandson, are more troubled by behavioural problems.

Children with FAS may also have a characteristic facial appearance and are smaller than other children of a similar age.

In all these children their brains have been damaged whilst they were developing in the womb. This damage results in very real disorders which can lead to disruptive behaviour. There are frequently intellectual problems such as difficulty in translating information, generalizing (everything is black and white), perceiving similarities and differences and memory problems. Logic can be impaired.

Your grandson appears to have be coping well intellectually but his difficulties with daily routines, memory and abstract concepts are typical of FAS. His bizarre habit of eating faeces is also known to occur in FAS.

The health risk to your grandson is not as great as you might fear although there is a definite risk of threadworm and a slight risk of him contracting a bowel infection as well as a hygiene risk to the rest of the family. His habit could also affect his appetite and possibly lead him to lose weight.

My main concern is that if this is a recent habit or one which has become much worse. It could be a sign that he is feeling under stress.

Children with FAS cope poorly with new situations and changes and can hugely over react to what seem to be quite minor differences in their day to day routine. It is probably worth exploring this possibility first, both by asking your grandson and talking to his school and any other carers.

There are some general ways in which you can help him to cope - you may well be familiar with these:
• structure active times as much as possible
• learn to look for warning signs that trigger out of control behaviour and intervene quickly
• reduce stimulation rather than add to it ¿ give him quiet 'alone' times
• break information or tasks into small manageable pieces
• back up what you say with visual props
• remember that even though he may perform some tasks better than other children of his age his behaviour may well be several years behind that of other children. Do not place unrealistic expectations on him
• establish routines. If he has to cope with change try to bring it in in a step-wise fashion with plenty of warning
• look for his strengths and praise any positive achievement however small

To help with his particular bizarre habit:
• ask his GP to check he is not constipated, occasionally this can go undetected and your grandson's behaviour may not improve until his constipation is resolved
• also ask his GP to test for or consider treatment for threadworm. His is at risk of having picked this up through his habit and the itching in his rectum would be uncomfortable and difficult for him to cope with unless the cause was treated
• ensure regular hand washing and keep his finger nails short to reduce the risk of him spreading infection as a result of his habit
• devise a way of helping him to monitor his own behaviour - this may mean a wall chart with a star for each day he doesn't put his fingers in his rectum
• ask everyone around him, at home and school, to avoid criticizing his bizarre behaviour or teasing him as this will only further lower his self esteem and will probably make the problem worse
• consider physical ways of making it harder for him to put his fingers in his bottom such as tighter fitting trousers and pants

This is a very difficult problem for you to manage on your own. Discuss it with your GP and with the paediatrician or child psychiatrist who is involved in your grandson's care. If by any chance he is not under the care of any specialist ask your GP to refer him as soon as possible.

We recommend readers seek personal medical attention in appropriate circumstances.