Transcript FASD in Simcoe County

Fetal Alcohol Spectrum
Disorders
Tonya Millsap
Catulpa Community Support Services
SYMPOSIUM 2008
Working Together for Kids & Teens with Disabilities
The Acronym ..
F = Fetal: changes in normal development in
utero
A = Alcohol: teratogen causes cell/process
changes and damage
S = Spectrum: damage presents from mild to
severe
D = Disorder: Difficulty/inability to function or
adapt as expected across a life span.
FASD itself is an educational term, not a clinical
diagnostic term.
Describes the spectrum of disabilities associated
with prenatal alcohol exposure.
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Fetal Alcohol Syndrome (FAS)
Partial FAS (pFAS)
Alcohol-Related Neuro-Developmental
Disorder (ARND)
Alcohol-Related Birth Defects (ARBD)
Canadian Guidelines for Diagnosis of FASD, 2005.
Alcohol crosses freely through the placenta and
risks the normal development of the fetus.
Damage can occur in various regions of the brain.
It is not the only factor contributing to the
development of the fetus.
RISK
Maternal Factors
Levels of exposure
Fetal Factors
Timing of the
alcohol exposure
Genetics
Metabolism
Adapted from D. Debolt in FASD: Considerations for Practice.
CMAJ 2005; 172 (5 suppl): S1-S21
Where there is alcohol, there is the risk of
FASD.
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Health Care – Primary, Secondary & Tertiary
Children’s Services
Education
Justice
Adult Developmental Services
Mental Health
Human Resources & Employment
Adapted from Donna Debolt in FASD: Considerations for Practice.
It is estimated that:
 9 babies in every 1,000 born in Canada have FASD
 FASD is the leading cause of developmental disability
among Canadian children
 The costs of FASD to society are high – direct monetary
costs are estimated at about 1.5 million per person with
FASD.
Public Health Agency of Canada, FASD: a framework for action, 2005.
Research
Youth Justice
Family Support
Interventions
Diagnostic Services
Screening
Prevention
FASD in Simcoe County: A Comprehensive Approach, 2008.
Present as a blueprint for case
management and service
planning.
• Invisible Disabilities - An individual’s
place, and success, in society is almost
entirely determined by neurological
functioning. A child with a brain injury is
unable to meet the expectations of
parents, family, peers, school, and career
and can endure a lifetime of failures. The
largest cause of brain injury in children is
prenatal exposure to alcohol. Often the
neurological damage goes undiagnosed,
but not unpunished.
FASLink, Bruce Ritchie.
Streissguth (1991)
“Fetal Alcohol Syndrome is not just a childhood
disorder, there is a predictable long term
progression of the disorder into adulthood in
which maladaptive behaviours present the
greatest challenge to management.”
Primary Disabilities
Secondary Disabilities
Provincial Outreach Program for
Fetal Alcohol Spectrum Disorder
(POPFASD)
BC Ministry of Education Initiative
http://www.fasdoutreach.ca/
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“A behaviour that most clearly reflects
differences in brain structure and function”
(Streissguth in Malbin)
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Impulsivity
Difficulty linking actions to outcomes
Slower auditory and cognitive processing
Inconsistent performance
Dysmaturity
Overly sensitive and stimulated
Ann Streissguth
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“develop over time when there is a chronic
‘poor fit’ between the person and his / her
environment.”
(D. Malbin, 2002)
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“difficulties that can occur when there is a
discrepancy between expectations and a person’s
ability to perform.”
(Quoted in Clarren, 2004)
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School Problems
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80%
30%
Mental Health Issues
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Victimization
Difficulties with independent
living
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Drug and alcohol issues
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60%
Employment Problems
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Trouble with the law
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60%
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Innappropriate sexual
behaviour
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80%
50%
Exploitation
Difficulties with Parenting
90%
A. Streissguth in C. Bryne, 2008.
 Living in a stable and nurturing home for 72% of life.
 Staying in a living situation for for average of longer than
2.8 years.
 Having a diagnosis by 6 years.
 Accessing Developmental Disability Services.
 Full FAS diagnosis.
 Never exposed to violence/victimized.
 Basic needs are met for 13% of life.
 Experiencing good quality home from 8-12 years.
(Ann Streissguth)
Necessary
Meaningful
Possible
Building A Comprehensive
Approach
The Master Key
Vision: Every person in every system is trained in FASD
issues and understands the nature of FASD as
neurological impairment, can recognize the symptoms of
invisible forms of FASD, can see the Invisible Gap.
Invisible Gap: Difference between apparent ability to
function and actual ability to function.
Quoted: Teresa Kellerman, FAS Coordinator
Arizona Division of Developmental Disabilities
FASD Centre for Excellence.
A Comprehensive Approach: Year
One
Research
Youth Justice
Family Support
Interventions
Diagnostic Services
Screening
Prevention
FASD in Simcoe County: A Comprehensive Approach, 2008
Bridging Gaps: Year One
Increasing community capacity to:
•Informally and formally recognize
•Support through the life span
•Assess & Diagnose
•Identify long term plan
References
Byrne, C. in “FASD Does Not Exist in Isolation: Psychiatric Comorbidity in FASD”. (2008). Vancouver, BC.
Chudley, A., Conry, J., Cook. J., Loock, C., Rosales, T., & LeBlanc,
N. (2005). Fetal Alcohol Spectrum Disorder: Canadian
Guidelines for Diagnosis. Canadian Medical Association
Journal.
Debolt, D. in FASD: Considerations for Practice.
FASD: A Framework for Action, (2005)
Streissguth, A, & Kanter, J. (Eds). (1997). The Challenge of Fetal
Alcohol Syndrome: Overcoming Secondary Disabilities.
Seattle, WA: University of Washington Press.