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Alcohol Can Hurt an Unborn Baby. Fetal Alcohol Spectrum Disorders (FASD) Education & Prevention. “Of all the substances of abuse (including cocaine, heroin, and marijuana), alcohol produces by far the most serious neurobehavioral effects in the fetus.” IOM Report to Congress 1996.
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Alcohol Can Hurt an Unborn Baby Fetal Alcohol Spectrum Disorders (FASD) Education & Prevention
“Of all the substances of abuse (including cocaine, heroin, and marijuana), alcohol produces by far the most serious neurobehavioral effects in the fetus.” IOM Report to Congress 1996
Fetal Alcohol Spectrum Disorders FASD in an umbrella term describing the range of effects that can occur in an individual whose mother drank alcohol during pregnancy.
Terminology Pregnancy Alcohol • Fetal Alcohol Syndrome (FAS) • Fetal Alcohol Effects (FAE) • Alcohol-Related Birth Defects (ARBD) • Alcohol-Related Neurodevelopmental Disorder (ARND) • Partial FAS (pFAS) + May result in
FASD Facts • 100 percent preventable • Leading known cause of preventable mental retardation • Not caused on purpose • Can occur anywhere and anytime pregnant women drink • Not caused by biologic father’s alcohol use • Not a new disorder
FASD These effects may include: • Physical • Mental • Behavioral • And/or learning disabilities with possible lifelong implications
The sole cause of FASD is women drinking alcoholic beverages during pregnancy!
Alcohol and Women If a woman is pregnant, it does not matter what form the alcohol comes in. • Wine spritzers • Alcohol pops • Beer • Wine coolers • Light beer, nonalcoholic beer • Energy Drinks Check labels for alcohol content.
FASD and Alcohol • All alcoholic beverages are harmful. • Binge drinking is especially harmful. • There is no proven safe amount of alcohol use during pregnancy.
Alcohol is by far the most commonly abused substance by female adolescents with 36.5% of girls ages 12-17 reporting alcohol use. • Approximately 20% of sexually active teenage girls ages 15-19 become pregnant each year in the U.S. • In 2004, the rate of binge drinking in the past month among pregnant women ages 15 to 17 was (8.8%); more than twice that of pregnant women ages 26 to 44 (3.8%). • U.S. Department of Health and Human Services Substance Abuse and Mental Health Services Administration 2007
2005 Message to Women from the U.S. Surgeon General • No amount of alcohol consumption can be considered safe during pregnancy. • Alcohol can damage a fetus at any stage of pregnancy. • The cognitive deficits and behavioral problems resulting from prenatal alcohol exposure are lifelong. • Alcohol-related birth defects are completely preventable.
The sooner a pregnant woman stops drinking alcohol, the better the outcome for the baby.
19% Substance Exposed 81% Not Exposed Extent of Exposure All newborns in the U.S. All exposed newborns 5% Other 5% Cocaine 17% Marijuana 73% Alcohol Source: National Institute on Drug Abuse, 1991
On any given day in the United States… • 10,657 babies are born • 1 baby will be born HIV positive • 3 babies will be born with Muscular Dystrophy • 4 babies will be born with Spina Bifida • 10 babies will be born with Down Syndrome • 20 babies will be born with FAS • 100 babies will be born with Alcohol Related Neurodevelopmental • Disorder
The Cost of Fetal AlcoholSyndrome (FAS) • Costs associated with caring for persons with FAS in the United States may be as high as $6billion. • The lifetime cost for each individual with FAS is $2 million or more, depending on how the costs are calculated. • One prevented case of FAS can save $2 million or more. Source: Lupton, et al., 2004
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 Increased savings through prevention Lupton, Burd, and Harwood (2004)
People who have brain damage as well as characteristic facial features and slowed growth are described as having Fetal Alcohol Syndrome (FAS)
Diagnosing Fetal Alcohol Syndrome • Prenatal maternal alcohol use • Growth deficiency • Central nervous system abnormalities • Dysmorphic features • Short palpebral fissures • Indistinct philtrum • Thin upper lip Source: Astley, S.J. 2004. Diagnostic Guide for Fetal Alcohol Spectrum Disorders: The 4-Digit Diagnostic Code, Third Edition. Seattle: University of Washington Publication Services, p. 114. Caucasian African American
8 Months Old Newborn
8 Years Old 7 Years Old
5 Years Old 18 Years Old
8 Years Old 18 Years Old
20 Years Old 30 Years Old
For Diagnosis in Utah Division of Medical Genetics University of Utah Department of Pediatrics 801-581-8943
Early diagnosis can help prevent secondary disabilities such as mental health problems, dropping out of school, trouble with the law and substance abuse.Fetal Alcohol Syndrome Diagnostic & Prevention Network
Potential Secondary Disabilities • Mental health problems 90% • Disrupted school experience 60% • Trouble with the law 60% • Inappropriate sexual behavior 50% • Alcohol and drug problems 30% • Dependent living 83% • Problems with employment 79% Streissguth
Thought Process with FASD Prenatal alcohol exposure can effect the neurochemical balance (or wiring) of the brain, so that messages are not transmitted as efficiently or as accurately as they should be.
Organic Brain Damage Several regions of the brain are seriously affected by prenatal alcohol exposure in terms of ability to function.
Organic Brain Damage • Cortex Frontal Lobes----The most noteworthy damage to the brain occurs in the prefrontal cortex, which controls the Executive Functions. • Executive Functions control thinking, reasoning, planning, emotions, problem solving, speech, impulses and judgment. Alcohol Health & Research World- 1994 Vol. 18T
Go with strangers Repeatedly break the rules Do not learn from mistakes or natural consequences Frequently do not respond to point, level, or sticker systems Have trouble with time and money Give in to peer pressure Typical Difficulties for Persons With an FASD Executive Function Deficits I’m late! I’m late!
Organic Brain Damage Corpus Callosum --- • Connects the hemispheres for the brain and allows information to be transmitted between them. • It allows both hemispheres to know what happens on both sides of the body.
Left Brain/Right BrainThe Corpus Callosum Right Brain Left Brain • Spatial abilities • Face recognition • Visual imagery • Music • Language • Math • Logic
Effects of Alcohol on the Brain A B C • Magnetic resonance imaging showing the side view of a 14-year-old control subject with a normal corpus callosum • 12-year-old with FAS and a thin corpus callosum • 14-year-old with FAS and agenesis (absence due to abnormal development) of the corpus callosum Source: Mattson, et al., 1994
FAS and the Brain These two images are of the brain of a 9-year-old girl with FAS. She has agenesis of the corpus callosum, and the large dark area in the back of her brain above the cerebellum is essentially empty space. A Source: Mattson, S.N.; Jernigan, T.L.; and Riley, E.P. 1994. MRI and prenatal alcohol exposure: Images provide insight into FAS. Alcohol Health & Research World 18(1):49–52.
Organic Brain Damage • Hippocampus ----- Memory, short term to long term recall, spatial relationships • Cerebellum ----- Balance, coordination, posture • Basil ganglia --- Controls unwanted movement to allow wanted movement
Overall Difficulties for Persons With an FASD Information • Taking in information • Storing information • Recalling information when necessary • Using information appropriately in a specific situation
Difficulty Generalizing Information The Student May… . Learn information as isolated entities, unrelated, fragmented . Be extremely concrete . Not transfer learned information into new contexts . Need re-teaching in a different location to understand general rule, i.e. “Don’t ride in all streets”
Primary Disabilities of Persons With an FASD • Lower IQ • Impaired ability in reading, spelling, and math • Lower level of adaptive functioning; more significantly impaired than IQ Permission to use photo on file. Streissguth, et al. (1996)
TIMELINES AND FASD • Actual age: 18 Developmental Age • Expressive Language------------------------20 • Comprehension---------6 • Money, time concepts------8 • Emotional maturity-----6 • Physical Maturity---------------------------18 • Social Skills------------------7 • Living Skills------------------------11 (D. Malbin) Research of Streissguth, Clarren et al.