#41 Confabulation & Perseverance with Dr Vanessa Spiller#41 Confabulation & Perseverance with Dr Vanessa Spiller
Pregnancy and Alcohol: The Surprising Reality
Clinical psychologist and parent Dr Vanessa Spiller talks with host Kurt Lewis about FASD as a complex brain-based disability, highlighting confabulation, perseveration and justice system risks. The conversation shares practical ideas for carers and stresses the need for greater awareness and understanding in both families and professional settings.
49:58•8 Sept 2026
Confabulation, FASD and Justice: Dr Vanessa Spiller on Brains, Behaviour and Fairness
Episode Overview
- FASD is highly variable and can resemble autism, ADHD, intellectual disability and other diagnoses, so professionals need to keep it firmly on their radar.
- Brain-based differences in executive functioning, memory, comprehension and adaptive skills can increase the risk of contact with the justice system.
- Confabulation is the brain filling gaps in memory, not deliberate lying, and confronting it head-on often increases distress and reduces recall.
- Perseveration reflects a brain that is ‘stuck’, so carers are better off using empathy, humour, distraction and regulation than direct demands to “move on”.
- People with FASD can be supported to state that they have significant brain-based differences and request a support person during any formal questioning.
““These brain-based differences cause symptoms that look like behaviours, but they are actually symptoms and we know they’re symptoms because we can go back to the brain areas that drive them.””
Understand the complexities of addiction with insights from a clinician who’s also a parent on the front line. This conversation brings together host Kurt Lewis and clinical psychologist Dr Vanessa Spiller, who has nearly 30 years’ experience and is caring for an adult son with Fetal Alcohol Spectrum Disorder (FASD). You’ll hear how Vanessa first studied psychology for over 13 years without FASD ever being mentioned, and how everything changed when her two-and-a-half-year-old son arrived with a diagnosis.
She explains how early life with him was a “desert” of practical parenting guidance, pushing her into research, book writing and training so she could work out “how on earth am I going to parent this little person.” A big focus is why FASD is a “chameleon” condition that can look like autism, ADHD, intellectual disability or “behaviour problems”, and why professionals must have FASD on their radar whenever there’s a long list of diagnoses and complex needs.
The chat then turns to justice and policing. Vanessa breaks down how brain-based differences in executive functioning, memory, comprehension and adaptive skills can make people with FASD more vulnerable to impulsive, opportunistic offences and unfair treatment. She unpacks confabulation as “filling in the gaps in memory” and perseveration as the brain getting “stuck on something”, and shows how both can be mistaken for lying or wilfulness.
You’ll pick up down-to-earth tips for carers on handling confabulation and perseveration at home, why arguing about “what really happened” usually backfires, and how humour, empathy and regulation can help far more than confrontation. There’s also practical advice on teaching people with FASD to state their brain-based needs and ask for support during questioning.
Anyone who cares about FASD, parenting, justice or fair treatment will find plenty to reflect on here; what might change for you if you saw challenging behaviour as a symptom of a brain difference first?
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