Many children with Fetal Alcohol Spectrum Disorder (FASD) show signs of developmental trauma. While psychotherapy with children with developmental trauma has been documented, this is not the case for the use of psychotherapy with children with FASD. Dyadic developmental psychotherapy (DDP), originally developed for children with developmental trauma and attachment issues, can also be used for children with FASD, but requires some adaptation to accommodate the neurodevelopmental challenges of this clientele. This article presents the most recent scientific knowledge on FASD and developmental trauma. Subsequently, the fundamentals of DDP will be presented. Finally, a case study will illustrate the use and adaptation of DDP with a child with FASD and developmental trauma.