Robin A. LaDue, Ph.D. Robert M. Schacht, Ph.D. Patricia Tanner-Halverson, Ph.D. Mark McGowan, M.A.

This fact sheet describes a summary of the training manual, Fetal Alcohol Syndrome: A Training Manual to Aid in Vocational Rehabilitation and Other Non-medical Services, which was a compilation of many years of study, research, and experience in the fields of fetal alcohol syndrome (FAS) and vocational rehabilitation (VR). People who are diagnosed with FAS or fetal alcohol related conditions (FARC) are at high risk for learning disabilities, hearing impairments, and mental retardation. Since the manual does not fully include the guidance and feedback given by professional trainers, it should only be used in an appropriate fashion and by properly trained professionals. The purpose of the training manual is to provide VR and school counselors with background information and tools as an adjunct to training. With this information, trainees will be better equipped to help people with FAS and related conditions to fulfill educational or employment goals and to reach their potential. The manual is intended to aid the trainee in the following areas:

• Understanding what fetal alcohol syndrome is and what it is not (Section I).
Diagnosis of FAS made by an expert trained in the assessment of birth defects requires the following: 1) confirmation of maternal alcohol exposure, 2) evidence of a characteristic pattern of facial anomalies, 3) evidence of growth retardation, and 4) evidence of central nervous system (CNS)

dysfunction. There are other diagnostic categories addressing the existence of alcohol-related CNS damage occurring in the absence of either facial anomalies or marked growth deficiencies. For many people, a diagnosis of FAS stigmatizes the birth mother. Therefore, diagnosis is a serious matter, and should be made by a team including, but not limited to, the dysmorphologist, an educational representative, a family or community advocate, a psychologist, a socialworker, an occupational therapist, a speech and language therapist, a public health nurse, and a VR counselor. Each member of the team contributes significant input and serves as an advocate, support, and educational resource for the family.

• Primary and secondary disabilities associated with FAS and FARC (Section II).
The VR system defines primary disability as the most handicapping disability. In the case of FAS, the primary disabilities result from brain damage and, as such, cannot be cured. However, FAS may result in one or more recognized disabilities, such as mental retardation, learning disabilities, depression, attention deficit disorder, hearing impairments, or speech and language disorders, among others. But the word “primary” is relative: Medical people tend to understand primary as referring to the cause, whereas, professionals in VR are more likely to understand primary as referring to the worker, an occupational therapist, a speech and language therapist, a public health nurse, and a VR counselor. Each member of the team contributes significant input and serves as an advocate, support, and educational resource for the family. most vocationally handicapping disability. Secondary conditions due to alcohol-related brain damage may include mental health problems, disrupted school experience, trouble with the law, confinement, inappropriate sexual behavior, alcohol and drug problems, unemployment, and difficulties with living independently. For people with FAS/FARC, it is the secondary conditions that most negatively impact gainful employment.