Fetal Alcohol Syndrome

1
Fetal Alcohol Syndrome

• Monique Burns
• Tabitha Capps
• Elizabeth Cash
• Angela Burney
• Patrick Bullock

2
What 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)

3
Effects 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)

4
Common 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)

5
Secondary 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)

6
FAS 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)

8
Abnormalities 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)

9
Facial 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

10
Abnormal 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)

11
Central Nervous System Abnormalities

• abnormal brain structures
• hydrocephalus (excessive fluid in brain)
• anencephaly (absence of brain)
• (Abel, 1984)

12
Brain of Child with FAS
http//www.come-over.to/FAS/FASbrain.htm
13
Central 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)

14
FAS 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)

15
FAS 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)

16
General 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)

17
Examples 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)

18
Studies 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

22
Cullen 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

23
So 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)

24
REFERENCES

• 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.

25
References

• 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
•  

26
References

• (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