Fetal Alcohol Syndrome
Other Health Impairments—Alcohol-related Diagnoses
The spectrum of alcohol-related diagnoses includes:
- Fetal Alcohol Syndrome (FAS)
- Fetal Alcohol Effects (FAE)
- PFAS (Partial Fetal Alcohol Syndrome)
- ARND (Alcohol Related Neurodevelopmental Disorder) or ARBD (Alcohol Related Birth Defects)
Our nation’s special education law, the Individuals with Disabilities Education Act (IDEA) defines diabetes under “other health impairment,” which means…
“…having limited strength, vitality, or alertness, including a heightened alertness to environmental stimuli, that results in limited alertness with respect to the educational environment, that is due to chronic or acute health problems such as asthma, attention deficit disorder or attention deficit hyperactivity disorder, diabetes, epilepsy, a heart condition, hemophilia, lead poisoning, leukemia, nephritis, rheumatic fever, sickle cell anemia, and Tourette syndrome; and adversely affects a child’s educational performance.”
[34 code of Federal Regulations §300.8(c)(9)]
FACTS AND STATS
The Center for Disease Control estimates that .02-1.5 cases of FAS occur for every 1,00 births. There are approximately three times that many cases of FASDs than FAS. Prevalence varies by state. (CDC, 2011).
FASDs are caused by a woman drinking alcohol during pregnancy. There is no known amount of alcohol that is safe to drink while pregnant. (CDC, 2011).
To prevent FASDs, a woman should not drink alcohol while she is pregnant or even when she might get pregnant. This is because a woman could get pregnant and not know for several weeks. In the US, half of pregnancies are unplanned. (CDC, 2011)
CHARACTERISTICS AND DIAGNOSIS
Deciding if a child has FASD takes several steps. There is no one test to diagnose FASD, and many other disorders have similar symptoms. Following is an overview of the diagnostic guidlines. For more detail the the full text (http://www.cdc.gov/ncbddd/fasd/documents/fas_guidelines_accessible.pdf)
- Abnormal facial features: smooth ridge between the nose and upper lip, thin upper lip, and a short distance between inner and outer corners of eyes.
- Growth deficits: below average height, weight, or both. For some children with FASD, growth problems resolve themselves early in life.
- Central nervous system problems:
- Structural: smaller than normal head size, significant changes in the structure of the brain as seen on brain scans such as MRIs or CT scans.
- Neurologic: there are problems with the nervous system that cannot be linked to another cause. Examples include poor coordination, poor muscle control, and problems with sucking as a baby.
- Functional: the person's ability to function is well below what is expected for his or her age, schooling or circumstances. (CDC, 2011)
To be diagnosed with FASD a person must have:
- Cognitive deficits or significant developmental delay in children who are too young for an IQ assessment.
- Problems in at least three of the following area:
- Cognitive deficits or developmental delays (specific learning disabilities, poor grades in school, performance differences between verbal and nonverbal skills, and slowed movements or reactions)
- Executive functioning deficits (poor organization and planning, lack of inhibition, difficulty grasping cause and effect, difficulty following multistep directions, difficulty doing things in a new way or thinking of things in a new way, poor judgment, and inability to apply knowledge to new situations)
- Motor functioning delays (delay in walking, difficulty writing or drawing, clumsiness, balance problems, tremors, difficulty coordinating hands and fingers, and poor sucking in babies)
- Attention problems or hyperactivity ('busy,' overly active, inattentive, easily distract, and/or difficulty calming down, completing tasks, or moving from one activity to the next)
- Problems with social skills (lack a fear of strangers, be easily taken advantage of, prefer younger friends, be immature, show inappropriate sexual behaviors, and have trouble understanding how others feel)
- Other problems (sensitivity to taste or touch, difficulty reading facial expressions, and difficulty responding appropriately to common parenting practices such as cause-and-effect discipline) (CDC, 2011).
No two people with an FASD are exactly alike. FASDs can include physical or intellectual disabilities, as well as problems with behavior and learning. These symptoms can range from mild to severe. Treatment services for people with FASDs should be different for each person depending on the symptoms. There is no cure for FASDs, but research shows that early intervention treatment services can improve a child’s development. (CDC, 2011)
Studies have shown that some protective factors can help reduce the effects of FASDs and help people with these conditions reach their full potential. These factors include: early diagnosis; involvement in special education and social services; loving, nurturing, and stable home environment; and absence of violence. (CDC, 2011)
Types of Treatment:
- Medical Care: concerns specific to the disorder should be monitored and addressed by a current doctor or though referral to a specialist.
- Medication: 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.
- Behavior and Education Therapy: may include friendship training, specialized math tutoring, executive functioning training, parent-child interaction therapy, and parenting and behavior management training.
- Parent Training: 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.
- Alternative Approaches: with any disability, injury, or medical condition, many untested therapies become known and are promoted by informal networks. (CDC, 2011)
Common areas of concern in the classroom:
- Easily frustrated
- Poor fine and gross motor skills
- Poor attention
- Lack of organizational skills
- Problems with concrete thinking
- Poor peer relations
Strategies for teachers:
- Place the child near the front of the room to help them focus
- Allow the students to have short breaks when necessary
- Create borders around children with FAS/FASD such as armrests, footrests, and beanbag chairs. This helps them feel more secure and calms them.
- Before the bell rings to go home, stop the activity and give them enough time to prepare and exit the classroom.
- Have them perform one task at a time. To make sure they understnad, have them repeat the instructions. If the activity is brand new, walk through it with them first.
- Taking notes can be difficult and may create a distraction as the child may focus more on writing than the context of the lecture. Provide them with a copy of the teacher's or another student's notes. Because their handwriting is often poor, a computer may be a better way for them to complete their assignments.
- Behavior problemts become more apparent as children enter grade school. Often, a slight bump from a fellow student feels like a push to someone with FAS/FASD. This may result in an outburst or fight. Punishment is not always the best answer since FAS/FASD children may not understand why they are being punished. Try defusing the situation as calmly as possible and moving into a new activity.
- Using visuals, concrete examples, and hands-on learning makes school easier. If one technique is not successful, try something new. Children with FAS/FASD can learn - they just need to use different paths to get there.
- Encourage success and reward positive behavior with praise or incentives. Positive reinforcement should be immediate. (www.nofas.org)
For additional information, please visit the CDC website below for information and links to websites developed for teachers working with students diagnosed with FASDs.
FAS Family Resource Institute (FAS*FRI)
Based in Idaho, the purpose of this non-profit is to identify, understand and care for individuals disabled by prenatal alcohol exposure and their families, and to prevent future generations from having to live with this disability. Visit the website contact this organization through their online form.
Children's Research Triangle
180 N. Michigan Ave., Suite 700
Chicago, IL. 60601
Children’s Research Triangle (CRT) is dedicated to the healthy development of children and their families. Their mission is to provide research driven services that improve the quality of life for all children with special needs or those who are at risk for developmental, behavioral, psychological, or educational problems.
National Organization on Fetal Alcohol Syndrome (NOFAS)
1200 Eton Court, NW
Washington, D.C. 20007
NOFAS is dedicated to eliminating birth defects caused by alcohol consumption during pregnancy and to improving the quality of life for those affected individuals and families.
Al-Anon/Alateen Family Group Headquarters
1600 Corporate Landing Parkway
Virginia Beach, VA 23454-5617
757-563-1600 or 1-800-356-9996
This organization helps families and friends recover from the stress of living with a friend or relative who has a drinking problem. Alateen is a recovery program for young people and is sponsored by Al-Anon members.
The Arc of the United States
1825 K Street, NW
Washington, D.C. 20006
The Arc promotes and protects the human rights of people with intellectual and developmental disabilities and actively supports their full inclusion and participation in the community throughout their lifetimes.