Fetal Alcohol Spectrum Disorder: A Preventable Epidemic
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Transcript of Fetal Alcohol Spectrum Disorder: A Preventable Epidemic
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Fetal Alcohol Spectrum Disorder: A Preventable Epidemic
Barry S Parsonson PhDExplore & Applied Psychology
International
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FASD: Causes• FASD is caused by maternal consumption of
alcohol during pregnancy;• Alcohol affects developing neural and physical
systems differentially according to timing in relation to fetal development stage, amounts consumed and duration of exposure;
• The minimum amount causing some effect is currently not known, hence advice against all alcohol consumption when pregnant;
• FASD is thus entirely preventable!
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FASD Diagnosis
• There are four internationally agreed classes of FASD based on assessment of severity using a 4-digit code relating to FAS characteristics;
• FAS, PFAS, ARND, & ARBD:• In each case, confirmed evidence of maternal
prenatal alcohol misuse is required;• DSM-V does not include FASD as a diagnosis
although it is described and identified as a “Condition for further study”!
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FASD Diagnosis 1-FAS
• Fetal Alcohol Syndrome (FAS) is the most severe form. It includes:
• Facial Anomalies (small eye slits, thin upper lip, smooth philtrum) and Microcephaly;
• Growth Deficiency (height or weight <10%ile)• CNS Damage with evidence of structural and/or
functional brain abnormality;• Confirmed Prenatal Alcohol Exposure (needed if
cluster of facial anomalies not present).
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Facial Anomalies of FAS
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FASD Diagnosis 2-PFAS
Partial Fetal Alcohol Syndrome (PFAS) is characterised by:• Growth Deficiency (height or weight <10%ile)• CNS Damage with evidence of structural
and/or functional brain abnormality;• Confirmed Prenatal Alcohol Exposure (Reliable
evidence of maternal alcohol misuse).
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FASD Diagnosis 3- ARND
Alcohol Related Neurodevelopmental Disorder (ARND) is characterised by:• CNS Damage: Evidence of structural or
functional brain abnormality;• Confirmed Prenatal Alcohol Exposure (Reliable
evidence of maternal alcohol misuse).
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FASD Diagnosis 4-ARBD
Alcohol Related Birth Defects (ARBD) is classified by:• Physical Defects: Heart, Kidney or other
anomalies present at Birth;• Confirmed Prenatal Alcohol Exposure: Reliable
evidence of maternal Alcohol Misuse.
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FASD Prevalence
• A Base Rate of 1% of the School Age population is estimated from a number of US, Canadian and European Studies;
• Some communities have rates of up to 8.5%;• Preliminary NZ data lead to guesstimates of at least
3000 school-age children with FASD;• Accurate data are difficult to obtain and probably
underestimate the true situation.• FASD is now the most common cause of ID.
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Post-Natal FASD Effects on Cognition & Learning
• Executive functioning (Planning, attention)• Memory (encoding, rote, working & spatial)• Reasoning (verbal, abstract, numerical)• Language (learning, comprehension, meaning)• Sensorimotor (visual/motor integration,
visual-spatial processing)• Attention (short span, distractible, often ADHD
labelled)
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Distribution of IQ Scores
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FASD Effects on Communication & Sensory Functioning
• Delayed Language Development• Impaired receptive & expressive language• Difficulties in language production &
comprehension affect learning• Poor social communication affects relationship
building• Hearing disorders found common in a small
FAS clinic sample
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FASD Behavioural Effects
• Physical Aggression• Lying and Confabulation• Impulsiveness and hyperactivity• Cheating, stealing, bullying & animal cruelty• Lack of remorse• Emotional lability• Substance abuse & self-harming
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FASD Lifespan Effects
Collectively, these Cognitive, Learning, Social, Communication and Behavioural deficits have lifetime effects. Data from samples indicate:• Family life (85% of children in foster care FASD)• Educational achievement (60% excluded)• Mental Health (87% 5-13 y.o.; 23% adults suicide)• Criminality (60% of FASD teens, many Prisoners)• Relationship and Employment difficulties are
common.
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Discussion Questions
• How do we, as a profession, intervene by way of increasing awareness and promoting prevention?
• Education? Who, when, how?• Increase Political and Public awareness? What
strategies might work?• What about the “Binge Drinking” Culture – Does
it contribute? If so, how to change that?• What can we offer to those on the FASD
spectrum? In Schools, Prisons, the Community?