1. Assessing FASD and Complex
Developmental Behavioural
Conditions (CDBC)
Interior HealthInterior Health
Children’s Assessment NetworkChildren’s Assessment Network
Presentation by:Presentation by:
Christy Bryceland, Ph.D., R. Psych.Christy Bryceland, Ph.D., R. Psych.
Okanagan Ability CentreOkanagan Ability Centre
www.okanaganabilitycentre.comwww.okanaganabilitycentre.com
cbryceland@telus.netcbryceland@telus.net

2. Fetal Alcohol Spectrum DisorderFetal Alcohol Spectrum Disorder
 Developmental disorder secondary to alcoholDevelopmental disorder secondary to alcohol
exposure in uteroexposure in utero
 Specific neurobehavioural pattern +/- physical signsSpecific neurobehavioural pattern +/- physical signs
 Identifiable deficits in at least 3 areas, which mayIdentifiable deficits in at least 3 areas, which may
include cognition, motor skills, executive functioninclude cognition, motor skills, executive function
and/or social skillsand/or social skills
 Prevalence is estimated at 9.1 per 1000 birthsPrevalence is estimated at 9.1 per 1000 births
Chudley et al., CMAJ, March 1, 2005Chudley et al., CMAJ, March 1, 2005

3. Impact on Brain FunctionsImpact on Brain Functions
 Learning deficitsLearning deficits
 Poor Impulse ControlPoor Impulse Control
 Social Skills deficitsSocial Skills deficits
 Language skills deficitsLanguage skills deficits
 Poor abstraction/metacognitionPoor abstraction/metacognition
 Math skills deficitsMath skills deficits
 Memory/attention/judgment deficitsMemory/attention/judgment deficits

4. Assessing FASDAssessing FASD
 Interior Health Children’s Assessment NetworkInterior Health Children’s Assessment Network
(IHCAN)(IHCAN)
 We are an assessment team that provides inter-We are an assessment team that provides inter-
disciplinary assessments to children with complexdisciplinary assessments to children with complex
developmental conditions.developmental conditions.
 Children must be referred by a medicalChildren must be referred by a medical
professional and there must be significantprofessional and there must be significant
suspicion/ confirmation of gestational exposuresuspicion/ confirmation of gestational exposure
to alcohol exposure plus impairment in a numberto alcohol exposure plus impairment in a number
of domains of functioning (development/of domains of functioning (development/
learning, mental health/behavioural,learning, mental health/behavioural,
adaptive/social skills)adaptive/social skills)

5. IHCANIHCAN
 IHCAN is funded through PHSA, andIHCAN is funded through PHSA, and
provides assessments for children 0-19 livingprovides assessments for children 0-19 living
in the Interior Health Authority catchmentin the Interior Health Authority catchment
area.area.
 Children referred for FASD or CCYChildren referred for FASD or CCY
assessments are seen in 6 sites within theassessments are seen in 6 sites within the
health region (Kelowna, Vernon, Kamloops,health region (Kelowna, Vernon, Kamloops,
Williams Lake, Nelson and Cranbrook).Williams Lake, Nelson and Cranbrook).

7. CDBC AssessmentsCDBC Assessments
 IHCAN completes assessments in 3 differentIHCAN completes assessments in 3 different
areas: FASD, Autism Spectrum Disorders andareas: FASD, Autism Spectrum Disorders and
other Complex Developmental Conditions (CCY)other Complex Developmental Conditions (CCY)
 We have been completing FASD assessmentsWe have been completing FASD assessments
since January 2006since January 2006
 Families undergoing IHCAN FASD assessmentFamilies undergoing IHCAN FASD assessment
can access the Key Worker Agency Programcan access the Key Worker Agency Program
(partnership with MCFD)(partnership with MCFD)

8. Complex Children and Youth (CCY)
 This is a category designed to catch children who do
not meet referral criteria for FASD or autism
spectrum disorders, but who present with “complex
developmental behavioural conditions.”
 The same conditions for intake apply: the child must
be showing impairment in multiple areas of
functioning, and community resources have not been
able to address (e.g. complex medical
condition+learning challenges)
 Need to access community resources first – has a
school psychoeducational assessment been completed
(if possible)?

9. IH Total FASD Referrals &IH Total FASD Referrals &
Assessments Age 0 -19 from 2006- JulyAssessments Age 0 -19 from 2006- July
20102010
ReferredReferred ~1000~1000
AssessedAssessed ~650~650
Children and YouthChildren and Youth
diagnosed with andiagnosed with an
FASDFASD
~2/3 or >400~2/3 or >400

10. Current FASD waitlist (July 2010)Current FASD waitlist (July 2010)
Region Under 6 6 + Total
EK – E. Kootenay 6 18 24
KB - Kootenay
Boundary
2 5 7
OK 1 - South OK 1 11 12
OK 2 – Central OK 3 21 24
OK3 – North OK 2 13 15
OK 4 –S. Arm 1 7 8
OK 5 - Revelstoke 0 1 1
TCS 1 – Merritt 1 5 6
TCS 2 - Kamloops 6 24 30
TCS 3 – Williams
Lake
5 18 23
Totals: 27 123 150

11. Ways for schools to support a
referral
 Provide documentation for families to take to
family doctor and/or paediatrician regarding
school’s concerns – be descriptive rather than
prescriptive
 Assist family in accessing referral –
encouraging medical/paediatric referral
 Paediatricians decide if it is an appropriate
referral for IHCAN

12. FASD: Canadian Diagnostic Guidelines 2005FASD: Canadian Diagnostic Guidelines 2005
 Diagnosis is complex and requiresDiagnosis is complex and requires
comprehensive history, physical andcomprehensive history, physical and
neurobehavioural assessment – anneurobehavioural assessment – an
interdisciplinary approach is necessaryinterdisciplinary approach is necessary
 In Canada, we utilize the University ofIn Canada, we utilize the University of
Washington Diagnostic Code and CanadianWashington Diagnostic Code and Canadian
Diagnostic GuidelinesDiagnostic Guidelines
Chudley et al., CMAJ, March 1, 2005Chudley et al., CMAJ, March 1, 2005

13. 4 Digit Diagnostic Code4 Digit Diagnostic Code
GrowthGrowth
DeficiencyDeficiency
FAS FacialFAS Facial
FeaturesFeatures
CNSCNS
DamageDamage
PrenatalPrenatal
AlcoholAlcohol
44 SevereSevere SevereSevere SevereSevere High RiskHigh Risk
33 ModerateModerate ModerateModerate ModerateModerate Some RiskSome Risk
22 MildMild MildMild MildMild UnknownUnknown
11 NoneNone NoneNone NoneNone No RiskNo Risk

14. FAS Facial FeaturesFAS Facial Features

15. 4 Digit Code & Canadian Diagnostic4 Digit Code & Canadian Diagnostic
GuidelinesGuidelines
 Application of the Code + Canadian guidelines resultsApplication of the Code + Canadian guidelines results
in multiple variations fitting into or being excludedin multiple variations fitting into or being excluded
from one of four diagnostic categories:from one of four diagnostic categories:
1.1. Fetal Alcohol Syndrome (confirmed exposure)Fetal Alcohol Syndrome (confirmed exposure)
2.2. Fetal Alcohol Syndrome (without confirmation)Fetal Alcohol Syndrome (without confirmation)
3.3. Partial FAS (confirmed exposure)Partial FAS (confirmed exposure)
4.4. Alcohol Related Neurodevelopmental DisorderAlcohol Related Neurodevelopmental Disorder
(confirmed exposure)(confirmed exposure)

16. University of Washington guidelines
You will also see diagnoses of:You will also see diagnoses of:
1.1. Static Encephalopathy (alcohol exposure unknown)Static Encephalopathy (alcohol exposure unknown)
2.2. Neurobehavioural Disorder (alcohol exposed)Neurobehavioural Disorder (alcohol exposed)
 These categories are used to diagnose individuals with
alcohol-related impairments who are not captured by
Canadian guidelines.
 This includes individuals for whom we cannot confirm
alcohol exposure, as well as those who have milder levels of
impairment.
 Diagnosis needed to access chronic health designation.
Some cases of success for categorizing “neurobehavioral
disorder” if evidence of school failure.

17. REMINDER:REMINDER:
 The different diagnosesThe different diagnoses do notdo not representrepresent
functional differences or “mild” forms offunctional differences or “mild” forms of
FASD; they only represent visible,FASD; they only represent visible,
physical features – CNS damage isphysical features – CNS damage is
present withpresent with allall six diagnostic categoriessix diagnostic categories

18. Interdisciplinary Team MembersInterdisciplinary Team Members
Core team members:Core team members:
 Intake CoordinatorIntake Coordinator
 Assessment CoordinatorAssessment Coordinator
 PaediatricianPaediatrician
 PsychologistPsychologist
The team may also include:The team may also include:
 Psychiatrist (can replace paediatrician)Psychiatrist (can replace paediatrician)
 Occupational TherapistOccupational Therapist
 Speech Language PathologistSpeech Language Pathologist

19. The Interdisciplinary FASD AssessmentThe Interdisciplinary FASD Assessment

20. Neurobehavioural Assessment:
9 domains
1. Sensory/Motor (“hard and soft signs”)
2. If available, imaging results showing differences in
brain structure.
3. Cognition
4. Communication
5. Academic Achievement
6. Memory
7. Executive Function
8. Attention/Activity Level
9. Adaptive Behaviour/Social Communication

21. A domain is considered “impaired”
when on a standardized measure:
 Scores are 2 standard deviations or more
below the mean
 This equates to:
a percentile rank of 2nd
or lower
a standard score of 70 or lower (most
measures)

22. The Normal Curve:

23. Psychology domains: Cognition
 Overall intelligence, verbal intelligence,
nonverbal intelligence
 Common measures:
Wechsler scales – the WAIS-IV, WISC-IV,
WPPSI-III
 4 Index Scores: Verbal Comprehension,
Perceptual Reasoning, Working Memory,
Processing Speed (not all within cognition)

24. Cognition
 You are likely to see a broad range of abilities
 A significant minority will be have an
intellectual disability (IQ below 70)
 Others will have even, “average” profiles
 Others will have highly uneven profiles,
usually with visual-spatial skills better than
verbal skills
 IQ is not highly predictive of function

25. Psychology domains:
Academic Achievement
 Standardized assessment by the psychologist plus
review of school records
 We can accept recent school testing if we have
standard scores
 Typically we assess with the WIAT-II (Canadian
norms)
• Reading
• Writing
• Math

26. Academic Achievement
 Academic skills may be relatively intact or
may be very low.
 Math problems are very common.
 Those who have language problems are also
likely to have poor reading comprehension.
 May do better with more concrete skills (word
reading, spelling) but have more challenges
with abstract skills (comprehension, math
reasoning)

27. Psychology domains: Memory
 Includes standardized assessment by the
psychologist plus interview questions to
parent/caregiver
 Testing such as the WRAML-2, NEPSY,
Children’s Memory Scale, WMS-III
 Measures of:
• Visual memory
• Verbal memory
• Working memory
• May include: immediate, delayed, recognition

28. Memory
 Many have poor functional memory – however, you
may see a variety of reasons for this.
• Some won’t be able to pay attention to what they’re
supposed to learn.
• Some won’t be able to actively search their memory,
but can recognize info in a multiple choice
framework.
• Problems with working memory are often distinct
from problems with short/long term memory.
 Those with language problems may have better visual
than verbal memory.

29. Psychology domains:
Executive Functioning
 A set of high-level thinking skills responsible
for organizing and directing the brain’s
activities in order to meet long-term goals
 Very sensitive
 Difficult to assess – use a combination of
standardized testing, parent/teacher report,
observation, and history
 Very difficult area in younger children –
harder to do valid and reliable testing

30. Executive functioning:
 Very common area of weakness – however,
standardized tests for children are relatively new and
are not always sensitive.
 Clinical manifestations may include severe problems
with safety awareness, inability to learn from
consequences, denying wrongdoing even when
caught “red handed,” inability to multitask, inability
to improvise when something goes wrong,
perseveration or “sticky thinking”

31. Executive Functioning
Our test guidelines mandate:
 Parent and/or teacher report of executive
functions in daily life
 Direct testing of:
• Inhibition
• Working Memory
• Planning/cognitive flexibility/
organizing/abstract reasoning (some of these
domains covered in other tests, e.g. WISC)

32. Psychology domains:
Attention and Activity Level
 Another sensitive indicator
 Some standardized testing may be possible, but most
crucial information is probably parent and teacher
report on formal questionnaires (e.g. Conner’s, Stony
Brook) + observation
 Teacher reports are very important
 Many children and youth seen in the system already
have an ADHD diagnosis – if it is considered
‘trustworthy’ then that alone may constitute evidence
of impairment

33. Psychology domains:
Adaptive functioning/social
communication
 Tests in many of the other areas are intended
to measure what the child can do under the
best possible circumstances (“ideal” testing
environment)
 Adaptive functioning tests are intended to
measure what the child does do in his/her own
environment – at school and at home

34. Adaptive functioning
 Adaptive behaviour is measured by
parent/teacher report – and also through
clinical interview with caregiver
 Common measures: Vineland, ABAS, SIB-R
(we most typically use ABAS)
 Includes real-life communication, self-care,
self-direction, home living and social skills
 Time, money, safety, social vulnerability are
key areas

35. Adaptive functioning
 Adaptive behaviour is often very low in this
population, even when intelligence is average
 In interpreting questionnaires we have to
consider the literacy, analytical skills and
possible bias of the informant, particularly
parents with FASD – in this case teacher
reports are crucial (they are generally helpful
collateral information)

36. Additional domains: sensory/motor
 Psychologist does screening of visual motor
integration, fine motor coordination and visual
perception (Beery VMI) and by interview
 Can refer to OT if significant concerns
 Sensory concerns are evaluated qualitatively –
by interview/observation

37. Additional domains: language and
social communication
 Psychology testing looks at verbal reasoning
skills
 Consideration of “higher level language” and
abstraction through some measures of
executive functioning
 Further assessment by SLP can be
recommended

38. Adjunct Assessment: SLP and OT
 Limited resource: approx 40 out of 500
assessments or 1/12
 Need evaluated on a case by case basis – can
be decided at intake or by psychologist after
testing completed
 Sometimes OT or SLP assessment has already
been completed by community – especially in
younger children. We can use this info.

39. Speech Language Assessment
 Standardized testing of core language (receptive and
expressive language) – assessment tools such as
Clinical Evaluation of Language Fundamentals - 4
 Additional testing of “higher level language” and
social communication – these measures seem less
standardized/more qualitative. Example: Test of
Narrative Language. Test of Problem Solving
(TOPS) is standardized measure of abstract language

40. Occupational Therapy Assessment
 Standardized assessment of fine motor skills
and visual motor integration
 Often: Bruininks-Oseretsky Test of Motor
Proficiency
 May also assess gross motor skills and sensory
sensitivities – sensory assessment is more
qualitative and thus difficult to quantify
severity in our ranking system

41. Team Deliberation and FamilyTeam Deliberation and Family
ConferenceConference
 After all appointments are completed, the teamAfter all appointments are completed, the team
spends time reporting their findings, agreeing uponspends time reporting their findings, agreeing upon
diagnoses and discussing the most appropriatediagnoses and discussing the most appropriate
recommendations.recommendations.
 The team then sits down with the family and sharesThe team then sits down with the family and shares
this information with them and with the supportthis information with them and with the support
people they may choose to invite.people they may choose to invite.
 We leave it up to families to invite schoolWe leave it up to families to invite school
professionals. Sometimes this is more sensitive (e.g.professionals. Sometimes this is more sensitive (e.g.
birth mothers) and we may do parts with family onlybirth mothers) and we may do parts with family only
even if professionals have been invited.even if professionals have been invited.

42. Assessment Goals:Assessment Goals:
 To ascertain if there is a Fetal Alcohol SpectrumTo ascertain if there is a Fetal Alcohol Spectrum
DisorderDisorder
 To discover what is making it difficult for thisTo discover what is making it difficult for this
child/youth to be successful, and whatchild/youth to be successful, and what
interventions we can recommend to assist theinterventions we can recommend to assist the
child and family with overcoming barrierschild and family with overcoming barriers
 To ensure that recommendations are specific,To ensure that recommendations are specific,
reasonable and achievable while focusing onreasonable and achievable while focusing on
identified needs and taking into account strengthsidentified needs and taking into account strengths
and personal/community resourcesand personal/community resources

43. Assessment Summary
 The multidisciplinary team will produce a short report on the
day of feedback (sometimes hand written).
 This summarizes diagnosis and key assessment findings as
well as key recommendations.
 This is the only report signed by all professionals, and is
needed to support designation under chronic health (given
multidisciplinary guidelines).
 We encourage families to share the report with schools but all
documentation is owned by families.

44. Key Recommendations
Tailored to the individual, but often recommend:
 An individualized learning plan at school (we do not
direct schools how to designate children – rather we
describe difficulties in a way to facilitate this should
schools feel it would be helpful)
 Support of the “key worker” – this is a family
advocate rather than someone who can work directly
with the child or youth. Limited mandate, variable
service.
 Possible medication recommendations
 Possible mental health follow up

45. Psychology Report
 Comes out several weeks after the team feedback.
 Shared directly with families and medical
professionals. Families are encouraged to provide a
copy to schools and if there is sensitive personal
information, we may provide a “school version” to
facilitate this.
 Summarizes findings in much more detail.
 Additional specific recommendations for families as
well as schools.

46. Psychology Report:
A consumer’s guide
Key components of report:
 Reason for Referral
 Identifying/Background information
 Behavioural Observations
 Tests used
 Results: review of test findings – correspond to
FASD domains
 Summary and diagnostic conclusions
 Detailed recommendations

47. Psychology Report:
A consumer’s guide
1. Flip to the summary/conclusions section – look for
the diagnoses as well as an overall description of
the concerns – what are the strengths and
weaknesses? What is the level of difficulty in
different areas?
2. Look at the recommendations – many of these are
aimed at schools to assist with developing an
IEP/school plan, understanding the child’s learning
style and providing appropriate accommodations
3. If desired, you can review test findings in more
detail.

48. Case example:
How do you get a “brain 3”?
John Smith example:
- 16 year old
- In utero alcohol, LSD, cocaine and marijuana in first 14 weeks
of pregnancy – stopped when she knew she was pregnant -
mom is adopted and believes she may have FASD herself
- History of learning problems as well as attachment disruption
- Has ADHD diagnosis – tried meds but couldn’t tolerate side
effects
- School avoidant in the last year (so school reports less
available) – choosing to attend shop class only
- Viewed as bright and capable and previous academic testing
revealed low average to above average skills (Woodcock
Johnson) but weak visual motor skills
- Has been identified as having LD in writing – some
accommodations provided

49. Case example:
How do you get a “brain 3”?
 Overall IQ not meaningful, large discrepancy
between IQ domains – visual skills are 75th
percentile,
verbal 16th
, working memory 5th
, processing speed 1st
 Significant academic problems – history of written
output challenges, on testing reading is average, but
written math and spelling/writing are below 1st
percentile
 VMI 9th
percentile, fine motor 4th
percentile (note OT
assessment would have been helpful, but not
available on outreach in small community)

50. Case example:
How do you get a “brain 3”?
 Memory testing showed visual memory at the 2nd
percentile, verbal memory scores scattered from
below average to average
 Executive functioning: reported difficulties in all
areas – testing shows weak scanning as well as
working memory/cognitive flexibility and multi-
tasking, and poor inhibition (not all testing is low)
 Very compliant and focused during testing – ADHD
not outwardly visible – now qualifies for inattentive
subtype

51. Case example:
How do you get a “brain 3”?
 Adaptive functioning at the 1st
percentile
 Strengths in communication and community
use
 Weaknesses in health and safety, home living,
self care, self direction, social and leisure

52. Case example:
How do you get a “brain 3”?
 Weaknesses in language reasoning and related
academic problems suggest a language-based
learning disability
 Also a specific LD: Disorder of Written
Expression, complicated by fine motor/visual
motor challenges and problems with visual
scanning
 Meets criteria for ADHD, inattentive subtype

53. Case example:
How do you get a “brain 3”?
 Multiple impaired domains: cognitive (scatter),
achievement, visual memory, executive functions,
attention and adaptive meet the “severe” criteria
 No findings of growth impairment or facial features
 Diagnosis is 1134 or Alcohol Related
Neurodevelopmental Disorder
 For John who appears high functioning and has
generally average to high average cognitive
(especially visual strengths) – this is truly an
“invisible disability”

54. Case Study: Recommendations
 Strengths based learning program – e.g. good at
mechanics – find a way to build program around
strengths
 Visual and hands-on learner
 Reduce verbal demands
 Adjust for slower processing speed
 Adaptations for written output challenges
 Recognize and support memory impairment
 Structured, predictable environment – lots of support
as “external brain”

55. Assessment Outcomes
 Better understanding of the child or youth’s learning
profile, challenges, strengths and needs
 Hopefully impacts to school planning and provision
of supports
 Limited access to intervention programs outside of
school context (not like ASD programming)
 In adulthood, may have access to disability services
such as Persons With Disabilities funding or Personal
Supports Initiative through Community Living BC
 Family may be eligible for Disability Tax Benefit

56. Designation of students for
Special Education Services
 FASD is most often designated under “chronic health
impairments”
 IHCAN covers 16 different school districts and each
has their own policy and interpretation of assessment
information with regards to designation of students
under Ministry of Education guidelines
 A diagnosis seems to be a requirement (not just a
description of challenges) and needs to include
medical assessment (multidisciplinary)

57. From the policy manual:
In some cases, students diagnosed through the Complex Developmental Behavioural
Conditions (CDBC) Network as children and youth with complex needs may be
included in this category. Regionally, the CDBC Network has been established to
assess children and youth with complex needs, including children and youth who
may have fetal alcohol spectrum disorder (FASD). A clinical diagnostic assessment by
the CDBC Network or by qualified specialists (psychiatrist, registered psychologist
with specialized training, or medical professional specializing in developmental
disorder) is required. The assessment must include and integrate information from
multiple sources and various professions from different disciplines that indicates the
student with FASD or the complex developmental behavioural conditions is exhibiting
an array of complex needs, with two or more domains being impacted (social
emotional
functioning, communication, physical functioning, self determination/
independence, and academic/intellectual functioning).
See: http://www.bced.gov.bc.ca/specialed/special_ed_policy_manual.pdf

58. FASD district partners
 SD 23: Sue Thompson (Central Okanagan) –
sthomson@sd23.bc.ca
250-979-0029
 SD 22 (Vernon): Cheryl Turner
cturner@sd22.bc.ca
250-549-9240
 For other partners see:
http://www.fasdoutreach.ca/about-us/district-
partners/district-partners

59. Where are services accessed?Where are services accessed?
 Ministry of EducationMinistry of Education
 Ministry of Children and Family DevelopmentMinistry of Children and Family Development
(Keyworker, CYSN, CYMH, Probation)(Keyworker, CYSN, CYMH, Probation)
 Adults- CLBC, Mental HealthAdults- CLBC, Mental Health
 Ministry of Housing and Social DevelopmentMinistry of Housing and Social Development
 Interior Health AuthorityInterior Health Authority
 Community AgenciesCommunity Agencies

60. Ministry of EducationMinistry of Education
 In B.C., children/youth identified with anIn B.C., children/youth identified with an
FASDFASD maymay qualify for additional supports inqualify for additional supports in
their educational settingtheir educational setting
 http://www.bced.gov.bc.ca/independentschools/bc_http://www.bced.gov.bc.ca/independentschools/bc_
 www.fasdoutreach.cawww.fasdoutreach.ca

61. MCFD – Keyworker programMCFD – Keyworker program
 Key Worker Agency Program and Parent toKey Worker Agency Program and Parent to
Parent Support Groups funded by MCFDParent Support Groups funded by MCFD
(Ministry of Children and Family(Ministry of Children and Family
Development) and contracted out to variousDevelopment) and contracted out to various
private agency around the provinceprivate agency around the province
 http://www.mcf.gov.bc.ca/fasd/kw_support.htmhttp://www.mcf.gov.bc.ca/fasd/kw_support.htm

62. MCFD – continued…MCFD – continued…
 Child and Youth Mental Health (CYMH)Child and Youth Mental Health (CYMH) ––
child/youth with an FASD may qualify forchild/youth with an FASD may qualify for
counselling and support if they have additionalcounselling and support if they have additional
mental health concernsmental health concerns
 Child and Youth with Special NeedsChild and Youth with Special Needs
(CYSN)(CYSN) – may provide supports if child/youth– may provide supports if child/youth
has an FASD and an intellectual disabilityhas an FASD and an intellectual disability

63. Victoria Foundation Funded PilotVictoria Foundation Funded Pilot
Projects for 2010Projects for 2010
 http://www.victoriafoundation.bc.ca/web/files/Sept2009_Fhttp://www.victoriafoundation.bc.ca/web/files/Sept2009_F
 Gateway Program at the John Howard Society (South CentralGateway Program at the John Howard Society (South Central
Okanagan)Okanagan)
 Pacific Community Resources Society (Vancouver-to-Pacific Community Resources Society (Vancouver-to-
Chilliwack)Chilliwack)
 Women’s Health Research Institute (Vancouver area)Women’s Health Research Institute (Vancouver area)
 Alberni Valley FASD Community Action Group (PortAlberni Valley FASD Community Action Group (Port
Alberni)Alberni)
 Fetal Alcohol Spectrum Disorder Society of BC (AsanteFetal Alcohol Spectrum Disorder Society of BC (Asante
Centre, Vancouver)Centre, Vancouver)

64. Community Living British ColumbiaCommunity Living British Columbia
 Adults with an FASD may now qualify forAdults with an FASD may now qualify for
life-long supports IF they have significantlife-long supports IF they have significant
impairment in adaptive functioning (below theimpairment in adaptive functioning (below the
0.1 percentile)0.1 percentile)
 Supports may include supported living,Supports may include supported living,
respite, employment support, skillrespite, employment support, skill
development, homemaker support anddevelopment, homemaker support and
development of support networksdevelopment of support networks
 http://www.communitylivingbc.ca/individuals-famhttp://www.communitylivingbc.ca/individuals-fam

65. Trouble with the Law/ForensicsTrouble with the Law/Forensics
 Forensic involvement opens service doorsForensic involvement opens service doors
 Specialized programs for youth who commitSpecialized programs for youth who commit
sexual and violent offensessexual and violent offenses
 General and specialized mental health servicesGeneral and specialized mental health services
for eligible youthfor eligible youth
 Community treatment and supervision ofCommunity treatment and supervision of
youth who have received a conditionalyouth who have received a conditional
dischargedischarge

66. Ministry for Housing and SocialMinistry for Housing and Social
DevelopmentDevelopment
 For some older youth (18+)/adults with anFor some older youth (18+)/adults with an
FASD and an inability to work full time,FASD and an inability to work full time,
financial support may be available via MHSDfinancial support may be available via MHSD
through the Persons with Disabilities or PWDthrough the Persons with Disabilities or PWD
 http://www.hsd.gov.bc.ca/PUBLICAT/bcea/pwd.hhttp://www.hsd.gov.bc.ca/PUBLICAT/bcea/pwd.h

67. Interior Health AuthorityInterior Health Authority
 IHA funds Alcohol and Drug counselling forIHA funds Alcohol and Drug counselling for
youth. Many of the counsellors have receivedyouth. Many of the counsellors have received
specific training regarding necessaryspecific training regarding necessary
modifications when treating youth with anmodifications when treating youth with an
FASDFASD
 Developmental Disability Mental Health –Developmental Disability Mental Health –
trained youth mental health therapiststrained youth mental health therapists
(generally youth also have an intellectual(generally youth also have an intellectual
disability to qualify)disability to qualify)

68. Summary – Community Services forSummary – Community Services for
individuals with an FASDindividuals with an FASD
 Without additional diagnoses or forensicWithout additional diagnoses or forensic
involvement, individuals with an FASD do notinvolvement, individuals with an FASD do not
generally qualify for specialized services in BCgenerally qualify for specialized services in BC
 In our region, there are no services that work directlyIn our region, there are no services that work directly
with the person affected by FASDwith the person affected by FASD
 The Key Worker Agency Program is the onlyThe Key Worker Agency Program is the only
provincial program for FASD and its mandate is toprovincial program for FASD and its mandate is to
work with families and other professionalswork with families and other professionals