Number: HARD-003 Description: How do fetal alcohol syndrome and fetal alcohol effect influence adoption processes worldwide? Narrative: Articles concerning the developmental needs of patients with FAS and FAE are on topic. More information about the risks and benefits of adoption of these patients, including profiles of adoptive parents who are best suited to deal with these difficulties. Any information dealing with official acts or laws associated with adoption and FAS/FAE are on topic. Documents concerning additional medical costs are relevant. Sources restricted to the effects on the Native American community are off-topic. item=purpose, value=Background item=genre, value=Overview item=granularity, value=Passage item=familiarity, value=2 Patients with FAS/FAE are at a higher than average risk for physical and sexual abuse and neglect when raised in their families of origin. These children need a supportive, loving home environment with clear guidelines and clear lines of communication in order to develop to their fullest potential. When foster (or adoptive) placement is necessary, the greatest progress is made by calm, low key individuals, who are secure and comfortable with themselves and live stable and predictable lives. Families who treat the FAS child as normally as possible, combining loving acceptance with firm limit setting seem more satisfied than do those who have high performance expectations. Due to their poor social judgment, underdeveloped independent living skills and impaired intellectual functioning, most FAS children will require a structured, sheltered living situation throughout their lives. The most severely affected may require a completely supervised and sheltered environment. For more functional patients, a group home or halfway house for developmentally disabled adults may be appropriate if continued residents with a family is not possible or desirable. NEEDS OF THE CARETAKER The foster or adoptive parent of a child with FAS assumes a responsibility far beyond that normally associated with parenting. The constellation of physical, intellectual, and behavioral characteristics that typifies patients with FAS can create a very demanding situation for any family. The children often require constant supervision. Parents require an extraordinary amount of energy, love, and most of all, consistency. Therefore, these parents need support in their efforts. This support can often be provided by the social service network to help prevent the burnout that often accompanies high-stress parenting situations. Those parenting FAS/FAE children need information about fetal alcohol syndrome in order to understand the physical, intellectual, and behavioral concomitants of the child's diagnosis. Parents must have a realistic view of the child's functioning in order to develop reasonable expectations and plan appropriate interactions for the child in order to minimize management problems. A well-run parent support group set up around the needs of those parenting handicapped children can be an ideal vehicle for parents to share information, gain support, and overcome the feeling of being "the only one" experiencing problems. Many caretakers of children with FAS/FAE will require some form of financial assistance as well. Adoption of FAS patients, as with other special needs children, can mean high costs and low subsidies for families. The recent emphasis on adoption of special needs children has focused on this problem and is attempting to address these issues. An advocacy-oriented caseworker can be an invaluable resource in helping potential foster and adoptive families identify available financial resources and negotiate their way through the maze of paperwork often required.