If this sounds familiar: "She received compliments from children at school, choosing to chase them with nails and shapr objects when they dared to play with her chosen friend for the day, and when she was rejected she bent their fingers backward and often cuffed the boys in the head so hard they cried... "In interview he presents as average in intelligence, but extremely immature in his social skills. He has no insight, his judgment is poor and his motivation for treatment is questionable...Remorse is considered to be absent (all class symptoms of FASD). As an adoptive parent I often overlook the fact that my son was exposed to alcohol, which is a toxic to a fetus. Even moderate drinking during pregnancy can cause it. Here are some statistics that surprised me, they were so high: 94 per cent with FASD (this is the new way of referring to any child who is affected by alcohol in any way) have been diagnosed with a mental health disorder. 60% experienced some confinement in a psychiatric. hospital/Residential Treatment Center (RTC), drug rehab, or prison 60% had disrupted school experiences (dropping out, expulsion, suspension) 60% trouble with law 50% inappropriate sexual behavior (I have NOT known this, and bet my one adopted son who perped on my other kids had a version of FASD) 50% susbstance abuse 80% had problems with jobs/independent living The most common misdiagnoses are Reactive Attachment Disorder (RAD), CD, ODD, ADHD, learning disabilities The book I'm reading is "Damaged Angels (An Adoptive Mother Discovers the Tragic Toll of Alcohol and Pregnancy) by Bonnie Buxton. She claims that 50-70% of kids in The Canadian System are alcohol affected in some way, and I think it's probably the same here in the States. Often, I think we don't see or want to see this possibility in our foster/adopt kids. I know that Lucas doesn't have classic Fetal Alcohol Syndrome (FAS) and no behavioral issues so I tend to sweep it under the rug---but would he have autism and strange learning patterns if his b-mom hadn't abused drugs and alcohol? I can't know. I'll bet Reactive Attachment Disorder (RAD) is the most commonly misdiagnosed disorder when it's really alcohol related because, after reading this book, NO REMORSE is a big factor--these kids don't "get" what they did and keep repeating it. Some adoptive parents mortgage the bank to help these kids and they can't change; they have organic brain damage. This book opened my eyes to my own child, and to possibly the child we adopted who perped on kids and killed animals. I always figured he didn't just have Reactive Attachment Disorder (RAD). He seemed too clueless about his own actions and too unable to learn. This is a great book for parents who adopted a child who they can't seem to help, especially if you know the child's b-mom was a substance abuser. There's lots of good info in it, including misdiagnosed interviews with adults who have to live with alcohol affects. I got it at the library--very well-written.