Connecting the Dots: Functional Behavior Evaluation in Fetal Alcohol Spectrum Disorder

This chapter describes a practical and forensically tested approach to conducting adaptive behavior assessments, also known as functional behavior evaluations (FBAs), in the FASD context. From stand-alone FBAs in contexts such as disabilities determination, where mental health evaluators conduct neuropsychological testing as well as adaptive assessments, to “gold standard” multidisciplinary assessments in high-stakes criminal matters involving multiple mental health and medical experts, the ultimate role of the FBA expert is to synthesize and analyze data from multiple sources and methods across the lifespan, integrating neurocognitive/adaptive assessment data with behavioral data to explain brain–behavior connections. The chapter highlights empirically based patterns expected in psychometric testing and adaptive assessment of those with FASD as well as behaviors that typically stem from such patterns, linking that information with neurobehavioral disorder associated with fetal alcohol exposure (ND-PAE), the DSM-5 diagnosis for the central nervous system (CNS) impairment in FASD medical conditions. The chapter concludes with suggestions for mental health professionals on how to present relevant data in reports or testimony in order to describe how the behavior at issue is consistent with developmental trajectory.