FASD 101 Susan Elsworth

Zeb

Zeb at his 3rd sleep study in 3 years.

April 2012 Upper Row - Levi Next Row - Knoll & Jackson Middle Row - Jesse, Ezekiel, Jude Front Row - Zebadiah & Irena April 2012

Non Awareness Not consider valid for a number of years Initially too few cases for condition Differences in terminology & evaluative tools

FASD Umbrella FAS - Medical markers, array of symptoms and acknowledgement of mother to consuming alcohol Partial FAS - Medical markers, array of symptoms and reliable source reports mother consumed alcohol FAE - Less prominent physical features and less severe symptoms

ARBD - Alcohol Related Birth Defects - Physical defects such eyes, ears, heart and limbs

ARND - Alcohol Related Neurological Developmental Disorders - decreased cranial size, inconsistent developmental levels, learning disabilities, poor impulse control, problems with social perceptions, deficiency in higher learning tasks, poor capacity for abstract

Phenotype Small appearing eyes Wide often flat space between eyes Thin upper lip Flat Filtrum

FAS Facial Features flat midface small head circumference smaller eye openings under eye folds simply formed, low set ears short, upturned nose thin upper lip flat, elongated philtrum (grooves above lip) small chin

The development of the facial features is set on days 19-21 of gestation.

CRITICAL PERIODS IN HUMAN DEVELOPMENT

Brain Comparison FAS Brain Normal Brain

Numbers 3.1 per 1000 have FAS 9.1 per 1000 are on the FASD Spectrum

Dr. Phil May Physically examined every first grader in 3 non disclosed midwest cities 13.5 per 1000 had FAS 14.9 per 1000 were on the FASD Spectrum

Suspected It is suspected that 1 out of 100 children were exposed to alcohol during gestation and may have been resulting damage.

DSM-V ND-PAE: Neurobehavioral Disorder Associated with Prenatal Alcohol Exposure

State of Indiana Women 18-44 (associated child bearing age) 45.6% report drinking alcohol 12.6% report binge drinking

Binge Drinking 3 or more drinks at a time or 7 drinks per week Drink = One 12 oz beer or 5 oz of wine or 1.5 oz of liquor

Risks A woman who is sipping a glass of wine over several hours will most likely not have the same risks as she would if she were stacking one drink on top of another. Some OB-GYNs tell pregnant women that having a drink is not harmful

Risk Factors Genetic composition of mother AND father Drinking history of mother and her family Health concerns of mother Nutrition of mother Prenatal care Gestational stage Amount of alcohol exposure

Most women who drink report they stopped drinking once they knew they were pregnant at the 6-8 week mark. 7.6% reported they continued to drink after they knew they were pregnant

Symptoms Inconsistent development Learning difficulties Poor impulse control Deficiency in higher learning Poor capacity for abstract Problems with memory

Sensory Integration issues Motor planning Auditory Disorders Difficulty in self regulation ADHD Odd eating behaviors Disconnect between actions & consequences

Stacking of Disorders Learning Disabilities Educational Disabilities Behavioral Disorders Emotional Disorders Social Challenges Legal Issues

60% of FASDs have trouble with the law 50% have been confined in jail or prison 35% have substance or alcohol addictions

Symptoms present differently at different ages and developmental stages

Treatment Permanent Therapies to address specific symptoms Adaptations Medications Family Support

Strategies Awareness Prevention or Interventions Services Support

Awareness Surgeon General Warning - “According to the Surgeon General, women should not drink alcoholic beverages during pregnancy because of the risk of birth defects.” Warning printed on labels Signs in bars

Minnesota put pregnancy test dispensers in the restrooms of targeted bars with a sign warning drinking while pregnant can result in birth defects Ads in publications Pamphlets in crisis pregnancy centers, OB- GYN offices, WIC, planned parent type agencies

Interventions Increase of initial screenings Reduction of unplanned pregnancies Brief motivational interviews at birth control dispensing locations

Contact Susan Elsworth susan.elsworth@gmail.com