I remember the first time I saw someone who likely had fetal alcohol syndrome.
There are characteristic facial features:
- Eye shape (“Short palpebral fissures”)
- Upper lip size (“Thin vermillion of upper lip”)
- Texture of the area between the upper lip and nose (“Smooth Philtrum”)
I was 21 years old and had only been working at a homeless shelter for a few weeks.
I knew something “wasn’t right” about the behavior, but I couldn’t identify it.
She was an adult, but somehow childlike.
She was REALLY hard to manage.
Fetal Alcohol Spectrum Disorder (FASD)
The broader diagnosis is “Fetal Alcohol Spectrum Disorders” (FASD).
The basic idea is that alcohol is REALLY bad for a developing fetus.
While FASD has distinctive facial features, that isn’t the real problem.
It also causes lifelong a developmental disability, impacting:
- Learning and memory
- Understanding and following directions
- Controlling emotions and impulsivity
- Depression and anxiety
- Difficulty performing daily life skills (feeding, bathing, counting money, telling time, etc.)
FASD and Homelessness
By some estimates, 1% to 5% of all first-grade children in the United States meet the criteria for FASD.
That statistic is sickeningly high!
There is almost no research around rates of FASD amongst homeless populations.
It is estimated, though that “special populations” have rates somewhere between 7% and 31%. My guess is that this is accurate for the homeless population, especially chronically homeless.
What’s my point?
POINT 1: Intellectual disabilities—whether they are caused by FASD or not—can cause challenging behavior that requires those around them to have higher level empathy and de-escalation skills.
POINT 2: The United States is probably going to enact sweeping policies that require people to “get better” quickly or lose their subsidized housing (permanent supportive housing and Section 8).
People who–through no fault of their own–have an intellectual disability will not be able to get better quickly (or ever). They will simply be on the streets.
A Final Thought
The work you do is hard and there has never been a harder time to do it.
Take care of your own mental health.
The world needs you to be able to continue the work…
Peace,
Ryan
