Understanding FASD and Sexuality: Sex Education Resources for Parents

Let’s talk about sex education when children have fetal alcohol spectrum disorder (or FASD), as we have parents reaching out for help in my free Facebook sex education group for parents, that parent group.

I must admit, I was surprised when I first noticed parents looking for sex education resources for their child or teen with FASD. As it’s something parents hadn’t previously asked for. I’ve been asked plenty of times for resources for autistic kids, as well as for kids with ADHD and other neurodevelopmental disorders. But never FASD.

So I decided to “google it” and quickly understood why parents were looking for resources! 😮

But before we get started, I want to give you a quick refresher on what FASD is and the traits you may see in your child or teen. This information is relevant as it affects how you will teach sex education (so they understand and remember what you say). Plus, it also gets you thinking about how their FASD traits may affect their experiences of love, sex and relationships.

Just in case this is relevant….. I also have some other sex-ed resource lists that may help you! I have a resource list that contains all of the sex education resources for children with a disability. As well as sex education resources for autistic and neurodivergent kids and another list for kids with ADHD.

How does FASD affect a child?

When an unborn baby is exposed to alcohol during pregnancy, the alcohol harms the development of the unborn baby’s nervous system, including the brain.

This results in the child having learning and behavioural problems, which may include:

• Learning difficulties.
• Memory problems.
• Impulsiveness.
• Limited attention span / ease of distraction / hyperactivity.
• Extreme mood changes, aggressive behaviour, or temper tantrums.
• Difficulty relating actions to consequences.
• Difficulty following instructions (but able to repeat them verbally).
• Difficulty with abstract thinking – e.g. mathematics, money or time.
• Slow cognitive processing (thinking).
• Difficulty with social relationships.

Children with FASD can have problems getting along with others because they may not be able to:

• Consider the consequences of their actions.
• Control their impulses.
• Correctly interpret the actions of other people.

What are the sexual outcomes for children and teens with FASD?

NOFASD in Australia has a free resource for health professionals: FASD and Sexuality (published November 2018).

This is what they have found.

Without sex education, children and teenagers with FASD are more likely to start displaying problematic sexual behaviours (if they already aren’t).

And because of differences in cognitive, social and adaptive functioning, it can take longer for children and teens with FASD to recognise nonverbal cues, understand social boundaries, control their impulses, and find ways to express their sexual feelings in a healthy (and safe) way.

This is why they are more likely to display sexual behaviours that are problematic, inappropriate and/or harmful.

These sexual behaviours include making inappropriate advances, engaging in unwanted touching, risky sexual behaviour, involvement in sex work, coercion, public masturbation, voyeurism, using sexually explicit language, not understanding personal boundaries or respecting privacy, and even forcing sexual intercourse.

This often leads to legal trouble, where they are either the victim or the offender.

What can parents do about this?

There’s not a lot of research in this area, but in 2018, a Canadian Issue Paper on FASD and Inappropriate Sexual Behaviour recommended that children and teenagers with FASD receive sex education that is tailored to their unique needs.

I’ve spent quite a few hours (if not days) trying to track down sex education resources that have been tailored for children and teens with FASD. There’s not a lot out there, but I’ve managed to find some that I am sure you will find helpful. Sex Ed Rescue (the website you’re currently on) also has a lot of sex education content to turn to!

So, this blog post will contain resources that have been specifically created for children and teenagers with FASD. You may also want to look at my resource lists for autistic children & teens, kids and young people with ADHD and disability.

How do I get started with sex ed?

A version of this was first published at FASD Network of Southern California – Health & Safety: Sexuality (Published 25 February 2020.) Minor grammatical changes and Australian spelling have happened. Shared here with permission.

The first resource that I want to share is one from the FASD Network of Southern California in the USA. It is so good that I am actually going to include it here in this blog post, as I don’t want you to miss the information they share.

Sexuality-Related Behaviour of Children With FASD

Younger children with FASD often may have no fear of danger, do not respond to verbal warnings, and have no stranger anxiety.

Younger children are highly tactile and may explore their bodies at inappropriate times (for example, during class time). They may also be very curious about the opposite sex.

Older children with FASD may seek close personal contact with everyone, share inappropriate information, and have difficulty distinguishing how to talk to or what to talk about with strangers, professionals, family, neighbours, school staff, etc.

They are sexually curious (as all older children and adolescents are) but they have difficulty interpreting social cues from the opposite sex (“He smiled at me, so he’s my boyfriend”).

Teenagers with FASD may have trouble remembering to use a condom every time they have sex and can’t foresee pregnancy in order to take precautions every time.

Teaching Safe Behaviour Around Sexuality for Persons With FASD

Strategies for Younger Children With FASD

• Practice constant supervision.
• Teaching personal boundaries is very important and must be taught and constantly reinforced at a young age.
• Teach relationships at home and wherever you go. If your child approaches strangers, deal with it on the spot, in front of the stranger.
• Clearly state that this is not a familiar person. Say, “This is a stranger. You do not talk to strangers (unless I give you permission).” Or use a phrase such as “Stranger Danger.”
• Teach “private bodies” rather than “private parts” so that children are not confused.
• Teach the names of body parts.
• Explain to your child that everyone must be an arm’s length away.
• Ask your child’s school about resources that teach “how to make a friend, how to be a friend.” Get the printouts and take them home to use.
• Model social interactions step by step; for example, how to shake hands and how to give or receive hugs. Watch to see if your child understands; if not, help them see the connection.
• (Note: If your child is sensitive about touching, tell your relatives in advance what your child prefers.)

Strategies for Older Children and Teens With FASD

• Supervise your child’s outings and activities as much as possible.
• The use of chairs with arms may help to delineate personal space.
• Provide cues for boundaries, such as masking tape on the floor and furniture.
• Consider making some simple rules (for example, “Everyone has to be an arm’s length away.”).
• Arrange a friendship as early as possible with a peer of your child who is responsible and who can act as a buddy when you are not around. Keep this person in mind to consider a friendship that can be taken into adulthood.
• Educate your child’s peers about FASD, and educate your child about what a safe and acceptable request from a friend is.
• Provide safe activity options for your teen to get involved in. (It’s not about what she can’t do; it’s what she can do).
• Be aware of the grade in which sex education is taught.
• Reassure your daughter that she will not get her period if she goes to school and learns about menstruation.
• Be open and willing to talk about menstruation. Explain it in concrete ways your daughter will understand.
• Let your daughter know that it’s okay to practice with panty liners months or years before her period begins.
• Mark your daughter’s period on a calendar. It will remind you and her.
• Show your daughter strategies for treating menstrual cramps, like using a hot water bottle.
• Be open and willing to talk about masturbation for pleasure and stress relief.
• Keep books about sex education all around the house.
• Practice with condoms and birth control months before required.
• Give lessons in sex education regularly. These lessons should cover a variety of topics at the level of your child’s understanding and in concrete terms:
  • Dating
  • Responsibilities of engaging in sexual behavior
  • Relationships
  • Assertiveness/the right to refuse to be touched and the right to refuse to have sex
  • Sexually transmitted infections
  • Pregnancy
  • Contraception strategies
  • Masturbation
  • Sexual abuse
  • Personal care and hygiene
  • Puberty changes/menstruation
  • Medical/gynecological examinations
• Provide longer-acting birth control than the traditional daily pill (Depo-Provera, the Patch or an IUD) for your daughter.
• Discourage inappropriate displays of affection.

Express clear behaviour expectations that conform with family and societal standards.

If your family values include “only married couples have sex”, say so, and make sure your child knows what you mean by “sexual behaviours.” (Many teenagers, for example, will argue that “oral sex” or “anal sex” is “not really sex”; so parents need to be very clear about their expectations.)

Recognise the importance of feelings.

Practice appropriate displays of affection.

If possible, chaperone your child’s dates or have a responsible friend double-date your child and their sweetheart.

Teach the difference between acceptable behaviours in a private setting and those which are acceptable in public.

Original content can be accessed here – FASD Network of Southern California – Health & Safety: Sexuality.

Resources about sexuality and FASD

How to support healthy sexual development and behaviours. Manitoba FASD Coalition from Canada, has a free 70 minute online webinar about how to support healthy sexual development and behaviours in children and youth with FASD (uploaded March 2023). I have watched it, and it is very informative, easy to listen to and full of helpful tips and practical advice! Well worth watching! Please have a look at the Manitoba FSAD Coalition website, as they have an annual FASD Info Series with interesting topics, and you can still access their previously recorded sessions.

Two simple rules that are essential for sex. A paper from David M. Boulding, who is an American lawyer and fetal alcohol consultant, on fetal alcohol and the rules for sex. He wrote this paper in 2016 because of the high number of parents reaching out to him with kids with FASD facing sexual assault charges. In summary, this is his views on what young people with FASD should know about sex. Do go and have a look at his blog, as he also has two videos and a paper about fetal alcohol and the law.

A book about the rules of sex. David Boulding (from the resource above) strongly suggests parents look at The Rules of Sex: For Those Who Have Never Been Told by Nora J. Baladerian. It has been written for young adults who have never had a concrete description of “the rules of sex” and may or may already have gotten in trouble just for lack of information. I am chasing a copy, and as soon as I have it, I will tell you what I think of it.

Strategies and approaches. Shannon Foster from Red River North CTS in the USA has a 2 page PDF with strategies and approaches to working with adolescents with FASD. It is brief but includes some ideas that parents may find helpful.

This is a resource for young people with a disability (so it was not created for FASD), but it is very relevant as it aims to prevent young people from being a sexual victim or perpetrators. SECCA from Australia has an interactive website, Sexuality, Relationships and Your Rights (SRAYR), which teaches people about their rights and the law related to their body, health, relationships and sexuality. It includes animated videos, pictures and easy English for teaching internet safety, unhealthy relationships, healthy relationships, becoming a parent, sexual health, your body, consent and more.

Resources about problematic sexual behaviours and FASD

Central FASD in Canada has a blog post about understanding FASD and sexual behaviours (published March 2021). It explains that without proper support, individuals with FASD are at a higher risk of being involved in and being the victim of problematic sexual behaviour.

Concordia University St. Paul in the USA, has a blog post that outlines why individuals with FASD may display sexually inappropriate behaviours. They identify ten reasons why their people with FASD may be sexually inappropriate: undiagnosed (which means no intervention and support), a diminished ability to appropriately express and exhibit empathy, confabulation and suggestibility, diminished ability to understand consequences of their actions, developmental immaturity, difficulty with abstract reasoning, impulsivity, lack of understanding personal boundaries, perseveration, and misinterpretation of intent/consent.

FASD Network of Southern California in the USA has a resource for dealing with unacceptable behaviour. It is filled with tips and tactics, plus a great resource list.

Raising Children in Australia has a helpful guide on sexual development in autistic children and teens. It isn’t about FASD (I did check, and they don’t have a FASD guide), but I think you may find it helpful as they discuss the differences.

Spotlight on FASD Podcast from the UK has a 23 minute episode on FASD and sexually inappropriate sexual behaviours. This is a good listen as two mums are talking with an expert in FASD.

Other FASD resources that may come in handy

Boyle Street Education Centre & Agnieszka Olszewska in Canada have a resource for young people with FASD- So you have been diagnosed with FASD? Now what? A handbook of hopeful strategies for youth and young adults. This is an older resource (published in 2007) but I am sharing it as it has useful information and strategies about relationships, feelings, how you learn, life skills and more. So I think that some of the information in here is relevant to sex-ed conversations, as well as recognising and understanding some of your child’s traits.

Central FASD in Canada has an 11-page Fact Sheet about FASD & Sexual Health that was written in 2021. Topics include why sex education should happen, common sexual behaviours & teaching points, sexual abuse, parental controls, and teaching strategies.

Edmonton and Area Fetal Alcohol Network in Canada, have a helpful blog post on how FASD affects language and communication (published Aprile 2021). I am sharing it as it may give you some ideas and strategies for teaching sex education to your child. They also have a 60 page PDF on FASD Strategies not Solutions.

FASD-CAN (Fetal Alcohol Spectrum Disorder Care Action Network) in Canada have a FASD resource page for families. I really like their 1 page printable I am a Caregiver, which briefly outlines the challenges, the support you need, and what to do. Spend some time looking through their website, as there are many other helpful resources, like their list of ten brain domains (functions) affected by FASD.

FASD Hub Australia has a great section for parents on tailored content for families living with FASD.

FASD Lane in the USA, is a website with lots of resources for adults with FASD (including an online forum and mailing list). It also has a list of resources for parents and caregivers.

FASD Network of Southern California in the USA has a health and safety resource that includes resources about drugs & alcohol, nutrition, medical & dental, security, sexuality, sleep and mental health.

FASD Network of Southern California in the USA has a living with FASD resource page that addresses how individuals with FASD are affected by the condition during different life stages. These stages include early childhood, childhood, adolescence and adulthood. If you have a tween or teen then you will want to have a look as they tackle the typical teen problems with FASD as well as mental health problems, disrupted school experience, trouble with the law, inappropriate sexual behaviour, unintended pregnancy, alcohol & drug problems, and more. The Resource Lists at the bottom of this page is very extensive.

FASD Network of Southern California in the USA, has a webpage of practical real life advice for parents and caregivers of people with FASD. It includes tips and tactics about behaviour, daily life, and adulthood for caregivers from caregivers, telling your child, getting treatment and online groups and resources.

KNOWFASD in Canada has a FASD resource database where you can choose your sex (male or female) and developmental stage to get relevant resources.

NoFASD (National Organisation for Fetal Alcohol Syndrome) in Australia has a free 25 page Toolkit for parents, caregivers and families. It covers FASD characteristics, interventions, management strategies and more. Plus, they have a resource page on managing challenging and/or extreme behaviour.

POPFASD (Provincial Outreach Program for Fetal Alcohol Spectrum Disorder ) in Canada has an extensive list of resources about FASD, including some about sexuality.

Sex education books for children

I have not found any sex education books that have been written specifically for children and teens with FASD.

I have a list of sex education books for children with a disability. I’ve individually reviewed these books; each has a video where I show you inside the book. You will find books on over 45 different topics, including puberty, body safety, consent, porn, sex, how babies are made and more.

I have a separate list of puberty and sex education books for autistic and neurodivergent children. And I also have a master list of sex education books for children that are sorted into topics (as well as ages).

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