Darci Kotkas

Debolt Fetal Alcohol Spectrum Disorder is a term used to support individuals who have been diagnosed with a “spectrum” of effects related to prenatal alcohol exposure. It includes (but is not limited to) Fetal Alcohol Syndrome, Alcohol Related Neurobehavioral Disorder, Partial Fetal Alcohol Syndrome and Static Encephalopathy.

 Children, adolescents and adults with FASD have complex medical, psychological and social needs.  They are difficult to provide stability for and existing resources are not often user friendly for these families. Debolt

 The critical message emerging from this work is the need to establish sound FASD Informed Practice to support the often complex needs of children and families. FASD Informed Practice implies that casework is carried out in a way that appreciates the specific challenges associated with FASD as a disabling condition and recognizes the need for adjustments and accommodations in the child welfare response.  A key element of the success of the Community of Practice initiative was the recognition that child welfare practice in response to FASD requires a specialized approach and leadership on practice needs to originate and develop within the workforce.

 Child Protective Services identify more high- risk children than any other public system.  The challenge is to recognize the need to do more than protect. Protecting without educating, healing and enriching children is an opportunity lost. The cost in human and financial resources is overwhelming.  Children born with FASD are among the fastest growing group of children entering the child welfare system…..

 What we Know  FASD is often overrepresented in children, adolescents and adults requiring services from child protection agencies – 50% of caseloads  The Enhancement Act’s philosophy of “least intrusive and time limited” is not congruent with what we know helps with these children and families.  Many contracted agencies that serve individual Child and Family Service Authorities are often unprepared to serve this high needs group.  Children and families experiencing the complexities of this poorly understood disability are often at the center of highly public child protection failures.

It is important to understand that early diagnosis and intervention are positively correlated with better long term outcomes for the children and their families. Appropriate diagnosis results in the children receiving relevant and targeted interventions, significantly improves their functioning, adaptability, self-awareness and self-esteem not to mention significantly improves parent- child interactions (Streissguth et al 2004).

1. Biological families are unaware of what has happened developmentally for their child 2. Rearing families are unaware of the etiology of the problems 3. Multiple placements distort the information and the functioning Debolt

1. School Failure 2. Mental Health Disorders 3. Addictions Streissgueth’s Secondary Disability Study 90% had mental health problems 30% had drug and alcohol use/misuse

If we get it:  We will have effective and cost efficient interventions  We will have enhanced collaboration  We will have improved developmental outcomes  We will reduce the intergenerational effects of FASD If we don’t:  We will have ineffective and costly interventions  There will be systemic frustration and blame  There will be multiple diagnosis (and explanations) over time.  There will be an escalation of symptoms despite “huge” effort.

1. Identification of high risk individuals is intervention. 2. Gathering relevant information to support a diagnosis of FASD is intervention. 3. Referring for formal diagnosis/assessment is intervention. 4. Diagnosis is intervention. 5. Diagnosis kick starts a multi-system organization of care. That is intervention. Debolt

 Training, training, & more training  Coaching and support  Respite and Relief Care  Grief and Loss support – The ability to give up what we wish this was to take on what it is

 There is a significant gap in our system of service for persons with disabilities. (Support for people with disabilities to be parents).  Many of these circumstances then lead to child protection involvement  Recognition of Non-compliance as non- competence shifts the traditional approaches and expectations of the child welfare system.

Creating improved outcomes for children with FASD Early identification Appropriate service planning Specialized training to agency staff, families and caregivers Increased placement stability Reduction in incidence an severity of secondary disabilities Effective transition to adult services Debolt

 Training for staff  Support application and integration into case practice.  Ensuring disability first lens  Assist workers in being strong advocates in leading collaborative partnerships to serve clients and families with this disability effectively.

 FASDtraining.com  May 1, 2015