Event Description:  When an individual has behaviors that cause difficulty in treatment settings, we often label the person as being non-compliant, unmotivated, or disruptive. When they are back in treatment numerous times, we say that they are not ready for sobriety. However, their behavior may well be due to brain damage caused by prenatal alcohol exposure, which is much more common than most people suspect. Due to this damage, which spans the intellectual spectrum, evidence based practices that rely on verbal interactions and reward and consequence systems are often not successful with them and set them up to fail. The majority of those with an FASD are not diagnosed and many have been misdiagnosed. As a result, typical interventions for them in substance use and mental health treatment, corrections, child welfare, and other systems of care are often ineffective and are frequently contraindicated. This presentation addresses the importance of recognizing an FASD in individuals in substance use treatment. The brain damage seen in FASD is examined and a method to identify those with an FASD is described.

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