Activity: Cognitive Capacities for Meaningful Participation

The aim of this activity is to recognize those who struggle to understand well-intentioned instructions in response to substance use.


Activity overview

The purpose of this role play activity is to:

  1. create empathy for those struggling to understand well-intended directives in response to substance use
  2. evaluate the automatic and often logical, well-intended direction offered to those living with substance dependency and the effects of prenatal exposure


(Slide 23) In an effort to find the right intervention ‘fit’ for substance users, Nixon describes 4 key deficits we ought to be mindful of problems with:

  1. set shifting
  2. incorporating feedback
  3. incorporating direction
  4. verbalizing related principles or rules

Activity instructions


  1. In pairs, role play the scenarios below with these 4 deficits in mind.
  2. As the audience listens for opportunities to try a new approach, they may call out ‘freeze’ and then take the place of either the person with FASD or the support person.
  3. Continue ‘freezing’ and role playing until a more effective, empathetic script is found.


  1. Daniel, age 17, was out roaming the streets all night. The police bring him home with a charge of public intoxication. While Danny had not been actively involved in the vandalism, he was found with a group that was drunk and smashing car windows. As he tells the story, you easily imagine 3 or 4 things he could have done differently to get out of or avoid the situation.
    • the person playing Daniel should demonstrate the struggle in set shifting (seeing the alternatives)
  2. You’ve been through this a thousand times. It’s barely past the 15th and Breanne is leaving messages on your cell, begging for gas money. Rent and groceries will surely follow. While she has managed to hold down a job, Breanne consistently blows her paycheck on booze.
    • the person playing Breanne should demonstrate the difficulty in processing feedback, which typically sounds like:
      • “how many times do we have to go through this!?”
      • “this isn’t working for you!”
      • “can’t you see the connection between drinking and running out of money every month?”
  3. Amber was fired again. She’s 22, unemployed and dependent on alcohol as a coping strategy for depression, domestic violence and a history of trauma. Amber’s girlfriend attends community college, recently freed herself from a bad relationship and has little patience for what she calls Amber’s “repeated bad choices.” From her place of idealism, this friend is prone to fixing Amber’s problems and doing all her thinking for her.
    • the person playing Amber should demonstrate the difficulty incorporating the well-intended direction of her friend
  4. Fernando, age 36, was released to the care of his aging mother following a restraining order. While drunk, he and his wife had gotten into a fight and the police responded to a domestic dispute call. Fernando sits silently in his father’s arm chair while his mother, a recovering alcoholic herself, demands to know why this keeps happening.
    • the person playing Fernando should demonstrate the difficulty with abstract concepts such as ‘higher power’ and ‘sobriety’ in addition to “why” and “what were you thinking”
Modified: 2015-09-09
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