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Module 4: FASD Signs and Symptoms

Secondary Disabilities

Primary disabilities are characteristics or behaviors that reflect differences in brain structure and function, such as mental retardation, attention deficits, and sensory integration dysfunction. Secondary disabilities are disabilities that the individual is not born with. These disabilities and behaviors develop over time because of a poor fit between the person and the environment.

Difficulties stemming from primary disabilities may lead to secondary disabilities. For example, negative behaviors may result from cognitive deficits, as shown in the table.

Primary and Secondary Disabilities

Primary Disability

Secondary Disability

Possible Reason for Behavior

Memory problems


Making things up to fill in the blanks

Failure to understand ownership


Attempt to buy friends

Little understanding of value of objects

Destructive behavior

Anger and frustration

Slow cognitive or auditory pace


Avoidance as a result of frequent failure, inability to process instructions

Many secondary disabilities can be lessened or avoided if individuals who work with the child understand FASD. These people will need to modify their approach to better support the way the child learns academic subjects and social behaviors. More research is needed to identify the specific effects prenatal alcohol exposure has on behavior and development and the way those effects impact performance and behavior in academic settings. Future findings may lead to the development of practical teaching methods to support the education of children with an FASD and prevent secondary disabilities.7

Examples of secondary disabilities include mental health problems (although some persons with an FASD are born with mental health problems), substance abuse problems, academic problems, and trouble with the law.

Source: Streissguth, A.P.; Barr, H.M.; Kogan, J.; et al. 1996. Final Report: Understanding the Occurrence of Secondary Disabilities in Clients With Fetal Alcohol Syndrome (FAS) and Fetal Alcohol Effects (FAE). Seattle: University of Washington Publication Services.

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