Transcript Face of Fetal Alcohol Syndrome

Fetal Alcohol Spectrum Disorders
Prevention, Education,
Intervention, and Advocacy
Presenter
Sr. Suzette Fisher, SND, Ed.S.
Emerging Issues in Maternal and Child Health
Audio-Conference
September 21, 2006
3:00 – 4:30 p.m. (EST)
OVERVIEW OF FASD
1. Terminology associated with prenatal
alcohol exposure
2. Cause and prevalence of FASD
3. Diagnostic criteria
4. Characteristics of FASD and
implications for intervention
5. State and national initiatives
OVERVIEW OF FASD
1. Terminology associated with prenatal
alcohol exposure
2. Cause and prevalence of FASD
3. Diagnostic criteria
4. Characteristics of FASD and
implications for intervention
5. State and national initiatives
DEFINITIONS
Fetal Alcohol Spectrum Disorders (FASD)
Fetal Alcohol Syndrome (FAS)
Fetal Alcohol Effect (FAE)
Alcohol-Related Birth Defects (ARBD)
Alcohol-Related Neurodevelopmental
Disorder (ARND)
OVERVIEW OF FASD
1. Terminology associated with prenatal
alcohol exposure
2. Cause and prevalence of FASD
3. Diagnostic criteria
4. Characteristics of FASD and
implications for intervention
5. State and national initiatives
CAUSE OF FASD
Alcohol consumption during pregnancy
“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 Report to Congress (1996)
“There is no known safe amount of alcohol
consumption during pregnancy.”
– Centers for Disease Control and Prevention, U.S. Surgeon General,
American Academy of Pediatrics
CAUSE
“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 Report to Congress (1996)
FASD is 100% preventable!
If you’re pregnant, don’t drink!
PREVALENCE
Estimate:
1 in 100 individuals are affected by
prenatal alcohol exposure.
OVERVIEW OF FASD
1. Terminology associated with prenatal
alcohol exposure
2. Cause and prevalence of FASD
3. Diagnostic criteria
4. Characteristics of FASD and
implications for intervention
5. State and national initiatives
DIAGNOSTIC CRITERIA
4-Digit diagnostic code
 Created in 1997
 Susan Astley, Ph.D. & Sterling Clarren,
M.D.
 256 codes
 22 diagnostic names
DIAGNOSTIC FEATURES
 Growth Deficiency
 Dysmorphic facial features
 CNS Damage
 Prenatal alcohol exposure
DIAGNOSTIC FEATURE
 Growth Deficiency


Prenatal and/or postnatal height and/or
weight below the 10th percentile
Physical anomolies





Respiratory problems
Heart problems
Eye and ear defects
Limb reduction
Hutchinson’s teeth
DIAGNOSTIC FEATURE
 Dysmorphic facial features of FAS



Short palpebral fissures (<10 %ile) – short
eye openings
Thin vermilion border of upper lip
Smooth philtrum
FACE OF ARND
Discriminating
Features
Associated
Features
None
None
It’s not about the face, it’s about the BRAIN!
DIAGNOSTIC FEATURE
 CNS Damage



Damage to the brain
Static encephalopathy – the damage to the
brain is permanent and unchanging.
This CNS dysfunction, or brain damage, has
the greatest impact on learning and
behavior.
DIAGNOSTIC FEATURES
 Prenatal alcohol exposure

Confirmed prenatal alcohol exposure
OVERVIEW OF FASD
1. Terminology associated with prenatal
alcohol exposure
2. Cause and prevalence of FASD
3. Diagnostic criteria
4. Characteristics of FASD and
implications for intervention
5. State and national initiatives
PRIMARY CHARACTERISTICS
OF FASD






Developmental
delays
Inconsistent
performance
Impulsivity
Distractibility
Attention deficits
Disorganization
Poor social skills Literal
thinking
 Difficulty with abstractions
 Memory impairments
 Deficits in higher-level
receptive & expressive
language

PRIMARY CHARACTERISTICS
OF FASD
 Difficulty generalizing
 Poor problem-solving
ability
 Difficulty with transitions
 Processing deficits
(visual, auditory,
sensory)
 Poor judgment
Difficulty understanding
cause/effect
Impaired motor
development
Able to repeat
instructions, unable to
put into action
Learning disabilities
PRIMARY CHARACTERISTICS
OF FASD
These characteristics vary among
individuals with FASD.
No single type of CNS damage or pattern
of dysfunction has been identified that
characterizes all children with FASD.
– Streissguth, A. 1997. Fetal alcohol syndrome: A guide for families and communities.
SECONDARY
CHARACTERISTICS
 Mental health issues
 Disrupted school
experience
 Trouble with the law
 Inappropriate sexual
behavior
– Streissguth, AP (1996)
 Confinement in jail or
treatment facilities
 Alcohol and drug
problems
 Dependent living
 Employment problems
DEVELOPING EFFECTIVE
STRATEGIES
Look for Clues as to the
underlying cause of the behavior.
INTERVENTIONS
 Effective interventions: With early identification and diagnosis the
proper supports can be put in place – at home, in school, at work
– to improve outcomes for individuals with this disability. Website
resources on the next slide provide suggestions for interventions.
New studies are in process to develop effective interventions.
 Parents, teachers, and other professionals need to learn to
respond and work differently with individuals with FASD.
 Early and effective interventions reduce the chances of dropping
out of school, trouble with the law, mental health issues, alcohol
and drug problems, housing and job issues
– Streissguth, AP, Barr, HM; Kogan, J, Bookstein, FL,1996).
FASD ARE LIFELONG
DISABILITIES
OVERVIEW OF FASD
1. Terminology associated with prenatal
alcohol exposure
2. Cause and prevalence of FASD
3. Diagnostic criteria
4. Characteristics of FASD and
implications for intervention
5. State and national initiatives
CURRENT EFFORTS
Double ARC
 Diagnosis
 Parent support
 Triumph classes
CDC
 Curricula
 Interventions
 Diagnostic guidelines
 Project Adapt
Ohio
SAMHSA
 FASD Town Hall Meeting
 State FASD Conference
 Federal subcontract for FASD
systems change
 Focus on awareness and
prevention
FASD Center for
Excellence
 20 local subcontracts
 10 States
 5 Juvenile Justice
PARENT & TEACHER SERIES
Facilitator Training for Parent Series
March 13 – 16, 2007
WEBSITES FOR FASD INFO
www.doublearc.org
www.cdc.gov/ncbddd/fas
http://fascenter.samhsa.gov/
www.nofas.org
www.notasingledrop.org
www.ebasedacademy.org
www.bced.gov.bc.ca/specialed/fas
www.education.gov.ab.ca/fasd/
CONTACT INFORMATION
Double ARC
3837 Secor Road
Toledo, Ohio 43623
419-479-3060
www.doublearc.org