Under the Hood: What Research Can Teach Us About Transitions

Growing Up Without Growing Out of Support

Sources:

Executive and Social Functioning Across Development in Children and Adolescents With Prenatal Alcohol Exposure — Rockhold et al., 2021.

Difficulties in Daily Living Experienced by Adolescents, Transition-Aged Youth, and Adults With Fetal Alcohol Spectrum Disorder — McLachlan et al., 2020.

When Expectations Grow Faster Than Support Needs Change

Growing up brings new opportunities—but it also brings a whole new set of expectations.

Manage your schedule. Remember your appointments. Get yourself where you need to be. Handle money. Find work. Maintain relationships. Figure out housing. Navigate services.

No pressure, right?

For people with FASD, an important consideration is that those expectations may change faster than support needs do.

A child may have an adult reminding them when to leave, what to bring and where they need to be. As a teenager, they're suddenly expected to juggle changing class schedules, assignments, activities and increasingly complicated friendships. Adulthood can add employment, finances, transportation, housing and appointments to the mix.

The person hasn't suddenly become less capable.

The world has simply started asking for more.

The Brain Behind the To-Do List

Researchers studying FASD often look at something called executive functioning.

That's the collection of skills we use to plan, organize, remember information, control impulses, solve problems, begin tasks and adjust when something changes.

In other words, many of the skills we rely on when someone says, “You're old enough to do this yourself now.”

A 2021 study by Rockhold and colleagues examined executive and social functioning in children and adolescents with prenatal alcohol exposure and found difficulties in both areas. The researchers also found evidence that the relationship between executive functioning and social functioning may become stronger across development.

As children get older, life becomes more complicated. Social expectations become subtler. School requires greater independence. Schedules get busier. There are more things to remember—and often fewer people reminding us.

The research gives us another way to look at what we're seeing:

Sometimes it's not that someone's abilities have gotten worse. The demands around them have gotten bigger.

A Birthday Doesn't Cancel a Support Need

There's no magical birthday when everyone wakes up knowing how to manage appointments, transportation, finances, housing and paperwork.

Wouldn't that be handy?

Canadian research led by McLachlan and colleagues examined clinical data from 726 adolescents, transition-aged youth and adults with prenatal alcohol exposure who had been assessed through FASD diagnostic clinics. The researchers identified significant difficulties across areas of daily living and highlighted the importance of developmentally informed assessment and needs-based services across the lifespan.

In other words, chronological age doesn't tell us everything about the support a person may need.

That doesn't mean support has to stay exactly the same.

A parent's reminder might become a calendar notification. Step-by-step help might become a written checklist. Someone who once managed appointments might gradually shift toward helping the person develop a system for managing them.

Growing independence doesn't always mean removing support. Sometimes it means changing what support looks like.

Change the Question

Research can also help us look differently at behaviour that might otherwise be misunderstood.

Missing an appointment could involve working memory or time awareness. Difficulty starting something could involve planning and task initiation. Becoming overwhelmed by a sudden change might involve cognitive flexibility or emotional regulation.

Instead of asking:

“Why aren't they doing this?”

we can ask:

“What could make this demand more manageable?”

Maybe it's a visual schedule. A phone reminder. Written instructions. Fewer steps at once. More processing time. Predictable routines. Help coordinating services.

None of this means people with FASD can't grow, learn, become more independent or take on new roles.

It means development is individual—and supports can evolve right alongside it.

Growing older doesn't have to mean growing out of support. Sometimes the best support simply grows up with you.