1. FOETAL ALCOHOL SPECTRUM DISORDERS (FASD) EUROPEAN PARLIAMENT STRASBOURGH, TUESDAY SEPTEMBER 4 TH 2007 Dr. Kieran D. O’ Malley MB,BAO,BCH, DABPN Consultant in Adolescent Psychiatry, Belfast Trust, UK (Previously ran FAS Clinic in Edmonton,Canada & Academic Faculty,FADU, University.of Washington,Seattle,USA)

7. THE EFFECT OF ALCOHOL AS A TERATOGEN DEPENDS ON - THE DOSE, - TIMING (TRIMESTER), - HOST (MATERNAL HEALTH) THERE IS`NO SAFE AMOUNT OF ALCOHOL CONSUMPTION DURING PREGNANCY ALCOHOL IS A TERATOGEN THROUGHOUT THE WHOLE OF PREGNANCY THIS INCLUDES THE CHRONICITY OF MOTHER’S ALCOHOL ABUSE, NUTRITIONAL FACTORS, SPECIFIC GENETIC FACTORS

9. PRENATAL ALCOHOL EXPOSURE CAUSES CHRONIC DEVELOPMENTAL AND NEUROPSYCHIATIC DISORDERS CALLED FOETAL ALCOHOL SPECTRUM DISORDERS (FASD) 1.FOETAL ALCOHOL SYNDROME (FAS), 15-20%,FACIAL DYSMORPHOLOGY 2.ALCOHOL RELATED NEURODEVELOPMENTAL DISORDER (ARND), 80-85%, NO FACIAL DYSMORPHOLOGY

10. PRENATAL ALCOHOL CAN CAUSE A CHRONIC DEVELOPMENTAL & NEUROPSYCHIATRIC DIS.(Dual Diagnosis) FROM INFANCY TO ADULTHOOD i.e. REGULATORY DISORDER (Infancy) ADHD (Childhood). DEPRESSION WITH IMPULSIVE SUICIDE RISK or MIXED `PERSONALITY DISORDER (Adulthood) S

16. PRENATAL ALCOHOL IS THE COMMONEST ‘ACQUIRED’ CAUSE OF MENTAL RETARDATION BUT 70 TO 75% of People with FASD ( FAS, OR FAE, now called ARND) Do NOT HAVE Mental Retardation BUT Do HAVE a Developmental Disability IT is the ‘Functional Disability’ coupled with the co-morbid Neuropsychiatric Disorder that becomes the management problem

18. PRIMARY PREVENTION -Labels on alcohol bottles,coupled with general population health education awareness projects -Parent/Child Assistance Programme with substance-abusing pregnant mothers (PCAP) -Alcohol counselling programmes for teenager girls -School education programmes on pregnancy, including safe sex,and the risks of alcohol, smoking & drugs -Medical /Nursing/Social Work University Education on the teratogenic causes of developmental disability and neuropsychiatric disorder, especially prenatal alcohol, SECONDARY PREVENTION -Identification of ‘At Risk’ Pregnancies -Identification of ‘ At Risk’ or alcohol-affected infants -Use of neuroprotective agents during pregnancy -Specialized early intervention multi-disciplinary clinics -Educated use of psychotropic medication

19. Swayze II et al., (1997). Pediatrics. 99:232-240 Agenesis of the Corpus Callosum