Transcript here - Fetal Alcohol Center for Training Online

FAS 101
PowerPoint Presentation I
Segment 3: FAS 101
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What This Presentation Addresses
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Description of FAS and ARND
How alcohol affects the fetus
Central nervous system and behavioral
problems of children with FAS/ARND
Diagnosing FAS
Why school staff should learn about FAS and
ARND
What Is FAS (Fetal Alcohol
Syndrome)?
A set of physical, behavioral, and cognitive
disorders seen in individuals exposed to
alcohol prenatally
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Diagnosing FAS
Child must have signs in each of three areas:
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Growth retardation
Abnormalities in the central nervous system
(CNS)
Facial abnormalities
What Is FAE (Fetal Alcohol Effects)?
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One or two (but not all three) diagnostic
signs of FAS. Typically have growth
retardation and CNS abnormalities.
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To separate physical and neurologic signs,
the terms ARBD and ARND were introduced.
What Is ARBD (Alcohol-Related
Birth Defects)?
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Physical abnormalities that can result from
prenatal alcohol exposure
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Typically includes cardiac, skeletal, renal,
auditory, and/or ocular system abnormalities
What Is ARND (Alcohol-Related
Neurodevelopmental Disorder)?
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CNS abnormalities that result from prenatal
alcohol exposure.
Children with ARND look normal, so they
often are not diagnosed.
Possible to have both ARBD and ARND.
In this course, the terms FAS and ARND will
be used together (i.e., FAS/ARND).
How Common Are FAS and ARND?
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Exact rates are not known.
In U.S., FAS estimates range from 2 to 15
cases per 10,000 births.
ARND and ARBD occur 3 to 4 times more
often than FAS.
FAS and ARND occur worldwide.
Why Does Alcohol
Affect the Fetus?
Alcohol is a teratogen—a substance or
condition that the fetus is exposed to that
impedes growth and disrupts normal
development.
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How Does Alcohol
Affect the Fetus?
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Alcohol in the mother’s blood moves across
the placenta to the fetus.
The more alcohol the mother drinks and the
longer the fetus is exposed to alcohol, the
greater the risk to fetal brain, body growth,
and physical development.
Alcohol use during pregnancy does not
always result in FAS.
What Influences the Effects of
Alcohol on the Fetus?
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Blood alcohol concentration of the mother.
Timing of exposure.
Genetic sensitivity of mother and fetus to
alcohol.
Metabolism of the mother.
If the mother continues heavy alcohol use, the
risk of having a child with FAS increases with
each pregnancy.
Timing of Alcohol Consumption
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First trimester: Alcohol can cause abnormalities in
the physical structure of all organs of the fetus.
In all 3 trimesters, alcohol affects the following:
Growth and size of fetus
Growth and development of the central nervous
system (brain and spinal cord)
Third trimester: Brain is particularly vulnerable to
alcohol.
How Much Alcohol Use Causes
FAS/ARND?
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We don’t know.
Surgeon General recommends no alcohol
use during pregnancy.
Whenever a pregnant woman stops drinking,
she can improve her baby’s health and her
own.
Role of the Father
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Father’s use does not biologically contribute
to FAS or ARND.
A heavy-drinking partner can create barriers
for a mother to abstain from alcohol during
pregnancy.
A supportive partner can positively influence
the mother to abstain during pregnancy.
Cognitive Impairments of FAS
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All people with FAS/ARND have cognition that is
diminished from their optimal cognition.
The majority have low-average to borderlineaverage I.Q. (70 to 85).
25% of people with FAS/ARND are mentally
retarded (I.Q. ≤70).
The challenge of affected children who “test fine”
but don’t function or advance appropriately in
classroom.
Central Nervous
System Problems
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Sleep and sucking disturbances in infancy
Mental retardation (ranging from mild to severe)
Short attention span
Speech and language disorders
Learning problems
Problems processing visual and auditory information
Poor reasoning or judgment
Memory problems
Problems generalizing information from one situation to
another
Behavior and FAS/ARND
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Hyperactivity, inappropriate social
behavior/difficulty reading social cues,
difficulty with transitions, low tolerance for
frustration.
Child may appear to be lazy or misbehaving
but often cannot do something because of
the way his/her brain works.
Focus on helping the child adopt appropriate
behaviors in specific situations.
IEPs and FAS/ARND
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IEP is a student-centered planning tool
created by a school team.
Addresses academics, behavior, social
interactions, and communication.
Periodic IEP meetings involving parents can
aid communication with family and indicate
when revisions to plan are necessary.
Evaluation for Special
Education Services
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Affected students may be evaluated for
special education services.
Evaluation focuses on IQ, achievement,
adaptive living skills.
Some districts perform more comprehensive
assessment.
Findings lead to development of IEP
(Individualized Education Plan) for student.
Do Children Outgrow the
Problems of FAS/ARND?
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There is no cure, but children learn to adapt as they
mature.
Some abnormalities (e.g., facial features, speech
and motor problems) may decrease over time.
Behavioral, emotional, and social problems can
become more evident in adolescents and adults.
Early diagnosis and provision of services can lead to
adaptations to lessen the severity of effects of
FAS/ARND.
Why Diagnose FAS?
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Parents and school can help more effectively.
Can eliminate other causes and focus on most
beneficial strategies for the child.
With diagnosis, child may become eligible for
services.
Early intervention is more likely to reduce the child’s
problems and increase his or her functioning.
Who Can Assess Children
for FAS/ARND?
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Diagnosis is made on basis of clinical signs.
No laboratory test, so diagnosis may be difficult.
Dysmorphologists, pediatric neurologists, clinical
geneticists are typically most skilled at
diagnosing FAS/ARND.
Prenatal exposure to alcohol can cause multiple
problems that present in a variety of ways in
children.
Assessment commonly happens when the child
reaches school age.
Secondary Disabilities
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Occur as a result of primary FAS/ARND
disabilities the child was born with.
One study found increased mental health
problems, trouble in school, trouble with the
law, inappropriate sexual behaviors.
Importance of early diagnosis and focused
intervention to improve outcomes.
How Can FAS/ARND Be
Prevented?
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Abstain from consuming alcohol while
pregnant
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Link alcohol-abusing women with programs
to help them stop drinking while pregnant
Why Should School Staff Learn
About FAS/ARND?
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Many traditional teaching strategies don’t work with
children with FAS/ARND.
Learning strategies for working with students with
FAS/ARND can prevent or reduce their disruptive
behaviors.
Many simple classroom adaptations for FAS/ARND
help all students.
When staff understand stressors of FAS on the
family, they can form better partnerships with
families.
Impact of FAS/ARND on the Family
Biological Family
• Some students with FAS/ARND live with
biological mother and/or father.
• Mother and father may feel guilt and anger
about her drinking during pregnancy.
• Challenge of getting help for child’s
problems.
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Impact of FAS/ARND on the Family
Biological Family
• Some students with FAS/ARND live with
biological mother and/or father.
• Mother and father may feel guilt and anger
about her drinking during pregnancy.
• Challenge of getting help for child’s
problems.
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Impact on the Family (Continued)
Foster and Adoptive Parents
• Many affected children live with foster or
adoptive parents.
• May be frustrated by lack of completeness of
child’s medical records.
• May have difficulty accepting that their dreams
for the child may not come to pass.
• Challenge of getting help for child’s complex
problems.
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School Staff Working with
Parents/Caregivers
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Acknowledge difficulty of raising a child with
FAS/ARND.
Ask parents what strategies work at home and be
receptive to what they share.
Assist parents in obtaining support services for child
and family.
Continue trying to connect with parents who do not
respond.
Build positive alliances that reinforce strengths of
child and family.
We Have Discussed
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Description of FAS and ARND
How alcohol affects the fetus
Central nervous system and behavioral
problems of children with FAS/ARND
Diagnosing FAS
Why school staff should learn about FAS and
ARND
PowerPoint Presentation II
Segment 5: FAS/ARND Strategies
FAS/ARND Strategies for School
Staff Handout: Keep in Mind
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Many children with FAS/ARND are in a
regular classroom. Their teachers need to be
aware of strategies for helping them.
Teachers already use many strategies that
work for students with FAS/ARND.
Strategies for FAS/ARND often help the
entire classroom run more smoothly.
FAS/ARND Strategies for School Staff
Handout: Keep in Mind (Cont’d.)
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Students with FAS/ARND may always need
bridges for comprehension (e.g., taping
alphabet to desk).
Some of the strategies require trying
something unfamiliar—give it a try!
If one strategy doesn’t work, try another.