Title: Fetal Alcohol Syndrome
1 Fetal Alcohol Syndrome
- Monique Burns
- Tabitha Capps
- Elizabeth Cash
- Angela Burney
- Patrick Bullock
2What is Fetal Alcohol Syndrome?
- FAS is a lifelong yet completely preventable set
of physical, mental and neurobehavioral birth
defects associated with alcohol consumption
during pregnancy. Some babies with
alcohol-related birth defects, including smaller
body size, lower birth weight, and other
impairments, do not have all of the classic FAS
symptoms. These symptoms are sometimes referred
to as Fetal Alcohol Effects (FAE). Researchers do
not all agree on the precise distinctions between
FAS and FAE cases. - (1994-2004, para. 1)
- Cause of the Problem Alcohol in a pregnant
woman's bloodstream circulates to the fetus by
crossing the placenta. There, the alcohol
interferes with the ability of the fetus to
receive sufficient oxygen and nourishment for
normal cell development in the brain and other
body organs. - FAS is the leading known cause of mental
retardation and birth defects. - (1994-2004, para. 2)
3Effects of Fetal Alcohol Syndrome
- Birth Defects
- Leading cause of mental retardation
- Multiple Organ Dysfunction
- Intra- and postnatal grow defects
- Lower Intelligence
- Dysfunction in central nervous system which can
lead to learning disability - Cranial and Facial Dysmorphology
- (Eustace et. al., 2003)
4Common Cognitive and Behavioral Problems
- Attention Deficit Hyperactivity Disorder
- Inability to foresee consequences
- Inability to learn from previous experience
- Inappropriate Behavior
- Lack of Organization
- Leaning Difficulties
- Poor Abstract Thinking
- Poor Adaptability
- Poor Impulse Control
- Poor Judgment
- Speech Problems
- (Koren et al., 2003)
5Secondary Disabilities and percent of cases
- Mental Health Problems 90
- Dependent Living 80
- Employment Problems 80
- Disruptive School Experience 60
- Trouble with the Law 60
- Confinement 50
- Inappropriate Sexual Behavior 50
- Alcohol or Drug Problems 30
- (Koren et al., 2003)
6FAS Diagnosis----brief definitions
- Microcephaly small size of the head in relation
to the rest of the body - Philtrum the vertical groove in the median
portion of the upper - Palpebral eyelid
- Hypoplasia incomplete development of an organ or
tissue - Microphthalmia abnormal smallness of the eyeball
- (Abel, 1984)
7 FAS Diagnosis
- A Patient must meet 3 criteria to be diagnosed
with FAS - Prenatal or postnatal growth retardation (below
10th percentile for body weight, length, or head
circumference) - Characteristic facial anomalies (at least 2 or 3)
- a. Microcephaly (below 3rd
percentile) - b. Microphthalmia or short palpebral
fissures - c. Underdeveloped philtrum, thin
upper lip, and maxillary
hypoplasia - Central nervous system dysfunction (neurological
abnormality, mental deficiency, developmental
delay. - (Abel 1984)
8Abnormalities in FAS Children
- Abnormal Facial Features
- Eyes
- Small, slant downward, drooping
eyelid, wide-set - Ears
- large, low set (below eyes),
posterior rotation (toward back of head), poorly
formed concha (hollow of external ear) - Nose
- upturned, shortened, hypoplasia of
nasal bridge - Mouth
- wide, thin upper lip, cleft palate,
cleft lip, poorly formed teeth, indistinct
philtrum - (Abel, 1984)
9Facial Features Associated with FAS The
illustration Below is from Vol. 18, No. 1, 1994
of the Journal Alcohol Health Research
Worldwww.niaaa.nih.gov/gallery/ fetal/faskid.htm
10Abnormal Organ Development
- People diagnosed with FAS may have
- abnormal organ development in the.
- Heart, kidneys, genitals, respiratory system,
liver, limb/joint and muscular abnormalities - (Abel, 1984)
11Central Nervous System Abnormalities
- abnormal brain structures
- hydrocephalus (excessive fluid in brain)
- anencephaly (absence of brain)
- (Abel, 1984)
12Brain of Child with FAS
http//www.come-over.to/FAS/FASbrain.htm
13Central Nervous System abnormalities can cause an
array of problems such as
- Mental retardation
- Hyperactivity
- Poor hand-eye coordination
- Learning disability (in absence of mental
retardation) - Cerebral palsy
- Seizure disorders
- Sleep problems
- Neonatal irritability
- Neonatal alcohol withdrawal
- Low APGAR scores
- (Abel, 1984)
14FAS Children and School
- Program/Curriculum needs should address a balance
of - --child/teacher directed activities
- --hands-on learning
- --small class size
- --flexibility of scheduling
- --few transitions
- --consistent adults
- --integrated teaching
- --realistic expectations
- --multi-sensory learning
- --focus on sensory and ego development
- --functional social and life skills rather than
academics - (1999, para. 4)
15FAS School cont
- Individual assessments are necessary in
establishing a - childs strengths and deficits.
- Evaluations include
- --Speech/Language
- --Occupational Therapy
- --Cognitive Functioning
- --Psychiatric
- --Neurological
- --Physical Therapy
- (1999, para. 2)
16General educational issues include
- --Hyperactivity
- --Impulsivity
- --Distractibility
- --Poor Social Skills
- --Poor memory
- --Poor Ego Development
- --Sensory Processing Dysfunction
- --Sensory defensiveness
- --Scattered cognitive skills
- --High-levels of anxiety and arousal
- --Learning Disabilities
- (1999, para. 2)
17Examples of Successful Programs
- Behavioral Regulation Training (BRT)
- BRT teaches parents ways to modify the childs
environment to reduce excess stimulation, use
appropriate social reinforcement, and communicate
choices rather than commands. - (2004, March 4, para. 3)
- Parent Child Interaction Therapy (PCIT)
- Behavioral specialists conduct group sessions
with parents to teach them appropriate and
effective behaviors and interaction techniques - (2004, March 4, para. 5)
- Parent-Assisted Social Skills Training
- Children participate in didactic training
sessions, behavior rehearsal, and coaching to
reduce maladaptive behaviors and promote
pro-social interaction skills - (2004, March 4, para. 6)
18Studies on FAS
- The reported rates of FAS vary widely. These
different rates depend on the population studied
and the surveillance methods used. CDC studies
show FAS rates ranging from 0.2 to 1.5 per 1,000
live births in different areas of the United
States. Other prenatal alcohol-related
conditions, such as alcohol-related
neurodevelopmental disorder (ARND) and
alcohol-related birth defects (ARBD) are believed
to occur approximately three times as often as
FAS. - (2004, March 4, para. 3)
19(Little, 1977)
- Effects of more moderate alcohol consumption
during pregnancy is unknown - There is an observed connection between moderate
alcohol use and lower birth weight - Alcohol use decreased dramatically after
conception
20(Little, 1977)
- In this sample, daily consumption of one once
of absolute alcohol before pregnancy is
associated with a decrease in birth weight of 91
grams. - One ounce consumed in late pregnancy is
associated with a decrease in birth weight of 160
grams.
21(Ihlen Tronnes, 1993)
- Did 2 studies 5 years apart at same hospital on
women that had just given birth - The 2nd groups alcohol consumption lowered by
more than 50
22Cullen Moriah,1995
- Not known if there is a safe amount of alcohol
use during pregnancy - Surgeon General recommends complete avoidance of
alcohol during pregnancy - 15-20 million Americans are heavy drinkers
23So Just Remember.
- When a pregnant woman drinks alcohol, so does
her unborn baby. There is no known safe amount
of alcohol to drink while pregnant and there also
does not appear to be a safe time to drink during
pregnancy either. Therefore, it is recommended
that women abstain from drinking alcohol at any
time during pregnancy. Women who are sexually
active and do not use effective birth control
should also refrain from drinking because they
could become pregnant and not know for several
weeks or more. - (2004, March 4, para. 1)
24REFERENCES
- Abel, Ernest L. (1984). Fetal alcohol syndrome
and fetal alcohol effects. New York London
Plenum Press. pgs. 73-79. - Cullen, T.A. Moriah, K.A., (1995). Screening
for alcohol abuse in pregnancy. American Family
Physician, 51. 1666-1670. - Eustace, Larry W., Kang, Duck-Hee, Coombs,
David. (March/April 2003). Fetal alcohol
syndrome A growing concern for health care
professionals. Journal of Obstetric,
Gynecologic, and Neonatal Nursing, 32(2),
215-221. - Ihlen, B.M., Amundsen, A. Tronnes, L. (1993).
Reduced alcohol use in pregnancy and changed
attitudes in the population. Addiction, 88.
389-394. - Koren, Gideon, Nulman, Irena, Chudley, Albert E.
Looke, Christine. (2003). Fetal alcohol
spectrum disorder. Medical Association Journal,
169(11), 1181-1185.
25References
- Little, R.E. (1977). Moderate alcohol abuse
during pregnancy and decreased infant birth
weight. AJPH, 67. 1154-1156. - Shea, C., Winners, S. (1999). Information on
Fetal Alcohol Syndrome/Fetal Alcohol Effects.
Retrieved April 8, 2004, from Northeast
Consultation and Training Center Web site - http//www.taconic.net/seminars/index.html
-
- (2004, March 4). The National Center on Birth
Defects and Developmental Disabilities.
Developing Intervention Strategies for Children.
Intervening with Children and/or Adolescents with
Fetal Alcohol Syndrome or Alcohol Related
Neurodevelopment Disorders. Retrieved April 8,
2004, from Center for Disease Control and
Prevention web site - http//www.cdc.gov/ncbddd/fas/intervening.htm
-
26References
- (2004, March 4).. The National Center on Birth
Defects and Developmental Disabilities.
Developing Intervention Strategies for Children.
Intervening with Children and/or Adolescents with
Fetal Alcohol Syndrome or Alcohol Related
Neurodevelopment Disorders. Retrieved April 8,
2004, from Center for Disease Control and
Prevention web site - http//www.cdc.gov/ncbddd/fas/fasask.htmhow
- (1994-2004). National Organization on Fetal
Alcohol Syndrome. Protecting Children and
Families by Fighting the Leading Known Cause of
Mental Retardation and Birth Defects. Retrieved
April 7, 2004. - http//www.nofas.org/main/FAS-FASD-ARND-ARBD.htm