1. FASD 101
Susan Elsworth

2. Zeb

3. Zeb at his 3rd sleep study in 3 years.

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

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

6. 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

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

8. 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

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

10. 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

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

12. CRITICAL PERIODS IN HUMAN DEVELOPMENT

13. Brain Comparison
FAS Brain Normal Brain

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

15. 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

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

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

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

19. 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

20. 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

21. 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

22. 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

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

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

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

26. 60% of FASDs have trouble with the law
50% have been confined in jail or prison
35% have substance or alcohol addictions

27. Symptoms present differently at different ages and developmental stages

28. Treatment Permanent Therapies to address specific symptoms Adaptations
Medications
Family Support

29. Strategies
Awareness
Prevention or Interventions
Services
Support

30. 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

31. 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

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

33. Contact
Susan Elsworth