Maria Catterick’s contribution to the Northern Children’s Homes Network Spring Conference invited us to look beyond visible behaviour. William “Liam” Curran’s 2026 paper adds evidence, urgency and a practical framework for turning that insight into better care.
When Maria Catterick from FASD Network UK joined us at the Spring conference, her contribution was one of those presentations that continued to generate conversation long after the session had finished. Some of those in attendance took almost immediate action, contacting social workers and arranging assessments for the children in their care.
For many delegates, Maria provided more than an introduction to foetal alcohol spectrum disorder (FASD). She offered a different way of thinking about some of the children we care for: looking beyond the behaviour that is immediately visible and considering the neurodevelopmental difficulties that may sit beneath it.
That matters particularly in residential childcare. Maria translated a complex subject into something recognisable and useful for people caring for children every day. Her positive impact came from combining expertise with a clear, compassionate message: when we understand the reasons a child is struggling, we can change the environment and the support around them.
A 2026 academic paper by our respected colleague William ‘Liam’ Curran adds further weight and urgency to that conversation.
FASD and children in care
Curran’s paper, Fetal alcohol spectrum disorder: A global perspective seeing the unseen: Fetal alcohol spectrum disorder(s) in child welfare service provision, begins from an uncomfortable premise: children involved with child welfare services frequently experience overlapping adversity and neurodevelopmental vulnerability, yet systems do not always identify or respond consistently to FASD and prenatal alcohol exposure.
The consequence is that neurodevelopmental impairment can be misunderstood as behaviour. This can lead to unsuitable interventions, instability and poorer outcomes for children whose needs have not been fully recognised.
The prevalence figures brought together in Curran’s paper should be of particular interest to everyone working with children in care. Estimated prevalence in the general population is around 1–5%. Research cited in the paper suggests rates of approximately 16.9 to 18.8% among children in foster care, with some estimates as high as 25%. Overall, FASD may be 10 to 40 times more prevalent in child welfare populations than in the general population.
These figures should not be used to claim that a fixed proportion of children living in children’s homes in England have FASD. The wider care population includes foster, residential, kinship and other settings, and prevalence estimates vary by study and method. They do, however, make one point unmistakable: FASD is not a peripheral issue for children’s social care.
For children’s homes, the possibility that a child’s needs may include unidentified neurodevelopmental impairment should therefore form part of our professional curiosity.
When behaviour is telling us something different
Perhaps the strongest connection between Maria’s presentation and Curran’s paper concerns the way adults understand behaviour.
Curran describes how neurodisability can be interpreted as oppositionality, non-compliance or behaviour arising only from trauma. A child may then receive repeated behaviour-management or trauma-focused interventions while difficulties with executive functioning, adaptive functioning, memory, impulse control and consequential thinking remain unidentified.
This is not a choice between trauma and FASD. Children affected by prenatal alcohol exposure may also have experienced neglect, abuse, disrupted attachment, loss and placement instability. The point is that trauma-informed practice alone may be insufficient when an underlying neurodevelopmental impairment remains unrecognised. Care needs to be both trauma-informed and neurodevelopmentally informed.
A child who repeatedly forgets an instruction may not be refusing to follow it. A child who appears to understand a consequence when it is explained may not be able to retrieve and apply that learning in the same situation tomorrow. A young person whose chronological age suggests increasing independence may have very different functional abilities in judgement, impulse control or risk awareness.
Curran uses the term dysmaturity to describe the gap that can exist between chronological age and developmental functioning. When adults do not recognise that gap, disability can easily be interpreted as wilful behaviour.
The question then changes. Instead of asking “Why won’t this child do what we have asked?” we may need to ask “What is making this difficult for this child to do?” That is a substantially different starting point for care.
Trying differently
This change in understanding has implications for behaviour support, safeguarding, education, relationships, independence planning and the expectations we place upon children. If the underlying difficulty is neurodevelopmental, increasing consequences, repeating instructions more forcefully or expecting a child to ‘learn from their mistakes’ may achieve very little. At worst, it can repeatedly place a child in situations in which adults expect them to demonstrate abilities they do not consistently possess.
Curran argues for disability-informed support, environmental accommodation and longer-term planning. In practice, this can mean greater structure and predictability; clearer and shorter communication; breaking tasks into manageable stages; recognising difficulties with memory and executive functioning; and providing practical scaffolding around decision-making, relationships, technology and risk.
This is not about lowering aspirations. It is about matching support to need so that children have a fair opportunity to succeed.
Support should not have to wait for a diagnosis
Perhaps one of the most useful aspects of Curran’s paper is its challenge to systems that make diagnosis the gateway to understanding or support. Formal diagnosis matters: it can bring clarity, inform care and open pathways to specialist help. But waiting for diagnosis can leave a child’s functional needs unmet, sometimes for years. Some children may never meet diagnostic requirements, particularly when reliable evidence about prenatal alcohol exposure is unavailable. In the northern region, particularly the North East, this is very relevant. In 2024, 569 people in the North East died from causes wholly attributable to alcohol. At 21.1 deaths per 100,000, the region had the highest alcohol-specific mortality rate in England, 53% above the national rate. When conditions partly attributable to alcohol are included, alcohol was estimated to have contributed to approximately 1,400 deaths across the region. Although deaths fell from their 2023 peak, the North East’s alcohol-specific death toll remained 30% higher than in 2019.
Curran’s 5-Step Neurodevelopmental Screening Approach prioritises functional assessment rather than diagnostic labelling. It asks practitioners to identify indicators of neurodevelopmental difficulty, gather developmental and prenatal histories where possible, use structured screening tools, consider the child’s pattern of functioning over time, and seek specialist multidisciplinary assessment when indicated.
The central message is straightforward: a child should not need a diagnostic label before adults begin responding intelligently to an identified neurodevelopmental need. Screening is not diagnosis, but it can help services recognise when a different formulation, reasonable adjustments or further assessment may be required.
From awareness to organisational practice
There is an equally important message for registered managers, responsible individuals and organisations providing children’s homes. FASD awareness cannot sit solely with one member of staff who happens to have attended training. Curran identifies the need for policy, procedure and protocol. Policy expresses the organisation’s commitment; procedure explains how practitioners should respond when concerns arise; and protocols translate those commitments into consistent frontline practice.
He also calls for workforce education, structured screening pathways, multidisciplinary collaboration and neurodevelopmentally informed care. For providers, that prompts practical questions:
- How confident are staff in recognising possible neurodevelopmental difficulties?
- Do assessments distinguish between what a child will not do and what they may not be able to do consistently?
- Does support reflect developmental and functional age as well as chronological age?
- When interventions repeatedly fail, do we simply repeat them, or reconsider our understanding of the child’s needs?
- Is knowledge about FASD embedded across the organisation, or does it depend on particular individuals?
- Are education, health, social care and specialist partners sharing a coherent understanding of the child?
Seeing the unseen
Curran concludes that the challenge for child welfare is no longer simply awareness, but implementation. FASD needs to move from the margins of practice and be recognised as a core neurodevelopmental issue, supported through organisational policy, clear procedures and protocols, workforce education, functional assessment and multidisciplinary collaboration.
That feels particularly pertinent following Maria Catterick’s contribution to our Spring Conference. Her knowledge, experience and quite brilliant presentation encouraged many of us to look differently at behaviour we might previously have understood mainly through the lenses of trauma, attachment or risk. Curran’s paper provides a compelling academic and practice framework for taking that thinking further.
There is a deceptively simple message beneath both: sometimes improving care does not begin with seeking to change the child. It begins with changing our understanding of them.
Further Reading
William Curran (2026), Fetal alcohol spectrum disorder: A global perspective seeing the unseen: Fetal alcohol spectrum disorder(s) in child welfare service provision, Child Protection and Practice, 10, 100334.
Further resources
Maria started a not-for-profit organisation for families affected by FASD called FASD Network UK and connects with over 1000 families who are facing the daily challenges of a lack of systemic support. Her interest in Foetal Alcohol Spectrum Disorder (FASD) stemmed from having direct experience of caring for a number of children with the condition. FASD is a permanent lifelong disability caused by prenatal alcohol exposure. FASD Network provide bespoke training for organisations to allow them to support individuals, support groups for families raising children with FASD, strategic development support, and conduct their own research and work with multi-agency partners.
Maria raises awareness and delivers training to multi-agency practitioners from health, education, community, addiction, justice, fostering, adoption, early intervention, social work, and other agencies. Her background is in social work, social care, community development and learning disabilities. She has worked within the voluntary sector for more than 30 years. She is the author of ‘Understanding FASD: A guide for parents, carers, and professionals’, which combines her lived experience as a foster carer with a practitioner’s perspective.
Visit FASD Network UK: www.fasdnetwork.org
FASD Network UK resources: www.fasdnetwork.org/resources.html