Adolescence is a challenging time for families with children with Fetal Alcohol Syndrome (FAS) and other alcohol-related disorders. As height, body proportions, and facial characteristics of normal teenagers change, other less obvious transformations are taking place as well. Normal teens begin to think in more abstract ways. This affects their performance at problem-solving tasks as well as their social judgment and behavior. As the adolescent matures, his parents, teachers, and peers begin to expect more independent behavior, more self-control, and more advanced social skills from them. This change in expectations is stressful for all teens, but especially for those with FAS and their families.

Families of adolescents with FAS also report that problems with behavior and conduct increase at this time. Expectations for more independent and responsible behavior accent the problems of the adolescent with FAS. Earlier in childhood, individuals with FAS were not required to make complicated choices, understand moral decisions, structure their own time or plan for their own futures. But adolescents are asked to do these things and this is a particular problem for those with disabilities. Impulsive decisions and limited social judgment skills contribute to the emergence of behavior problems. These may include defiance of authority at home, difficulties with peers and teachers, and encounters with the police and the legal system.

While many families do report difficulties at this time, this is not the experience of all families. Most studies have been based on more severely affected teens. Supervision and guidance in their families often has been limited by the presence of a parent involved in substance abuse and unable to provide adequate care. Many adolescents with FAS, however, are not having such severe problems and so have not come to the attention of doctors or psychologists. Future research should focus on characteristics of adolescents who are behaving in more adaptive ways and their families. Based on studies of other disabled individuals, it is likely that meeting the challenge of the adolescent years will depend both on characteristics of the teen and the availability of a flexible and supportive family environment.

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The Maternal Substance Abuse and Child Development Project is funded in part by the Georgia Department of Human Resources Division of Mental Health, Developmental Disabilities and Addictive Diseases.

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The Maternal Substance Abuse and Child Development Study is under the direction of Claire D. Coles Ph.D., with the Department of Psychiatry and Behavioral Science, Emory University School of Medicine. For more information, please contact: Claire D. Coles: ccoles@emory.edu ; Karen K. Howell: khowell@emory.edu