Fetal alcohol spectrum disorders (FASD)

Fetal alcohol syndrome

Fetal Alcohol Syndrome (FAS) The term FAS was first used in 1973 by Dr. David Smith and Dr. Ken Lyons Jones at the University of Washington. While FASD describes a range of disorders, FAS is a specific birth defect caused by alcohol use while pregnant. FAS is a diagnosis: It is medical diagnosis Q86.0 in the International Classification of Diseases (ICD-10). Results from drinking in weeks 16 through 20

Who needs to know?

Parent of a child with a disability Educator Student Nurse Therapist Social worker Case manager Foster parent Adopted parent

What is bing drinking?

* Binge = 4 or more standard drinks on one occasion for women

Diagnostic terminology

Alcohol-related neurodevelopmental disorder (ARND) Partial FAS (pFAS) Fetal alcohol effects (FAE) Alcohol-related birth defects (ARBD) Static encephalopathy (an unchanging injury to the brain)

More causes of FASD's

All alcoholic beverages are harmful. Binge drinking is especially harmful.* While it's true that not every woman who drinks during pregnancy will have a child with an FASD, that does not mean that these disorders are rare or random. Any time a pregnant woman consumes alcohol, it becomes possible that her baby will have an FASD.

QUIZ: WHICH TERATOGEN HAS THE GREATEST IMPACT ON THE DEVELOPING FETUS?

Cocaine Heroin Alcohol *** Marijuana

What are standard drinks

Daily drinkers were consuming drinks that were anywhere from three to six times the size of a standard drink. The majority of drinkers underestimated the number of fluid ounces they were consuming by about 30%. Standard drink is 0.6 oz ETOH Now are saying 2 drinks per week are standard.

Typical Difficulties For Persons With an FASD: Information processing

Do not complete tasks or chores and may appear to be oppositional Have trouble determining what to do in a given situation Do not ask questions because they want to fit in Have trouble with changes in tasks and routine They usually don't remember or understand Use one command at a time

Economic costs of FAS

FAS alone is estimated to cost the United States nearly $4 billion each year. The average lifetime cost for each child with FAS is almost $3 million.

Is FASD intentional?

FASDs are not caused intentionally by the mother: Many women simply may not know when they are first pregnant or may not be aware of the harm that alcohol consumption during pregnancy can cause.

FASD facts

FASDs are the leading known cause of preventable Intellectual disabilities (previously referred to as"mental retardation"). FASDs effect an estimated 40,000 newborns each year in the United States. FASDs are more common than autism. The effects of FASDs last a lifetime. People with an FASD can grow, improve, and function well in life with proper support. FASDs are 100% preventable.

Typical Strengths of Persons With an FASD

Friendly and cheerful Likable Desire to be liked Helpful VerbalDetermined Have points of insight Hard working They are usually not mallicious Every day is a new day!

Typical Difficulties For Persons With an FASD: Self esteem and personal issues

Function unevenly in school, work, and development - Often feel "stupid" or like a failure Are seen as lazy, uncooperative, and unmotivated -Have often been told they're not trying hard enough May have hygiene problems Are aware that they're "different" from others Often grow up living in multiple homes and experience multiple losses

Typical Difficulties For Persons With an FASD: Information processing

Have trouble following multiple directions Say they understand when they do not Have verbal expressive skills that often exceed their verbal receptive abilities Cannot operationalize what they've memorized (e.g., multiplication tables) Misinterpret others' words, actions, or body movements

Typical Difficulties For Persons With an FASD: Information processing

Have trouble following multiple directions Say they understand when they do not Have verbal expressive skills that often exceed their verbal receptive abilities Cannot operationalize what they've memorized (e.g., multiplication tables) Misinterpret others' words, actions, or body movements They cannot apply the knowledge

Risks of Not Accurately Identifying and Treating an FASD: For the family

Loss of family Increased substance use Premature death Financial strain Emotional stress

PRIMARY DISABILITIES THAT CAN OCCUR IN PERSONS WITH AN FASD

Lower IQ ImpImpaired ability in reading, spelling, and arithmetic Lower level of adaptive functioning

Facts about alcohol use in pregnant women

Nearly 12 percent of pregnant women report using alcohol in the past month. Past-month alcohol use among pregnant women and recent mothers aged 15 to 44 did not change significantly between 2002-2003 and 2006-2007.

More facts about alcohol use in pregnant women

Nearly 16 percent of pregnant women aged 15 to 17 used alcohol in the past month, and they consumed an average of 24 drinks in that month (i.e., they drank on an average of 6 days during the past month and had an average of about four drinks on the days that they drank).

The amount of alcohol drank that causes FASD

No amount of alcohol consumption during pregnancy is proven to be safe. FASDs are not caused by the biological father's alcohol use. The first born is usually the worst

More on economic costs of FAS

One prevented case of FAS saves: $130,000 in the first 5 years $360,000 in 10 years $587,000 in 15 years More than $1 million in 30 years

Identifying an FSAD

Only trained professionals can diagnose a disorder from the FASD spectrum. Ideally, diagnosis is done by a team that may include: Geneticists Developmental pediatricians Neurologists Dysmorphologists (physicians specializing in birth defects) Education consultants Psychologists, psychiatrists, and social workers Occupational therapists Speech and language specialists

TYPICAL DIFFICULTIES FOR PERSONS WITH AN FSAD: Executive Function and Decision-Making

Repeatedly break the rules- They usually don't remember the rules Give in to peer pressure Tend not to learn from mistakes or natural consequences Frequently do not respond to reward systems (points, levels, stickers, etc.) Have difficulty entertaining themselves Naïve, gullible (e.g., may walk off with a stranger) Struggle with abstract concepts (e.g., time, space, money, etc

Typical Difficulties For Persons With an FASD

Sensory: May be overly sensitive to bright lights, certain clothing, tastes and textures in food, loud sounds, etc. Physical: Have problems with balance and motor coordination (may seem "clumsy").

Some strategies to help

Simple, simple, simple Help them get started Environment Routines Patience - can't vs. won't Good peer examples

Possible Signs of an FASD: Signs that may suggest the need for an FSAD

Sleeping, breathing, or feeding problems Small head or facial or dental irregularities Heart defects or other organ dysfunction Deformities of joints, limbs, and fingers Slow physical growth before or after birth Vision or hearing problems Mental retardation or delayed development Behavior problems Maternal alcohol use

Factors Associated With Reduced Life Complications

Stable home Early diagnosis No violence against oneself More than 2.8 years in each living situation Recognized disabilities Diagnosis of FAS Good quality home from ages 8 to 12 Basic needs met for at least 13 percent of life

Trends in treatment

Strategies to assist persons with an FASD and their families continue to increase dynamically: SAMHSA's FASD Center for Excellence provides a variety of materials for families, providers, and educators: http://fasdcenter.samhsa.gov In addition to materials, the National Organization on Fetal Alcohol Syndrome (NOFAS) provides a directory of FAS resources: www.nofas.org/resource/directory.aspx The Centers for Disease Control and Prevention (CDC) are currently researching new approaches to FASD at sites across the country.

The cause of FASD's

The sole cause of FASDs is the fetus being exposed to alcohol during the pregnancy. Alcohol is a teratogen: A drug or other substance capable of interfering with the development of a fetus, causing birth defects. "Of all the substances of abuse (including cocaine, heroin, and marijuana), alcohol produces by far the most serious neurobehavioral effects in the fetus." The only cause is exposure to alcohol en utero.

FASD facts

Umbrella term describing the range of effects that can occur in an individual whose mother drank alcohol during pregnancy. May include physical, mental, behavioral, and/or learning disabilities with possible lifelong implications. Not a diagnosis.

Risks of Not Accurately Identifying and Treating an FASD: For the individual with the FSAD

Unemployment Loss of family Homelessness Jail Premature death Increased substance abuse Wrong treatment or intervention is used