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Working to Prevent Fetal Alcohol Spectrum Disorders Through High School and Middle School Curricula

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Title: Working to Prevent Fetal Alcohol Spectrum Disorders Through High School and Middle School Curricula


1
Working to Prevent Fetal Alcohol Spectrum
DisordersThrough High School and Middle School
CurriculaThis presentation was designed for
use in Middle School and High School
Introductory Biology, Health, Family and Consumer
Science Classes
Indiana FASD Prevention Taskforce
2
Fetal Alcohol Spectrum DisordersWhy a person
should NOT drink alcohol if she COULD get
pregnant!
Indiana FASD Prevention Taskforce
3
Fetal Alcohol Spectrum Disorders (FASD)
  • Possible Diagnoses
  • Fetal alcohol syndrome (FAS)
  • Partial FAS (pFAS)
  • Alcohol-related neurodevelopmental
    disorder (ARND)
  • Alcohol-related birth defects (ARBD)



FAE (fetal alcohol effects) is an older term used
to describe the last three listed above.
4
On any given day in the United States
  • Approximately 11,000 babies are born
  • 1 of these babies is HIV positive
  • 3 of these babies are born with muscular dystrophy
  • 4 of these babies are born with spina bifida
  • 10 of these babies are born with Down syndrome
  • 20 of these babies are born with FAS
  • 100 of these babies are born with a FASD

From the Executive Summary of the IOM Report.
FAS Community Resource Center.
http//www.come-over.to/FASCRC
5
The Prevalence of FAS and FASD
  • The prevalence of FAS is estimated to be about 1
    in 500 to 1 in 1000 births
  • The prevalence of FASD is estimated to be nearly
    1 in 100 births

Eustace LW 2003 Substance Abuse and Mental
Health Services Administration and the Centers
for Disease Control and Prevention
6
How much is too much?
  • The more alcohol consumed during pregnancy, the
    higher the risk for adverse effects
  • Binge drinking is particularly harmful!
  • No amount of alcohol has
  • been proven safe to
  • consume during pregnancy
  • Every FASD is 100 preventable!

7
What is a Drink?
A Binge is four or more drinks on one occasion
for a woman five or more for a man A Drink is
12 ounces of beer, five ounces of wine, or 1.5
ounces of hard liquor

8
The Effect of Alcohol on a Babys Development
  • Alcohol freely crosses the placenta from the
    mother to the baby
  • Blood alcohol levels of the baby are equal to
    that of the mother, within minutes of consumption
  • The critical period is the entire pregnancy

9
The Effect of Alcohol on a Babys Development
Development of the brain is occurring throughout
the pregnancy, which means that alcohol exposure
at any point may cause brain damage.
Figure from http//www.fda.gov/cber/gdlns/rvrpreg_
fig1.gif
10
The Diagnosis of FAS
  • Defined by four criteria
  • Exposure to alcohol while in the womb
  • Characteristic facial features
  • Growth problems
  • Involvement of the central nervous system (the
    brain)

11
FASD Facial Features Smooth Philtrum and Thin
Upper Lip
Smooth philtrum (little to no groove above upper
lip)
Thin upper lip
NOTE Although these features are associated with
fetal alcohol syndrome, they may also be seen in
people who do not have a FASD.
12
FAS Facial Features Short Palpebral Fissures
(Eye Openings)
Eyes are measured from the outer corner to the
inner corner
13
The Effect of Alcohol on Growth
  • Alcohol consumption increases the risk for having
    a baby with growth problems
  • After birth, exposed children may continue to
    have a decreased growth rate and subsequent short
    stature

Day and Richardson, 2004, AJMG 127C28-34.
14
Alcohol Affects Overall Brain Size
Brain of a healthy baby
Brain of a baby exposed to alcohol
Photo by Sterling Clarren, MD http//www.come-over
.to/FAS/FASbrain.htm
15
Alcohol Affects Brain Function
  • Developmental delays
  • Learning difficulties
  • Mental retardation
  • Speech/language disorders
  • Problems with memory, perception, and the senses

16
Normal
FAS
  • Differences in brain function may appear as
  • Taking longer to process information
  • Problems remembering things
  • Difficulties with generalizing, forming
    associations, and understanding abstract concepts
  • Problems understanding consequences or
    cause-and-effect

Malbin D. 2002
17
A teenager with a FASD, who is 18 years old, may
function at the level of a child or adolescent
Emotional maturity Comprehension Social
skills Concepts of money and time Living
skills Reading ability Physical maturity
6 years 6 years 7 years 8 years
11 years 16
years 18 years
Skill Developmental Age Equivalent
Adapted from www.efsmanitoba.com/html/Final20Pap
er20Defining20Needs20of20women20with20FAS_E2
.htm
18
Primary vs. Secondary Disabilities
  • Primary disabilities result from brain damage due
    to the alcohol exposure
  • Secondary disabilities develop over time due to
    lack of intervention and unmet needs
  • They are believed to be preventable

19
Secondary Disabilities in FASD
  • Mental health issues
  • Disrupted school experiences
  • Inappropriate sexual behavior
  • Trouble with the law
  • Confinement in jail or treatment facilities
  • Alcohol and drug problems
  • Dependent living
  • Employment problems

http//come-over.to/FAS/
20
Secondary Disabilities
www.fasdcenter.samhsa.gov Streissguth AP, et al.
2004
21
The Long Term Consequences of FAS
  • Only 3 of children lived with biological mother
  • Poor behavior was common
  • Average academic function was between 2nd and 4th
    grade
  • Independent living was uncommon among adults with
    FAS

Streissguth et al. 1991
22
For More Information
  • Fetal Alcohol Spectrum Disorders Trying
    Differently Rather Than Harder, by Diane Malbin,
    MSW. Available at www.FASCETS.org.
  • Fetal Alcohol Syndrome A Parents Guide to Caring
    for a Child Diagnosed with FAS, by Leslie Evans,
    MS, et al. Available for download at
    http//otispregnancy.org/pdf/FAS_booklet.pdf
  • Fetal Alcohol Syndrome, Fetal Alcohol Effects
    Strategies for Professionals, by Diane Malbin,
    MSW. Hazelden Foundation, Center City, MN.
  • Fetal Alcohol Syndrome Practical Suggestions and
    Support for Families and Caregivers, by Kathleen
    Tavenner Mitchell, MHS, LCADC, and the National
    Organization on Fetal Alcohol Syndrome. Available
    at http//www.nofas.org/estore

23
References
  • Alan Guttmacher Institute. Facts on American
    teens sexual and reproductive health.
    www.guttmacher.org/pubs/fb_ATSRH.htm
  • The Centers for Disease Control and Prevention.
    Fetal alcohol spectrum disorders.
    www.cdc.gov/ncbddd/fas/fasprev.htm
  • Day NL and Richardson GA. 2004. An analysis of
    the effects of prenatal alcohol exposure on
    growth A teratologic model. American Journal of
    Medical Genetics Part C. 127C28-34.
  • Eustace LW, et al. 2003. Fetal alcohol syndrome
    A growing concern for healthcare professionals.
    Journal of Obstetric, Gynecologic, and Neonatal
    Nursing. 32215-221.
  • The Institute of Medicine. 1996 Report on FAS.
    http//www.come-over-.to/FAS/ IOMsummary.htm
  • Lupton C, et al. 2004. Cost of fetal alcohol
    spectrum disorders. American Journal of Medical
    Genetics Part C. 127C242-50.
  • Mattson SN, et al. Teratogenic effects of alcohol
    on brain and behavior. National Institute on
    Alcohol Abuse and Alcoholism. http//pubs.niaaa.ni
    h.gov/publications/ arh25-3/185-191.htm
  • Streissguth AP, et al. 1991. Fetal alcohol
    syndrome in adolescents and adults. Journal of
    the American Medical Association. 265(15)1961-7.
  • Streissguth AP, et al. 2004. Risk factors for
    adverse life outcomes in fetal alcohol sydnrome
    and fetal alcohol effects. Developmental and
    Behavioral Pediatrics 25(4)228-238.
  • Substance Abuse and Mental Health Services
    Administration Fact Sheets. http//www.fasdcenter.
    samhsa.gov/grabGo/factSheets.cfm

24
Helpful Websites
  • National Organization on Fetal Alcohol Syndrome-
    www.nofas.org
  • Fetal Alcohol Syndrome, Education and Training
    Services, Inc.- www.fascets.org
  • The FASD Center for Excellence, Substance Abuse
    and Mental Health Services Administration-
    www.fascenter.samhsa.gov
  • FASlink- http//www.acbr.com/fas/
  • The Arc- http//www.thearc.org/fetalalcohol.html
  • The Centers for Disease Control and Prevention-
    http//www.cdc.gov/ncbddd/fas/default.htm

25
Indiana Resources
  • The Fetal Alcohol Syndrome Center of Indiana -
    Indiana University Medial Center 975 West Walnut
    Street, IB 130 Indianapolis, IN 46202 Phone
    317-274-2450  Fax 317-274-2387   Provides
    diagnosis, education and patient advocacy for
    those affected with prenatal alcohol exposure.
  • CNS - Center for Neurobehavioral Sciences 3010
    E. State Ft. Wayne, IN 46805 Phone
    260-471-2300  Toll Free 1-800-901-8416 Provides
    therapy, education and patient advocacy for those
    affected with prenatal alcohol exposure.
    Organizes a support group for parents and
    caregivers (and other interested parties) of
    those with a FASD.

26
Indiana Resources
  • Indiana Department of Health - IN Perinatal
    Network (IPN), Prenatal Substance Use Prevention
    Program (PSUPP) 2 N Meridian Street
    Indianapolis, IN 46204 Phone 317-233-1269
  • Fax 317-233-1300
  • Referrals and early intervention for
    substance-using pregnant
  • women. Training for professionals.
  • Indiana Protection and Advocacy Services 4701 N
    Keystone Avenue, Suite 222, Indianapolis, IN
    46205
  • Phone 800-622-4845 or 317-722-5555       Fax
    317-722-5564 Statewide agency for persons with
    developmental disabilities. www.in.gov/ipas

27
www.health.state.mn.us/fas/catalog
28
Slides developed by Lisa J. Spock, Ph.D.,
C.G.C. Gordon Mendenhall, Ed.D. Assisted
by David D. Weaver, M.D. Becky Kennedy,
M.Ed. James M. Ignaut, M.A., M.P.H.,
C.H.E.S. Supported by Indiana University
School of Medicine Indiana State Department of
Health Indiana Department of
Education University of Indianapolis
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