1. Fetal Alcohol Spectrum Disorders Fetal Alcohol Syndrome Fetal Alcohol Effects Alcohol-Related Neurodevelopmental Disorder Alcohol-Related Birth Defects

2. Fetal Alcohol Spectrum Disorders In mid-April of 2004, the National Organization on Fetal Alcohol Syndrome (NOFAS) brought together experts to create terminology addressing the broad effects associated with prenatal alcohol exposure

3. Fetal Alcohol Spectrum Disorders As a result, a definition for Fetal Alcohol Spectrum Disorders (FASD) was developed: “ (FASD) is an umbrella term describing the range of effects that can occur in an individual whose mother drank alcohol during pregnancy. These effects may include physical, mental, behavioral, and/or learning disabilities with possible lifelong implications.”

4. FASD History Knowledge of the harm linked between alcohol and a fetus is not new (centuries old) First ‘official’ documentation 100 years old Breakthrough in 1960’s and 1970’s:1970’s  In 1968 Dr. Paul Lemoine studied 127 children with features and symptoms related to prenatal alcohol exposure  In 1970’s further study in Seattle termed the condition “fetal alcohol syndrome”

5. FASD Prevalence Approximated On any given day in the United States, 10,657 babies are born…  1 of these babies is HIV positive  10 of these babies are born with Down Syndrome  20 of these babies are born with Fetal Alcohol Syndrome  100 of these babies are born with an alcohol related disorder (1 out of 100)

6. Fetal Alcohol Syndrome (FAS) Affects 1-3 babies per 1000 FAS is the leading cause of intellectual delay FAS is the leading cause of birth defects Caused by a mother’s heavy drinking during pregnancy  Central nervous system (brain, spinal cord) damage Untreated, this primary disability can lead to secondary disabilitiessecondary disabilities  Environmental issues complicate the condition Many FAS-affected children in foster care FAS is irreversible

7. Four Fetal Alcohol Syndrome Criteria Growth problems Specific facial features Central nervous system damage or dysfunction Prenatal alcohol exposure 4-Digit Diagnostic Code (WA State Diagnostic & Prevention Network) 4-Digit Diagnostic Code

8. Growth Problems Growth retardation  Bone growth - prenatally and postnatally  Height  Weight  Head circumference  Heart malformations

9. FAS Characteristics Physical characteristics  Small head  Small eyes  Large cheeks  Thin upper lip  Flat nose  Clinical presentation (AAFP, 2005) Clinical presentation

10. Fetal Alcohol Syndrome (FAS) Cognitive Impairments Learning disabilities (differences)  Visual-spatial learning Objects on table (remembered, not placed correctly)  Slower reaction times (eye movements - geometric patterns)  Difficulty planning, organizing Difficulty letting go of problem-solving strategies, even when they do not work  Memory deficits  Encoding, rather than recall (different from Down’s Syndrome) Attention deficits  May be misdiagnosed ADHD  May focus and maintain attention well, but shift attention poorly Source: NIAAA

11. FAS Behavioral Problems Poor impulse control Difficulties with social interaction Inappropriate sexual behavior Substance abuse Problems with the law

12. Fetal Alcohol Syndrome Vignettes (Fetal Alcohol Syndrome, National Academies Press:1996. Page 54) http://books.nap.edu/books/0309052920/html/54.html#pagetop

13. Fetal Alcohol Effects (FAE) Those affected with prenatal alcohol exposure Those without all the symptoms of FAS  Growth deficiencies  Behavior problems  Substance abuse  Cognitive deficits  Some facial features  FAE now has more specific terms

14. Alcohol-Related Neurodevelopmental Disorder Issues related to nervous system:  Communication problems  Memory problems  Learning disabilities (differences)  Visual & spatial skill problems  Problems with motor skills

15. Alcohol-Related Birth Defects Defects in major organ systems:  Abnormal development  Underdevelopment Heart Kidneys Eyes, ears Skeleton

16. Is Any Amount of Alcohol Considered Safe? There is no “safe” amount of alcohol consumption (Chart: MN Department of Health) There is no “safe” amount of alcohol consumption Most physicians will recommend pregnant women abstain from alcohol consumption According to American Pregnancy Association:  2-4 drinks, frequently, can lead to FAE  5-6 drinks, frequently, can lead to FAS According to Fetal Alcohol Syndrome (Institute of Medicine; National Academies Press: 1996, p. 68)  Effects of mild alcohol intake are controversial  Existing research suggests alcohol bingeing related to FAS

17. Protective Factors Early diagnosis Special education Social services Nurturing environment Absence of violence (National Center on Birth Defects and Developmental Disabilities)

18. Early Intervention

19. Common Issues Among FAS Babies Sleep disturbances Poor sucking response Crying Underdevelopment Toilet training Distractibility, difficulty following directions Disobedience Source: Teresa Kellerman, Coordinator, FAS Resource Center

20. Affected Individuals Randy (ARND) Randy Matt (FAS) Matt Stefanie (FAS) Stefanie Sinja (FAS; English child living in Germany) Sinja Patrichia Rose (FAS) Patrichia Rose David with Fetal Alcohol Syndrome (video clip) David

21. FAS: Real People Fetal Alcohol Syndrome: A Biological Basis Fetal Alcohol Syndrome: A Biological Basis (Youtube.com)

22. Legislation Labor-Health & Human Services-Education Appropriations Proposal to address FASD in Community Health Centers Information at National Organization on Fetal Alcohol Syndrome (NOFA) Information at National Organization on Fetal Alcohol Syndrome (NOFA)