2448 Hamilton Road, Bright's Grove, Ontario N0N 1C0 Phone: (519) 869-8026 E-Mail: info@faslink.org

1. FASlinkFetal Alcohol Disorders Society 2448 Hamilton Road, Bright's Grove, Ontario N0N 1C0 Phone: (519) 869-8026 E-Mail: info@faslink.org Website: www.faslink.org

2. Don’t Ask My Child to Fly © Bruce Ritchie 1997

3. Don't ask my child to fly, for he has not wings. .

4. Don't ask my child to remain calm amid the din, for her ability to screen out the noises has been taken away.

5. Don't ask my child to be careful with "strangers", for he is affectionate with everyone and prey for the unscrupulous. .

6. Don't ask my child to "settle down", for the clock which works for you and I, does not exist for her. .

7. Don't ask my child to not play with the toys of others, for he has no concept of property.

8. Don’t ask my child to remember you tomorrow, although you met today. .

9. Don't ask my child to heal your wounds, for her hands cannot hold a scalpel or sutures.

10. Don't ask my child to meet the challenges set by society, for you have denied her the tools. .

11. Don't ask my child to forgive you for standing idly by, . while he was in trouble in his mother's womb,

12. for he will, but He may not.

13. An individual’s place, and success, in society is almost entirely determined by neurological functioning.

14. A neurologically injured child is unable to meet the expectations of parents, family, peers, school and career and can endure a lifetime of failures. • The largest cause of neurological damage in children is prenatal exposure to alcohol. • These children grow up to become adults. • Often the neurological damage goes undiagnosed, but not unpunished.

15. What is FASD? • Fetal Alcohol Syndrome (FAS), • Fetal Alcohol Effects (FAE), • Partial Fetal Alcohol Syndrome (pFAS), • Alcohol Related Neurodevelopmental Disorders (ARND), • Static Encephalopathy (alcohol exposed) (SE) and • Alcohol Related Birth Defects (ARBD) are all names for a spectrum of disorders caused when a pregnant woman consumes alcohol.

16. "Of all the substances of abuse, including heroin, cocaine, and marijuana, alcohol produces by far the most serious neurobehavioral effects in the fetus.” --Institute of Medicine 1996 Report to Congress

17. Ethanol alone was found to interact with over 1000 genes and cell events. Ethanol responsive genes directly regulate and are themselves regulated by the activity of other proteins and cell processes. Genetics Uddin RK, Treadwell JA, Singh SMDepartment of Biology and Division of Medical Genetics, The University of Western Ontario

18. There is no safe level of alcohol consumption during pregnancy. .

19. FASD is 100% Preventable www.faslink.org

20. Legally intoxicated is defined as a Blood Alcohol Level (BAL) of .08%. • Permanent brain cell damage begins at a BAL of .07%. • A 100 lb (45 kg) female consuming 5 standard drinks will reach a BAL of .25% - three times the legal limit. BAL reduces .01% per hour. • A drink equals a 12 oz. regular beer, 1 oz. shot of 100 proof liquor, 1.5 oz. shot of 80 proof liquor, or 4 oz. glass of regular table wine.

21. Statistics Canada, Canadian Community Health Survey, 2000/01 • 6.8% of girls ages 12 to 14 • 19.8% of girls age 12 to 19 • 26.0% ages 20 to 24 • 19.9% ages 20 to 34consumed 5 or more drinks on each occasion 12 or more times per yearAn additional: • 13.8% of girls ages 12 to 14 • 32.2% ages 15 to 34 consumed 5 or more drinks on each occasion 1 to 11 times per year.

22. Prenatal Alcohol Exposure • 37% of babies have been exposed to multiple binges (5+ drinks/session), often before the girl knew she was pregnant. • Another 42% are exposed to multiple sessions of 1 to 4 drinks per occasion. • 15%to18% continue to drink throughout the pregnancy, 4% at elevated levels.

23. Maternal prenatal alcohol consumption even at low levels is adversely related to child behavior. • The effect was observed at average exposure levels as low as 1 drink per week.

24. Just one glass of wine a week can make babies “jump” in the womb throughout a nine-month pregnancy. Experts believe this abnormal hyperactive behaviour is the result of alcohol slowing or retarding the formation of the central nervous system. Alcohol Startle Response Ultrasound image of fetus when exposed to alcohol

25. FASD is so grossly under-reported that the traditional FAS statistics are almost meaningless. • Very few doctors have received any training in diagnosing FASD • Many will not diagnose FASD for fear of stigmatizing the child and/or the mother.

26. FASD is not a threshold condition. • FASD is a continuum ranging from mild intellectual and behavioural issues to the extreme that often leads to profound disabilities or premature death. • It is somewhere in the middle of the continuum that the issues attract the attention of parents, educators, medical and social work professionals, and eventually the justice system.

27. Incidence • Most of the issues that attract sufficient attention are behavioural and performance issues. • "The most outstanding characteristics of FAS are bad judgment and the inability to make the connection between an act and its consequences." (Streissguth, AP)

28. Incidence • Approximately 20% of Canadian school age children are receiving special education services, most for conditions of the types known to be caused by prenatal alcohol exposure.

29. Foolish, drunken, or harebrain women most often bring forth children like unto themselves Aristotle in Problemata Behold, thou shalt conceive and bear a son: And now, drink no wine or strong drink. Judges 13:7 (1070 B.C.) Alcohol as a teratogen

30. Effects of Alcohol as a Teratogen on the Baby

31. Brain damage resulting from prenatal alcohol photo: Clarren, 1986

32. Alcohol is toxic at all concentrations • Damage varies due to volume ingested, timing during pregnancy, peak blood alcohol levels, genetics, mother’s health and nutrition, and environmental factors.

33. FASD is a lifetime disability • It is not curable. A child does not "grow out of it". • However, early diagnosis and intensive, and appropriate, intervention can make an enormous difference in the prognosis for the child.

34. FAS – Only the tip of the iceberg • Fetal Alcohol Syndrome • Partial Fetal Alcohol Syndrome • Alcohol Related Neurodevelopmental Disabilities • Alcohol Related Birth Defects • Clinically suspect but appear normal • Normal, but never reach their potential Adapted from Streissguth

35. Early diagnosis can help prevent secondary disabilities such as • mental health problems • dropping out of school • trouble with the law and • substance abuse.

36. Parents often find that their ability to cope with the child's behavior changes dramatically when they understand that the problems are most likely based on organic brain damage, rather than the child's choice to be inattentive or uncooperative.

37. Prenatal alcohol damage can include: • Loss of intellectual functioning (IQ) • Mild to severe vision problems • Dangerously high pain tolerance • Severe loss of intellectual potential • Mental Retardation • Dyslexia • Serious maxilo-facial deformities • Dental abnormalities • Cleft palate

38. Immune system malfunctioning Behavioral problems Attention deficit disorders ADD/ADHD Extreme impulsiveness Poor judgement Little or no retained memory Deafness Little or no capacity for moral judgement

39. Little or no capacity for interpersonal empathy • Sociopathic behaviour • Epilepsy • Tremors • Cerebral palsy • Renal failure • Asthma • Complex seizure disorder

40. Developmental speech and language disorder • Developmental delay • Height and weight deficiencies • Tight hamstrings • Cognitive perseveration • Echolalia • Autistic traits • Rigidity • Sleep disorder

41. Developmental coordination disorder • Adaptive esotropia • Tourette's traits • Central auditory processing disorder • Night terrors • Precocious puberty • Social problems

42. Depression • Reactive outbursts • Heart defects • Heart failure • Suicide • Death

43. FAS Physical Abnormalities • 98% are under normal height and weight • 84% Microcephalic • 89% Mental and Motor Retardation • 80% Speech impediments • 20% Hearing problems • 20% Swallowing/Feeding problems • 72% Hyperactive • 58% Slack muscles • 20% Autism/Aggressive/Social Problems

44. FAS Physical Abnormalities • 95% Facial anomalies • 29% Heart defects • 10% Kidney defects • 46% Genital deformities • 25% Eye problems • 16% Bent crooked little finger • 51% Shortened and bent little finger • 13% Underdeveloped fingers • 9% Hip deformities • 16% Small teeth

45. FAS Physical Abnormalities • 30% Pigeon Chest • 7% Concave chest • 7% Cleft palate • 44% Spinal dimple • 12% Hernia • 35% Hairgrowth on back of neck

46. Without diagnosis, FASD can create a number of secondary disabilities.

47. The girls get knocked up and the boys get locked up. They are followers, easily misled, with little or no appreciation of consequences. Without intervention, many drop out of school, ride the justice system merry-go-round or become "homeless street people and squeegee kids". They are required to compete in society but have been denied the tools to do so.

48. The brain's Frontal Lobescontrol: judgement, inhibition, concentration, self-control, conscience, personality and emotional traits as well as cognition and memory, motor speech and movement skills.

49. The Left Hemisphere • deals with language based memory • logical interpretation of language • mathematics • abstraction and reasoning • facts and rules (such as safety and social).

50. The Right Hemisphere • deals with holistic functioning • processing of images, sound, touch, • for a "holistic" picture. • Memory here is visual, auditory and spatial.