A cluster of effects caused by prenatal exposure of the fetus to alcohol is called fetal alcohol syndrome (FAS). These effects can consist of growth deficiency, characteristic facial features, such as palpebral fissures, a flat midface with a short upturned nose, or a smooth or long philtrum. In addition, prenatal alcohol exposure can cause significant central nervous system (CNS) abnormalities without any physical signs, such as intelligence, attention, learning, memory, language, and motor and visuospatial abilities. The high incidence of persons with FAS or fetal alcohol effects (FAE) who have displayed inappropriate sexual behaviors remains undiagnosed, making it highly likely that our adults and adolescent sexual offender treatment programs maintain many individuals with neurological impairment due to prenatal alcohol exposure. This study examined the implications of their neurological impairment for the approaches undertaken to assess and treat. It was suggested that rather than labeling an individual with FAS/FAE specific problems they struggle with should be identified. The identification of functional problems or cognitive deficits is more practical for clinicians trying to develop effective interventions as opposed to a diagnosis. Identified treatment implications of common cognitive deficits include: deficits in response inhibition and deficits in executive functions. Therefore, treatment planning for adolescents with FAS/FAE and sexual offending behaviors must address two interrelated issues: their cognitive deficits and their sexual offending. Recommendations such as using external aides in the training of temporal order and sequencing, scheduling regular daily sessions of shorter duration, using visual imagery and cue cards for memory enhancement, cognitive-behavioral and skills-based interventions, and a provision of treatment in either small groups or one-on-one to reduce the risk of persons being overwhelmed by social stimulation all have common sense appeal. However, their effectiveness for persons with FAS/FAE is unknown. Without evidence-based interventions, clinicians must be exploratory and creative, but assumptions about effectiveness should not be made. References