Exploring the experiences of social workers in working with children suspected to have fetal alcohol spectrum disorders

Abstract

Fetal alcohol spectrum disorder (FASD) is one outcome from prenatal alcohol exposure. Social workers are likely to encounter children with the condition, due to the greater likelihood of prenatal alcohol exposure among children in social services settings. This study explores the experiences of social workers in working with children suspected of having FASD and the support offered to social workers, the children and their families. Semi-structured interviews followed by qualitative framework analysis were conducted with seven child and family social workers along with one child protection solicitor who had experience of handling FASD cases. The two main themes that emerged from the data were a lack of knowledge about FASD and the paucity of diagnosis. Lack of knowledge among the social workers was linked to difficulty in managing children suspected to have the condition, feelings of frustration and normalisation of challenging behaviours. The paucity of diagnosis led to an under-emphasis of FASD in assessments, a dearth of specialist services and confusion about its specific effects in contexts of multiple substance misuse and harmful socio-environmental factors. The need for increased FASD awareness within social services and the development of FASD-targeted support for children and families is highlighted. Social workers would benefit from the inclusion of FASD-focused training in their curricula and professional development plans. Improving the diagnostic capacities of health institutions would address the paucity of diagnosis and raise the profile of FASD, especially in the social services setting.

The challenges that social care services face in relation to looked after children with neurodevelopmental disorders: A unique insight from a social worker perspective

“…Having an in-depth knowledge of how the child with an NDD presents in their behaviours is essential to providing the correct provision and support that is individual to each child. Many of the participants acknowledged that they had a limited understanding of NDDs and unpicking what was causing the underlying behaviours was confusing, difficult and frustrating for the participants, which is congruent with some existing literature (Chasnoff, Wells and King, 2015; Gilbert, et al., 2021). Deciphering what behaviours were caused by trauma, attachment or an NDD was a significant issue for many of these participants as a result of the similar behavioural symptomatology:… because often children can be diagnosed with ADHD and actually it’s more about their attachment disorder.…”

“…Considering that these children’s needs cannot be met using standardised support and intervention services, there is still a paucity of research into LAC who have an NDD (Gilbert, et al., 2021). Early identification and intervention are considered the most effective pathways for supporting and meeting the needs of these children (Pasco, 2018).…”

Immediate and repeat interrogative suggestibility in a sample of adolescents with fetal alcohol spectrum disorder

“…Findings from this study suggest that individuals with FASD are significantly vulnerable to leading questions and interrogative pressure. A range of other professions, within the criminal justice system and beyond, may also benefit by taking note of these preliminary findings, since individuals with FASD are likely to encounter a range of other professionals (Gilbert et al, 2021; Gudjonsson, 2018).…”

Best practices for justice: Practitioner views on understanding and helping youth living with fetal alcohol spectrum disorder (FASD)

“…or other neuro-conditions (Gibbs et al, 2020;Gilbert et al, 2021). Practitioners appear unaware of the full extent of FASD, how to identify the characteristics of it, how to access assessment and diagnosis, and what strategies or interventions might be helpful.…”