Fetal Alcohol Canadian Expertise (FACE) Research Roundtable International FAS Day - Sept 2002 Christine A. Loock, MD, FRCPC Associate Professor, UBC CCSA Board & FAS NAC Member, BC FAS Provincial Medical Consultant,

The Pediatrician’s Dilemma Pediatrician

Today’s Goals for Research Roundtable n Overview of current Canadian FAS research (Awareness, At-Risk, Affected, Basic Science) n Discuss trends in nomenclature (“FASD”) n Interventions for women at risk n Standardizing FAS diagnosis and reporting (Health Canada) –Telediagnosis –BC’s HSR (Vital Statistics); UW DPN 4 Digit Code ; –Education and Training : UBC Curricula; Provincial Initiatives; March of Dimes CD ROM training n Basic Science : Anti-oxidants; Meconium Screening n BC Initiatives and Recap

YELLOW POINT

Take Home Points n My role in closing today’s Roundtable: –Stand Up, Speak up, Shut up n IT TAKES A COMMUNITY : –Every child needs a family –Every mom needs a mom –Every person needs a community

Guiding Principles n Respect n Understanding n Compassion n Hope

Common Expensive Preventable Bottom Line

FETAL ALCOHOL SPECTRUM DISORDER Fetal Alcohol Syndrome (FAS) n Brain n Growth n Facial features “Fetal Alcohol Effects” (FAE) = Partial FAS & Alcohol Related Neurodevelopmental Disorder (ARND)

Research Intervention Prevention requires Coordination Education & Training

AWARENESS (primary) AFFECTED (tertiary) AT-RISK (secondary) PREVENTION STRATAGIES

The Scream, Edvard Munch In the beginning (of our FAS work ) ~ Early 1990’s

Who is at risk? “ If you drink, don’t screw: or if you screw, don’t drink! MOD~ 1996” Or if you do, please use effective contraception! CL 2002 from Time 2002

Henri de Toulouse-Lautrec ~1895

Who’s at higher risk?: Remember the “10 P’s” ! n poverty n poor prenatal care n poor nutrition and health n poly-drug use n prostitution (sex trade) n parent, partner, peer problems (A&D) n psychiatric concerns ( mood, anxiety, thought disorders) n prior abuse (childhood sexual+/- physical)

“Mother – Baby Diad” Issues around “Mothering” and Substance Abuse

AWARENESS AFFECTED AT-RISK ACCOUNTABILITY

Guiding Principles n Respect n Understanding n Compassion n Hope

Common Expensive Preventable Bottom Line

YWCA Crabtree Corner, Downtown Eastside