Presentation
This guide also presents a special look at FASD prevention in Aboriginal Australian communities, and may be of use to professionals who work with Native Americans. Contents: PDF Department of Health, Western Australia. [itcmi.org]
Like in other types of disabilities, it is important to recognize the variety of presentations that is possible and pursue a functional and individualized approach. [canchild.ca]
Neurobehavioral Disorder/Alcohol Exposed (ND/AE) is a diagnostic outcome classification for patients who present with: moderate CNS dysfunction. prenatal alcohol exposure (confirmed). [depts.washington.edu]
However, the risk is present at any time during pregnancy. Risk factors The more alcohol you drink during pregnancy, the greater the chance of problems in your baby. There's no known safe amount of alcohol consumption during pregnancy. [mayoclinic.org]
Although alcohol exposure presents a physical risk to the fetus much like mercury and thalidomide, it is in the area of behaviour that alcohol seems to do the most long-term damage. [pregnancy.com.au]
Entire Body System
- Weakness
A child is diagnosed with an FASD by looking carefully at certain physical characteristics, growth patterns, and learning strengths and weaknesses. [urmc.rochester.edu]
A letter was written to Parliament voicing concerns about the gin problem and stating that, "too often the cause of weak, feeble, and distempered children, who must be, instead of an advantage and strength, [become] a charge to their country." [azcourts.gov]
Children with FAS can also occasionally have additional problems such as: Epilepsy Hearing and ear problems Height and weight issues Hormonal disorders Liver damage Kidney and heart defects Mouth, teeth and facial problems Weak immune system How FAS develops [drinkaware.co.uk]
Diagnostic category does not necessarily predict cognitive level, (i.e., needs of FAS, pFAS and ARND can all be substantial). 14 Learning disabilities, language and communication disabilities are common. 1 Executive functioning skills are often a significant weakness [vkc.mc.vanderbilt.edu]
- Atrial Septal Defect
defects atrial septal defect (ASD) ventricular septal defect (VSD) cono-truncal anomalies Ocular/ophthalmic ptosis strabismus optic nerve hypoplasia Renal dysplastic kidneys Genitourinary hypoplasia of external genitalia 8 Other evidence of intrauterine [radiopaedia.org]
Your baby may be born with a congenital heart defect, like a hole in the heart called atrial septal defect (also called ASD) or ventricular septal defect (also called VSD), depending on where the hole is. [marchofdimes.org]
Eyes
- Strabismus
Fetal Alcohol Syndrome 3_0112 Slideshow Many children with FASDs have strabismus, microphthalmia and/or short eye openings known as palpebral fissures. They may also experience refractive vision problems associated with smaller head size. [clinicaladvisor.com]
[…] excavatum 8 vertebral segmental anomalies: congenital scoliosis limb anomalies fusion of upper limbs: radio-ulnar synostoses Cardiac septal defects atrial septal defect (ASD) ventricular septal defect (VSD) cono-truncal anomalies Ocular/ophthalmic ptosis strabismus [radiopaedia.org]
J Pediatr Ophthalmol Strabismus. 1997;34:17-23. Mattson SN, et al. A decrease in the size of the basal ganglia in children with fetal alcohol syndrome. Alcohol Clin Exp Res. 1996;20:1088-93. Mattson SN, et al. [rarediseases.org]
According to the American Association for Pediatric Ophthalmology and Strabismus, FAS is the leading preventable cause of birth defects and neurological and developmental disabilities in the U.S. There are six to nine cases of FAS per 1,000 births. [addictionresource.com]
- Visual Impairment
Visual impairment and hearing problems may also exist. Children with FAS are often naïve. With poor judgment and decision-making skills, they sometimes find themselves facing substance abuse and difficulties with the law later in life. [medbroadcast.com]
Psychiatrical
- Inappropriate Sexual Behavior
Typical and atypical seizures may be present. 12 Inappropriate sexual behavior may be more common than anticipated. [vkc.mc.vanderbilt.edu]
[…] with independent living and with employment Inappropriate sexual behaviors Early death by accident, homicide or suicide Prevention Experts know that fetal alcohol syndrome is completely preventable if women don't drink alcohol at all during pregnancy [mayoclinic.org]
When older they may also exhibit inappropriate sexual behaviors. Diagnosing FAS The sooner FAS can be diagnosed the better a child’s outcome is likely to be. [addictionresource.com]
Substance use; inappropriate sexual behaviors, such as inappropriate exposure, improper touching, and promiscuity; and consequent legal problems have been reported in adults diagnosed with FAS. 50, 59, 60 Delayed diagnosis and misdiagnosis contribute [pediatrics.aappublications.org]
- Fear
Unfortunately, FASD persists in part because many women who are pregnant and drink are ashamed or afraid to come forward, fearing stigma or prosecution, said Kathleen T. [apa.org]
Some of these indicators include: Academic problems, especially with math and memorizing tasks Birth mother with a history of substance use problems Difficulty with attention or exhibits hyperactivity FAS facial features High-risk behaviors or has no fear [ctclearinghouse.org]
But he fears it will be difficult to police. “There are 37 000 illegal shebeens in the province and only a few hundred police officers available to enforce it.” As Macdonald notes, the costs to society are high. [who.int]
Children with FAS may show a lack of empathy, an unusual lack of fear of strangers that is normal in children, and immaturity. When older they may also exhibit inappropriate sexual behaviors. [addictionresource.com]
- Denial
Most often, affected individuals are seen as lazy, unmotivated, disorganised, in denial, or dishonest. [pregnancy.com.au]
- Aggressive Behavior
[…] teach kids social skills counseling with a mental health professional Doctors may prescribe medicines to help with some of the problems associated with FAS, including attention deficit hyperactivity disorder (ADHD), depression, aggressive behavior, sleep [kidshealth.org]
Neurologic
- Neglect
[…] palsy Communication disorder Complications in adoption and foster care Complications to Congenital Heart Disease Enuresis, encopresis Developmental delays Down Syndrome Failure to thrive Fetal Alcohol Syndrome Fragile X Syndrome History of abuse and/or neglect [phoenixchildrens.org]
Although psychological factors such as abuse and neglect can add to the intensity of the problems, the behaviors should be viewed first and foremost as a result of brain damage from alcohol. [childrensal.org]
Many individuals experience multiple home/foster home placements, neglect, and abuse. 18 Evaluate and refer for attention-related disorders. [vkc.mc.vanderbilt.edu]
[…] drugs), another medical condition (e.g., traumatic brain injury, delirium, dementia), another known teratogen (e.g., Fetal Hydantoin syndrome), a genetic condition (e.g., Williams syndrome, Down syndrome, Cornelia de Lange syndrome), or environmental neglect [nofas.org]
[…] involvement with a US child social services system can indicate a higher likelihood of having had PAE and a need for careful screening for FASD. 21, 49, 81 A history of involvement with child protective services related to parental substance use or to child neglect [pediatrics.aappublications.org]
Treatment
Treatment No one treatment is right for every child, as FASD and its constellation of symptoms differ from one child to another. [healthychildren.org]
Services - Provides assessment and short-term treatment for children and teens with developmental delay or disability and challenging behaviors. [urmc.rochester.edu]
That said, due to its varying degrees of effects and severity, treatment must be determined at an individual level, as Koren et al state: “as a diagnosis of FASD in and of itself does not provide enough information on the appropriate treatment that must [canchild.ca]
Provide referrals for alcohol abuse treatment. Refer parent for appropriate prenatal medical care. [policy.dcfs.lacounty.gov]
The types of treatment options include medication to help with some symptoms, behavior and education therapy, parent training, and other alternative approaches. No one treatment is right for every child. [verywell.com]
Prognosis
The earlier you can place a child who has the syndrome in appropriate educational classes and provide essential social services, the more improved the prognosis. [verywell.com]
What is the prognosis of fetal alcohol syndrome? As noted in the above discussion, an individual with FAS may experience a lifelong litany of both physical and intellectual challenges. [medicinenet.com]
Look for early intervention programs in your state as that can better the prognosis. [drugabuse.com]
The prognosis for FAS improves dramatically if: The condition is diagnosed before a child is six. Treatment and therapy start as early as possible. The child is brought up in a loving, stable, and violence-free home. [addictionresource.com]
Etiology
The prevalence of FASD has been estimated to be at 9.1 per 1,000 live births in the United States. 3, 4 Etiology: Prenatal alcohol exposure The range of deficits in FASD is associated with many factors, including the amount, time and frequency of exposure [vkc.mc.vanderbilt.edu]
Diagnosing FAS also means a comprehensive history has documented any other in utero substance exposures, including tobacco, medications, or illicit substances of abuse, and that other possible genetic and environmental etiologies have been excluded, specifically [pediatrics.aappublications.org]
Epidemiology
Susan Astley is Professor of Epidemiology and Pediatrics at UW Schools of Public Health and Medicine. Dr. Astley’s primary area of expertise is Fetal Alcohol Spectrum Disorders (FASD). [alaskapublic.org]
Early epidemiological studies revealed infants with FASD-like features in the absence of maternal alcohol, where the fathers were alcoholics. [frontiersin.org]
Fetal Alcohol Syndrome: Diagnosis, Epidemiology, Prevention, and Treatment (Washington, DC: National Academy Press). - Astley SJ and Clarren SK. (2000). [revistas.unc.edu.ar]
Epidemiology of fetal alcohol syndrome in a South African community in the Western Cape Province. Am J Public Health. 2000 Dec. 90(12):1905-12. [Medline]. May PA, Gossage JP, White-Country M, et al. [emedicine.medscape.com]
Prevalence and Epidemiologic Characteristics of FASD from Various Research Methods with an Emphasis on Recent In-School Studies. Developmental Disabilities Research Reviews, 15(3), 176-192. doi:10.1002/ddrr.68 Olson, H.C. (2012). [ncjfcj.org]
Pathophysiology
Pathophysiology Alcohol crosses the placenta and rapidly reaches the fetus. [emedicine.medscape.com]
Because the term was too broad and vague for practical clinical or epidemiologic use, it was retired from use in 1996 and replaced with 2 pathophysiologically based diagnostic categories: ARBD and ARND. 5 – 7 Despite greater public awareness, improved [pediatrics.aappublications.org]
Prevention
FASDs are 100% preventable by avoiding alcohol during pregnancy, but prevention presents a challenge to Native American communities due to the high prevalence of risk factors like binge-drinking in the family, intergenerational trauma, and violence. [itcmi.org]
[…] a women's health perspective to FASD prevention (Nancy Poole) Next Steps in FASD Primary Prevention (Robin Thurmeier, Sameer Deshpande, Anne Lavack, Noreen Agrey, and Madgalena Cismaru) Preventing Fetal Alcohol Spectrum Disorders: The Parent-Child Assistance [wiley.com]
FASD is a PREVENTABLE disability. To date, most prevention strategies have focused on educating women of reproductive years. [dhss.alaska.gov]
According to the Centers for Disease Control and Prevention (CDC), "to prevent FASDs, a woman should not drink alcohol while she is pregnant, or when she might get pregnant. [michigan.gov]
She is the director of Washington State FAS Diagnostic & Prevention Network (FAS DPN). [alaskapublic.org]