This research explores the complex relationship between Fetal Alcohol Spectrum Disorder (FASD) and Attention-Deficit/Hyperactivity Disorder (ADHD), two conditions that frequently co-occur yet present overlapping behavioural and cognitive profiles. The authors highlight that while impulsivity, inattention, and emotional dysregulation are common in both diagnoses, individuals with FASD often demonstrate deeper challenges in executive functioning, adaptive behaviour, social cognition, and developmental history, particularly when prenatal alcohol exposure is suspected but not confirmed. Through a combination of literature review and a multidisciplinary case study, the article emphasizes how ADHD is often diagnosed earlier and treated pharmacologically, yet underlying FASD-related needs may go unmet when clinicians, educators, and caregivers are not equipped to differentiate between the two. The paper reinforces the importance of comprehensive, team-based diagnostic approaches and caution against relying solely on surface-level behaviours.
Reflection for FASD Instructional Coaches
This research highlights a potential issue in classrooms: students with ADHD could also have underlying neurodevelopmental effects from FASD. If ADHD treatments only help a little, it’s not due to defiance or lack of effort; it may be because their brain from FASD requires different support.
For Instructional Coaches, the key takeaway is to look beyond the label. If a student shows emotional immaturity, inconsistent learning, or high dependence on adult prompts, educators should be encouraged to consider FASD-informed approaches rather than intensifying behavioural expectations.
This article strengthens the case for shifting school responses from compliance-based strategies to brain-based supports, more structure, modelling, and co-regulation rather than reward–punishment systems.