Topical Brief No. 10 – Confabulation and FASD: Understanding the Difference Between Lying and Memory Gaps

Confabulation       
Unintentional and brain-based
Often told confidently because it feels true
No clear motive to deceive
Common in memory or cognitive disorders (like FASD, TBI, dementia)

Lying
Intentional and purposeful
Often told hesitantly or defensively
Usually has a motive or goal (avoid trouble, gain something)
Common in typical development when making a choice

It’s important to note that calling confabulation “lying” can harm trust and relationships — especially for youth who already experience frequent misunderstanding and shame. How can we tell when it is confabulating or lying? It truly doesn’t matter, handle it in the same connected way.

REAL-LIFE EXAMPLE

Scenario:
A caregiver asks, “Did you turn in your homework yesterday?”
Child or adolescent with FASD replies: “Yes, I turned it in.”

In reality, the youth intended to turn it in, thought about turning it in, and may even remember handing it over — but never did.

Their brain filled in the missing details to complete the story. The answer isn’t a lie; it’s the student’s perceived truth. They are maybe remembering turning in homework three weeks ago.

WHAT CONFABULATION CAN LOOK LIKE

• Providing inconsistent versions of the same event.
• Making up stories that sound believable but aren’t accurate. Sometimes, the stories are not believable at all.
• Insisting something happened that didn’t, or denying something that did.
• Becoming frustrated or defensive when challenged (“That’s not what happened!”).

SUPPORTING SOMEONE WHO CONFABULATES

1. Stay Curious, Not Confrontational

Instead of saying, “That’s not true,” try:
“Hmm, I remember it a little differently — let’s figure it out together.”
Gentle curiosity prevents shame and keeps communication open.

2. Avoid Questions You Already Know the Answer To

If you already know what happened, don’t ask questions like “Did you take that?” or “Did you hit him?” — this sets the person up to confabulate.

Their brain may try to fill in gaps or avoid trouble, even when they don’t mean to lie. Instead, calmly describe what you know happened and focus on what needs to happen next.

3. Teach About Confabulation in Simple Terms

You can help the child or teen understand what’s happening in their brain by saying something like:
“Because of the way your brain works, sometimes it can trick you or confuse you. It might make you think something is true when it isn’t. You can let us help you when that happens — otherwise people might think you’re lying, and we know that’s not what’s really going on.”

This kind of conversation builds self-awareness and teaches that you’re a safe person to help sort things out.

4. Use Neutral Questions

Avoid rapid-fire questions that rely on recall (e.g., “Why did you do that?”).

Try supportive prompts instead:
“Tell me what you remember about what happened.”

5. Support Memory Gaps

• Use visual reminders (schedules, photos, checklists).
• Review events together daily.
• Write down or record key information immediately after activities.
• Repeat and rehearse routines so information moves into long-term memory.

6. Build Trust

Repeated accusations of “lying” can damage relationships and increase anxiety. When trust is strong, individuals feel safer admitting when they’re unsure.

7. Educate Others

Teachers, therapists, and case workers often misinterpret confabulation as dishonesty. Sharing this brain-based perspective helps shift blame from the individual to the neurological differences that drive the behavior.

Affiliate Link Disclosure: This web page contains affiliate links which means at no cost to you we will receive a small commission when you click and purchase a book through the link provided above. We only share resources we know and trust will give our viewers valuable information.