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Fetal Alcohol Spectrum Disorders

Fetal Alcohol Spectrum Disorders. Fetal Alcohol Syndrome Fetal Alcohol Effects Alcohol-Related Neurodevelopmental Disorder Alcohol-Related Birth Defects. Fetal Alcohol Spectrum Disorders.

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Fetal Alcohol Spectrum Disorders

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  1. Fetal Alcohol Spectrum Disorders Fetal Alcohol Syndrome Fetal Alcohol Effects Alcohol-Related Neurodevelopmental Disorder Alcohol-Related Birth Defects

  2. Fetal Alcohol Spectrum Disorders • In mid-April of 2004, the National Organization on Fetal Alcohol Syndrome (NOFAS) brought together experts to create terminology addressing the broad effects associated with prenatal alcohol exposure

  3. Fetal Alcohol Spectrum Disorders • As a result, a definition for Fetal Alcohol Spectrum Disorders (FASD) was developed: • “ (FASD) is an umbrella term describing the range of effects that can occur in an individual whose mother drank alcohol during pregnancy. These effects may include physical, mental, behavioral, and/or learning disabilities with possible lifelong implications.”

  4. FASD History • Knowledge of the harm linked between alcohol and a fetus is not new (centuries old) • First ‘official’ documentation in 1899 • Breakthrough in 1960’s and 1970’s: • In 1968 Dr. Paul Lemoine studied 127 children with features and symptoms related to prenatal alcohol exposure • In 1970’s further study in Seattle termed the condition “fetal alcohol syndrome” \ Source: Clarren, Sterling K. Recognition of Fetal Alcohol Syndrome. JAMA. 1981;245(23):2436-2439. doi: 10.1001/jama.1981.03310480052033

  5. FASD Prevalence • Approximated • On any given day in the United States, 10,657 babies are born… • 1 of these babies is HIV positive • 10 of these babies are born with Down Syndrome • 20 of these babies are born with Fetal Alcohol Syndrome • 100 of these babies are born with an alcohol related disorder (1 out of 100) • Source: FAS Community Resource Center

  6. Fetal Alcohol Syndrome (FAS) • Affects 1-3 babies per 1000 • FAS is the leading cause of intellectual delay • FAS is the leading cause of birth defects • Caused by a mother’s heavy drinking during pregnancy • Central nervous system (brain, spinal cord) damage • Untreated, this primary disability can lead to secondary disabilities • Environmental issues complicate the condition • Many FAS-affected children in foster care • FAS is irreversible

  7. Four Fetal Alcohol Syndrome Criteria • Growth problems • Specific facial features • Central nervous system damage or dysfunction • Prenatal alcohol exposure • 4-Digit Diagnostic Code (WA State Diagnostic & Prevention Network)

  8. Growth Problems • Growth retardation • Bone growth - prenatally and postnatally • Height • Weight • Head circumference • Heart malformations

  9. Low Birth WeightSource: Clinical Advisor. Fetal Alcohol Spectrum Disorders. http://www.clinicaladvisor.com/fetal-alcohol-spectrum-disorders/slideshow/585/#4

  10. FAS Physical Characteristics • Facial characteristics • Small head • Small eyes • Large cheeks • Thin upper lip • Flat nose • Clinical presentation (AAFP, 2005)

  11. Vision IssuesSource: Clinical Advisor. Fetal Alcohol Spectrum Disorders. http://www.clinicaladvisor.com/fetal-alcohol-spectrum-disorders/slideshow/585/#2

  12. Fetal Alcohol Syndrome (FAS) Cognitive Characteristics • Learning disabilities (differences) • Visual-spatial learning • Objects on table (remembered, not placed correctly) • Slower reaction times (eye movements - geometric patterns) • Difficulty planning, organizing • Difficulty letting go of problem-solving strategies, even when they do not work • Memory deficits • Early stages, rather than recall (different from Down’s Syndrome) • Attention deficits • May be misdiagnosed ADHD • May focus and maintain attention well, but shift attention poorly Source: NIAAA, Alcohol Alert, December 2000

  13. Brain SizeSource: The Clinical Advisor. Fetal Alcohol Spectrum Disorders. http://www.clinicaladvisor.com/fetal-alcohol-spectrum-disorders/slideshow/585/#1

  14. FAS Behavioral Problems • Poor impulse control • Difficulties with social interaction • Inappropriate sexual behavior • Substance abuse • Problems with the law

  15. Fetal Alcohol Syndrome Vignettes(Fetal Alcohol Syndrome, National Academies Press:1996. Page 54) http://books.nap.edu/books/0309052920/html/54.html#pagetop

  16. Fetal Alcohol Effects (FAE) • Those affected with prenatal alcohol exposure • Those without all the symptoms of FAS • Growth deficiencies • Behavior problems • Substance abuse • Cognitive deficits • Some facial features • FAE now known as two diagnoses: Alcohol-Related Neurodevelopmental Disorder, Alcohol-Related Birth Defects

  17. Alcohol-Related Neurodevelopmental Disorder • Issues related to nervous system: • Communication problems • Memory problems • Learning disabilities (differences) • Visual & spatial skill problems • Problems with motor skills

  18. Alcohol-Related Birth Defects • Defects in major organ systems: • Abnormal development • Underdevelopment • Heart • Kidneys • Eyes, ears • Skeleton

  19. Is Any Amount of Alcohol Considered Safe? • There is no “safe” amount of alcohol consumption (Chart: MN Department of Health) • Most physicians will recommend pregnant women abstain from alcohol consumption • According to American Pregnancy Association: • 2-4 drinks, frequently, can lead to FAE • 5-6 drinks, frequently, can lead to FAS • According to Fetal Alcohol Syndrome (Institute of Medicine; National Academies Press: 1996, p. 68) • Effects of mild alcohol intake are controversial • Existing research suggests alcohol bingeing related to FAS

  20. Protective Factors • Early diagnosis • Special education • Social services • Nurturing environment • Absence of violence (National Center on Birth Defects and Developmental Disabilities)

  21. Early Intervention

  22. Common Issues Among FAS Babies • Sleep disturbances • Poor sucking response • Crying • Underdevelopment • Toilet training challenges • Distractibility, difficulty following directions • Disobedience Source: Teresa Kellerman, Coordinator, FAS Resource Center

  23. Affected Individuals • Randy (ARND) • Matt (FAS) • Stefanie (FAS) • Sinja (FAS; English child living in Germany) • Patrichia Rose (FAS) • David with Fetal Alcohol Syndrome (video, 2:48)

  24. FAS: Real People Fetal Alcohol Syndrome: A Biological Basis (Youtube.com)

  25. Resources • Fetal Alcohol Syndrome Diagnostic and Prevention Network (UW), 206-598-0555 • National Organization on Fetal Alcohol Syndrome Washington State (Mill Creek), 206-940-2832 • Fetal Alcohol Drug Unit (UW), 206-543-7155

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