1. 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,

2. The Pediatrician’s Dilemma Pediatrician

3. 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

4. YELLOW POINT

5. 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

6. Guiding Principles n Respect n Understanding n Compassion n Hope

7. Common Expensive Preventable Bottom Line

8. 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)

9. Research Intervention Prevention requires Coordination Education & Training

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

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

13. 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

14. Henri de Toulouse-Lautrec ~1895

15. 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)

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

17. AWARENESS AFFECTED AT-RISK ACCOUNTABILITY

19. Guiding Principles n Respect n Understanding n Compassion n Hope

20. Common Expensive Preventable Bottom Line

21. YWCA Crabtree Corner, Downtown Eastside