Fetal alcohol spectrum disorders (FASDs) is an umbrella term used to describe the range of effects that can occur in an individual with prenatal alcohol exposure. These effects can have lifelong implications including physical, mental, behaviour, and/or learning issues. One of the important things to remember is that people diagnosed with FASD will also have strengths and talents so it is important to find out what the person does well and encourage them in it. Some common personal and skill areas include being Caring, Articulate, Friendly, Musical, Artistic, Creative, Practical, Athletic, Animal skills, Nature Skills etc. Some are in professional careers, have attended university and are raising their own children.
In simple words, they are a group of conditions that can occur in a person whose mother drank alcohol during pregnancy. These effects can include physical problems and problems with behaviour and learning. Often, a person with an FASD has a mix of these problems.
No two children with FASD are exactly alike, either behaviorally or physically.
Some of the co-occurring, behavioural, social and learning characteristics may include:
– Issues with attention, concentration or hyperactivity.
– Academic issues, including specific deficits in mathematics & memory skills.
– Very specific language deficits e.g. poor receptive language.
– Short term or working memory issues
– Adaptive functioning issues that grow more significant with age.
– Challenges with emotional regulation
– Social or relationship challenges including difficulty making or sustaining friendships
despite being sociable.
– Sensory impairments such as vision or hearing.
– Sensory sensitivities.
– The tendency to be oppositional or defensive when requests are made.
– Inconsistent performance – can do something one day but cannot the next.
– Lack of abstract reasoning, cause & effect logic, fails to generalise
– Poor sense of self and issues with a theory of mind.
THE FIRST STEP
If you’re pregnant and can’t stop drinking, ask your obstetrician, primary care doctor or mental health professional for help.
Because early diagnosis may help reduce the risk of long-term problems for children with fetal alcohol syndrome, let your child’s doctor know if you drank alcohol while you were pregnant. Don’t wait for problems to arise before seeking help.
If you have adopted a child or are providing foster care, you may not know if the biological mother drank alcohol while pregnant — and it may not initially occur to you that your child may have fetal alcohol syndrome. However, if your child has problems with learning and behaviour, talk with his or her doctor so that the underlying cause might be identified.
- Foetal Alcohol Syndrome, FAS
- Partial Foetal Alcohol Syndrome, PFAS
- Alcohol-Related Neuro-developmental Disorder, ARND
- Alcohol-Related Birth Defects, ARBD
Fetal Alcohol Syndrome (FAS)
FAS is on the most severe end of the FASD spectrum. It describes people with the greatest alcohol effects, causing signs and symptoms so distinct that the diagnosis is based on special measurements and findings in each of the 3 following areas:
Three specific facial abnormalities:
- smooth philtrum (the area between the nose and upper lip), thin upper lip, small palpebral fissures (the horizontal eye openings)
- Growth deficit (lower than average height, weight or both)
- Central nervous system (CNS) abnormalities (structural, neurologic, functional, or a combination of these)
Partial Fetal Alcohol Syndrome (pFAS)
When a person does not meet the full diagnostic criteria for FAS but has a history of prenatal alcohol exposure and some of the facial abnormalities, as well as a growth problem or CNS abnormalities that person is considered to have partial FAS (pFAS).
Alcohol-Related Neurodevelopmental Disorder (ARND)
People with ARND do not have abnormal facial features or growth problems, but do have problems with how their brain and nervous system were formed as well as how they function. These individuals may have:
- Intellectual disabilities
- Behaviour or learning problems
- Nerve or brain abnormalities
In particular, 2011 federally convened committee that reviewed the science noted that these children are most likely to have problems with neurocognitive development, adaptive functioning, and or behaviour regulation.
Neurobehavioral Disorder Associated with Prenatal Alcohol Exposure (ND-PAE)
In addition to confirmed prenatal alcohol exposure, these individuals have impairment of neurocognition, self-regulation, and adaptive functioning. ND-PAE combines deficits is these three areas in conjunction with the following:
- Evidence of prenatal alcohol exposure
- Childhood onset of symptoms
- Significant distress or impairment in social, academic, occupational, or other important areas of function
Alcohol-Related Birth Defects (ARBD)
People with ARBD have problems with how some of their organs were formed and or how they function, including:
- Bones (possibly the spine)
Cause and Prevention
The alcohol crosses the placenta and enters the baby’s blood where it can damage the developing brain and other organs leading to an FASD. There is no known safe amount of alcohol during pregnancy or when trying to get pregnant. There is also no safe time to drink during pregnancy. Alcohol can cause problems for a developing baby throughout pregnancy, including before a woman knows she’s pregnant. All types of alcohol are equally harmful, including all wines and beer.
To prevent FASDs, a woman should not drink alcohol while she is pregnant, or might be pregnant. This is because a woman could get pregnant and not know for up to 4 to 6 weeks.
If a woman is drinking alcohol during pregnancy, it is never too late to stop drinking. Because brain growth takes place throughout pregnancy, the sooner a woman stops drinking the safer it will be for her and her baby.
- Don’t drink alcohol if you’re trying to get pregnant. If you haven’t already stopped drinking, stop as soon as you know you’re pregnant or if you even think you might be pregnant. It’s never too late to stop drinking during your pregnancy, but the sooner you stop, the better it is for your baby.
- Continue to avoid alcohol throughout your pregnancy. Fetal alcohol syndrome is completely preventable in children whose mothers don’t drink during pregnancy.
- Consider giving up alcohol during your childbearing years if you’re sexually active and you’re having unprotected sex. Many pregnancies are unplanned, and damage can occur in the earliest weeks of pregnancy.
- If you have an alcohol problem, get help before you get pregnant. Get professional help to determine your level of dependence on alcohol and to develop a treatment plan.
The term FASDs is not meant for use as a clinical diagnosis. Diagnosing FAS can be hard because there is no medical test, like a blood test, for it. And other disorders, such as ADHD (attention-deficit/hyperactivity disorder) and Williams syndrome, have some symptoms like FAS.
Children with an FASD can have brain abnormalities that lead to problems in day-to-day functioning despite having a normal IQ, so a comprehensive evaluation is indicated. All children with involvement in foster care or adoption processes―especially international adoptions―should always be evaluated for a possible FASD.
To diagnose FAS, doctors look for:
- Abnormal facial features (e.g., the smooth ridge between the nose and upper lip)
- Lower-than-average height, weight, or both
- Central nervous system problems (e.g., small head size, problems with attention and hyperactivity, poor coordination)
- Prenatal alcohol exposure; although confirmation is not required to make a diagnosis
- Attention-deficit/hyperactivity disorder (ADHD)
- Aggression, inappropriate social conduct, and breaking rules and laws
- Alcohol or drug misuse
- Mental health disorders, such as depression, anxiety or eating disorders
- Problems staying in or completing school
- Problems with independent living and with employment
- Inappropriate sexual behaviours
- Early death by accident, homicide or suicide
- Developmental services
- Educational interventions
- Behaviour modification
- Parent training
- Social skills training
- Medications and other medical therapies
- Transition planning
- Advocacy in school and the workplace
- Referral for community support services
People with FASDs have the same health and medical needs as people without FASDs. Like everyone else, they need well-baby care, vaccinations, good nutrition, exercise, hygiene, and basic medical care. But, for people with FASDs, concerns specific to the disorder must also be monitored and addressed either by a current doctor or through referral to a specialist. The types of treatments needed will be different for each person and depend upon the person’s symptoms.
Types of medical specialists might include:
Primary care provider
Mental health professionals (child psychiatrist and psychologist, school psychologist, behaviour management specialist)
No medications have been approved specifically to treat FASDs. But, several medications can help improve some of the symptoms of FASDs. For example, medication might help manage high energy levels, inability to focus, or depression.
Following are some examples of medications used to treat FASD symptoms:
This type of medication is used to treat symptoms such as hyperactivity, problems paying attention, and poor impulse control, as well as other behaviour issues.
This type of medication is used to treat symptoms such as sad mood, loss of interest, sleep problems, school disruption, negativity, irritability, aggression, and anti-social behaviours.
This type of medication is used to treat symptoms such as aggression, anxiety, and certain other behaviour problems.
This type of medication is used to treat symptoms of anxiety.
Medications can affect each child differently. One medication might work well for one child, but not for another. To find the right treatment, the doctor might try different medications and doses. It is important to work with your child’s doctor to find the treatment plan that works best for your child.
Behaviour and Education Therapy
Behaviour and education therapies can be important parts of treatment for children with FASDs. Although there are many different types of therapy for children with developmental disabilities, only a few have been scientifically tested specifically for children with FASDs.
Children with FASDs might not respond to the usual parenting practices. Parent training has been successful in educating parents about their child’s disability and about ways to teach their child many skills and help them cope with their FASD-related symptoms. Parent training can be done in groups or with individual families. Such programs are offered by therapists or in special classes.
Although each child is unique, the following parenting tips can be helpful:
- Concentrate on your child’s strengths and talents
- Accept your child’s limitations
- Be consistent with everything (discipline, school, behaviours)
- Use concrete language and examples
- Use stable routines that do not change daily
- Keep it simple
- Be specific-say exactly what you mean
- Structure your child’s world to provide a foundation for daily living
- Use visual aids, music, and hands-on activities to help your child learn
- Use positive reinforcement often (praise, incentives)
- Supervise: friends, visits, routines
- Repeat, repeat, repeat
- Families might need support from a family counsellor or therapist. Parents might also benefit from local support groups, in which parents of children with FASDs can discuss concerns, ask questions, and find encouragement.
With any disability, injury, or medical condition, many untested therapies become known and are promoted by informal networks. These therapies are referred to as alternative treatments. Before starting such a treatment, check it out carefully, and talk to your child’s doctor. Your child’s doctor will help you weigh the risks and benefits of these therapies.
Some of the alternative treatments used for people with FASDs include:
Relaxation therapy, visual imagery, and meditation (especially for sleep problems and anxiety)
Creative art therapy
Yoga and exercise
Acupuncture and acupressure
Massage, Reiki, and energy healing
Vitamins, herbal supplements, and homoeopathy
Celebrities may be highly regarded in the society as among those influencing global change through their opinions on critical issues on foreign policy, the environment or healthcare, however, a number of them suffer a series of health issues in which some of them may be open enough to disclose to the public while a few others may choose to keep a secret.
Bernard Sanders, popularly known as Bernie Sanders, is a famous US politician and a notable celebrity best known for his services in the political sphere of the United States of America. He is currently serving as the junior United States Senator from Vermont. Sanders is reportedly suffering from different illnesses including gout, hernias, diverticulitis, and a cyst on his vocal cord. He is also said to be among the millions of Americans who are victims of Fetal Alcohol Syndrome (FAS). These conclusions were drawn taking a look at his lack of impulse control, beady little eyes, and poor social skills. He was said to have suffered this from birth as a result of his mother’s intake of dangerous alcoholic drink when she was pregnant with him.
The American born actor, producer, and activist is one of the Fetal Alcohol Syndrome celebrities. He was born on October 28, 1974, as Joaquin Rafael Bottom; his father’s name is John Lee Bottom and his mother is Arlyn Bottom. Although he was born into a Christian home, Phoenix, alongside his siblings, River, Rain, Liberty and Summer appeared to have had a rough upbringing with a mother who probably was into much alcohol intake.
A closer look at Joaquin’s face will reveal a scar that goes from his lip up to his nose. It is called a microform cleft lip, a facial and oral malformation that occurs in a child during the first weeks in their mother’s womb. Born in a financially unstable household, Phoenix is one of the numerous Americans suffering from FAS which is now widely considered as the most common birth defect in the nation.
The microform cleft requires no corrective surgery since it rarely brings damages, the appearance of the scar does not in any way affect his abilities as an actor which has, in turn, earned him several international attention.
From the early 1980s when he professionally ventured into acting, Phoenix has gradually polished his skills to become a refined actor. His appearance in such renowned films as Gladiator helped in his rise to fame in the entertainment industry. Phoenix was also a victim of alcoholism. In April 2005, he was checked into rehab to be treated for alcoholism. He was even engaged in an accident as a result of his alcoholic behaviour. He was one of those who supported Bernie Sanders during the 2016 Democratic Party presidential primaries.
Reese Witherspoon is a popular American entrepreneur, actress, and producer who has earned several awards for her active roles in the movie industry. The awards she has so far earned include an Academy Award, a BAFTA Award, a Primetime Emmy Award and two Golden Globe Awards. She is best known for taking a role in the drama series The Man in the Moon as well as the 1999 American Black comedy-drama film titled Election, among other films.
Born on March 22, 1976, in Southern Baptist Hospital, New Orleans, Louisiana, Witherspoon’s original name is Laura Jeanne Reese Witherspoon and her father’s name is Dr John Draper Witherspoon, a former medical student at Tulane University while his mother’s name is Mary Elizabeth “Betty” (née Reese).
The Hollywood star has a thin upper lip, malformed cranium, and difficulty in learning which are classic signatures of the Fetal Alcohol Syndrome. Some of her physical deformities which also include behavioural attitudes like a rapidly changing moods and lacklustre personal hygiene are her birth defect. But despite these shortcomings, Reese has never failed to remain focused on her dreams of becoming a phenomenal actress.
It’s been rumoured that Witherspoon’s mother was into excessive alcohol drinking when she was pregnant with her. Reese is also rumoured to be an excessive alcoholic like her mother.
SCOTS DJ Peter Bowers is one of the few celebrities who has been bold enough to speak about their health challenges not minding the stigma attached to it. Speaking during an interview with BBC Scotland documentary, the renowned DJ revealed how he struggled with learning difficulties and loneliness after doctors diagnosed him with FAS, thanks to his mother who was a heavy alcohol drinker. He said not only was he faced with learning challenges while growing up, but he also had to suffer from the challenge of not being with his parents at the time he needed them the most.
When asked about what he feels about his mother’s action, he emotionally said: “I was 10 when I found out Mum had died because of the drinking and I think she’s up there now looking over me, saying that she’s sorry”.
Notwithstanding the health challenges, Peter has been able to rise above the effect of his predicament and has been able to semi-independently make something good out of his life. Supported by charity C-Change, Peter is at his best in his career as a DJ.