Primary Disabilities
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Primary Disabilities

Primary disabilities are those disabilities that a child is born with due to prenatal exposure to alcohol. These disabilities may impact cognitive, physical, behavioural or sensory functioning. The following list is examples of primary disabilities. Remembering not all children are alike, so not all primary disabilities on this list will apply to all children.

Developmental delays  

  • Often acts younger than his or her age.
  • Reduced cognitive pace.

Inconsistent performance

  • Seems to “get it” one day and lose it the next which leads people to believe that the child is intentionally being difficult.


  • Constantly in motion.


  • Says and does whatever comes to mind without thinking about consequences. Has no filters.

Attention deficits, distractibility

  • At times their lack of ability to stay focused on a task for very long is due to attention deficits.
  • May also be easily distracted.


  • Has difficulty planning and implementing so often can’t find things.

Poor social skills

  • Has problems making and keeping friends, doesn’t understand social cues or body language
  • Poor understanding of personal boundaries

Literal thinking

  • Doesn’t understand subtle jokes or statements that have double meanings; take things very literally. For example, don’t say, “Hit the road” when you mean “Leave”, or “Cut it out” when you mean “Stop”.

Difficulty with abstract concepts  

  • Struggles with abstract concepts such as math, money, time, ownership, and consequences.

Difficulty with transitions

  • Needs help when switching from one activity to another. May become very involved in current activity and will have difficulty changing to a new one especially if it is felt that the current activity is incomplete.

Memory problems

  • Difficulty storing and retrieving information.
  • Gaps in memory leads to storytelling or filling in the blanks

Processing deficits

  • May think more slowly, may only understand every third word of normally paced conversation.

Ability to repeat instructions, but inability to put them into action

  • Can “talk the talk but not walk the walk”

Inability to predict outcomes or understand consequences and cause/effect

  • Poor judgment

Difficulty generalizing from one situation to another

  • A lesson learned in one situation does not carry over to a new situation.

Motor Development

  • May have underdeveloped fine and gross motor skills


  • High or low pain tolerance, sensitivity to light, sound, texture or touch.

In addition to understanding the primary disabilities of a child diagnosed under FASD it is important to understand the concept of chronological age versus developmental age. The brain-based invisible physical disability with behavioral symptoms causes gaps in development. The child’s physical body continues to grow but skill development is scattered. Not all 18 year olds with a diagnosis under FASD will present in the following manner. This is an illustration to help understand the gaps in skill development. 

The following chart outlines that gap in skill development:

Development Profile of an 18 year old with FASD

Expressive Language-communicating their thoughts and ideas     20
Comprehension- understanding what is said to them      6
Concepts of Money and Time      8
Emotional Maturity      6
Physical Maturity     18
Reading     16
Social Skills-how they relate to others, understanding societal rules      7
Living Skills-taking care of themselves (i.e., cooking, dressing, hygiene)     11


Malbin, D. V. (2002). Trying Differently Rather Than Harder: Fetal Alcohol SpectrumDisorders (2nd Ed.). Portland, OR: Fetal Alcohol Syndrome Consultation, Education and Training Services (FASCETS), Inc.

Developmental Resource Centre Waterloo RegionSunbeam Centre