Fetal Alcohol Spectrum Disorders (FASD)

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FETAL ALCOHOL SPECTRUM DISORDERS The Basics

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Fetal Alcohol Spectrum Disorders (FASD): The BasicsThis presentation is broken into five sections: Understanding Fetal Alcohol Spectrum Disorders (FASD) Individuals With An FASD – Strengths, Difficulties, and Approaches Prevention and Risk Reduction Resources Conclusion

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Section 1: Understanding Fetal Alcohol Spectrum Disorders (FASD)Section 1 includes: Fetal Alcohol Spectrum Disorders (FASDs) Diagnostic Terminology Facts About FASDs Facts About Alcohol Use Among Pregnant Women Cause of FASDs What’s a Standard Drink? Economic Costs of FAS

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Fetal Alcohol Spectrum Disorders (FASD) Umbrella term describing the range of effects that can occur in an individual whose mother drank alcohol during pregnancy. May include physical, mental, behavioral, and/or learning disabilities with possible lifelong implications. Not a diagnosis.

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Diagnostic TerminologyFetal Alcohol Syndrome (FAS) The term FAS was first used in 1973 by Dr. David Smith and Dr. Ken Lyons Jones at the University of Washington. While FASD describes a range of disorders, FAS is a specific birth defect caused by alcohol use while pregnant. FAS is a diagnosis: It is medical diagnosis Q86.0 in the International Classification of Diseases (ICD-10).

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Other Diagnostic Terminology Pregnancy+AlcoholMay result in Alcohol-related neurodevelopmental disorder (ARND) Partial FAS (pFAS) Fetal alcohol effects (FAE) Alcohol-related birth defects (ARBD) Static encephalopathy (an unchanging injury to the brain)

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Facts About FASDsFASDs are the leading known cause of preventable mental retardation.1 FASDs effect an estimated 40,000 newborns each year in the United States.2 FASDs are more common than autism.3 The effects of FASDs last a lifetime. People with an FASD can grow, improve, and function well in life with proper support. FASDs are 100% preventable.

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Facts About FASDsNo amount of alcohol consumption during pregnancy is proven to be safe.1 FASDs are not caused by the biological father’s alcohol use. FASDs are not caused intentionally by the mother: Many women simply may not know when they are first pregnant or may not be aware of the harm that alcohol consumption during pregnancy can cause.

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Facts About Alcohol Use Among Pregnant WomenNearly 12 percent of pregnant women report using alcohol in the past month. Past-month alcohol use among pregnant women and recent mothers aged 15 to 44 did not change significantly between 2002-2003 and 2006-2007. Nearly 16 percent of pregnant women aged 15 to 17 used alcohol in the past month, and they consumed an average of 24 drinks in that month (i.e., they drank on an average of 6 days during the past month and had an average of about four drinks on the days that they drank).

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Cause of FASDs The sole cause of FASDs is the fetus being exposed to alcohol during the pregnancy. Alcohol is a teratogen: A drug or other substance capable of interfering with the development of a fetus, causing birth defects.“Of all the substances of abuse (including cocaine, heroin, and marijuana), alcohol produces by far the most serious neurobehavioral effects in the fetus.” —IOM Report to Congress, 1996

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Cause of FASDsAll alcoholic beverages are harmful. Binge drinking is especially harmful.* While it’s true that not every woman who drinks during pregnancy will have a child with an FASD, that does not mean that these disorders are rare or random. Any time a pregnant woman consumes alcohol, it becomes possible that her baby will have an FASD.* Binge = 4 or more standard drinks on one occasion for women

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What’s A Standard Drink?

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What’s a Standard Drink? In recent research, frequent drinkers and the majority of women reported drinking larger-than-standard drinks: Daily drinkers were consuming drinks that were anywhere from three to six times the size of a standard drink. The majority of drinkers underestimated the number of fluid ounces they were consuming by about 30%.

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Economic Costs of FASFAS alone is estimated to cost the United States nearly $4 billion each year. The average lifetime cost for each child with FAS is almost $3 million.Increased costs

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Economic Costs of FASOne prevented case of FAS saves: $130,000 in the first 5 years $360,000 in 10 years $587,000 in 15 years More than $1 million in 30 years Increased savings through prevention

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Section 2: Individuals With an FASD – Strengths, Difficulties, and ApproachesSection 2 includes: Primary Disabilities That Can Occur in Persons With an FASD Typical Strengths of Persons With an FASD Typical Difficulties for Persons With an FASD Risks of Not Accurately Identifying and Treating an FASD Factors Associated With Reduced Life Complications Identifying an FASD Possible Signs of an FASD Trends in Treatment

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Primary Disabilities That Can Occur in Persons With an FASD Lower IQ Impaired ability in reading, spelling, and arithmetic Lower level of adaptive functioning

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Typical Strengths of Persons With an FASDFriendly and cheerful Likable Desire to be liked Helpful VerbalDetermined Have points of insight Hard working Every day is a new day!

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Typical Difficulties For Persons With an FASDSensory: May be overly sensitive to bright lights, certain clothing, tastes and textures in food, loud sounds, etc.Physical: Have problems with balance and motor coordination (may seem “clumsy”).

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Typical Difficulties For Persons With an FASDInformation Processing: Do not complete tasks or chores and may appear to be oppositional Have trouble determining what to do in a given situation Do not ask questions because they want to fit in Have trouble with changes in tasks and routine

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Typical Difficulties For Persons With an FASDHave trouble following multiple directions Say they understand when they do not Have verbal expressive skills that often exceed their verbal receptive abilities Cannot operationalize what they’ve memorized (e.g., multiplication tables) Misinterpret others’ words, actions, or body movementsHow do I ‘straighten’ my room?Information Processing:

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Typical Difficulties For Persons With an FASDTend not to learn from mistakes or natural consequences Frequently do not respond to reward systems (points, levels, stickers, etc.)Have difficulty entertaining themselves Naïve, gullible (e.g., may walk off with a stranger) Struggle with abstract concepts (e.g., time, space, money, etc.)I’m late! I’m late!Executive Function and Decision-Making:Repeatedly break the rules Give in to peer pressure

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Typical Difficulties For Persons With an FASDSelf-Esteem and Personal Issues: Function unevenly in school, work, and development – Often feel “stupid” or like a failure Are seen as lazy, uncooperative, and unmotivated –Have often been told they’re not trying hard enough May have hygiene problems Are aware that they’re “different” from others Often grow up living in multiple homes and experience multiple losses

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Risks of Not Accurately Identifying and Treating an FASDFor the individual with an FASD: Unemployment Loss of family Homelessness Jail Premature death Increased substance abuse Wrong treatment or intervention is usedFor the family: Loss of family Increased substance use Premature death Financial strain Emotional stress

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Factors Associated With Reduced Life ComplicationsStable home Early diagnosis No violence against oneself More than 2.8 years in each living situationRecognized disabilities Diagnosis of FAS Good quality home from ages 8 to 12 Basic needs met for at least 13 percent of life

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Identifying an FASDOnly trained professionals can diagnose a disorder from the FASD spectrum. Ideally, diagnosis is done by a team that may include: Geneticists Developmental pediatricians Neurologists Dysmorphologists (physicians specializing in birth defects) Education consultants Psychologists, psychiatrists, and social workers Occupational therapists Speech and language specialists

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Last Updated: 8th March 2018

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