What is FASD?

 
 

•Key Facts on FASD
•FASD: UK Perspective
•Sensible Guide to a Healthy Pregnancy
•White Matter, The Brain's Connective Network Damaged By Prenatal Alcohol Exposure
•Online video info on FASD
•Is Fetal Alcohol Spectrum Disorder Just Another "Disease of the Week?"


Key Facts on Fetal Alcohol Spectrum Disorder

  1. 1.•Fetal Alcohol Spectrum Disorders (FASD) are caused by maternal drinking alcohol in pregnancy.

  2. 2.•No amount of alcohol and no time in pregnancy have been established as safe for the fetus. 

  3. 3.•Fetal Alcohol Spectrum Disorders are the biggest single cause of mental disabilities in most industrialized countries, and could be totally prevented if all women abstained from alcohol in pregnancy.

  4. 4.•Less obvious and seemingly milder fetal alcohol damage is sometimes called Fetal Alcohol Effects (FAE). This term has fallen out of use and has been largely replaced by  Alcohol-Related Neurodevelopmental Disorder (ARND), Partial Fetal Alcohol Syndrome (pFAS) or Static Encephalopathy. These conditions can be equally damaging to babies but are rarely diagnosed. (To keep this simple, we're going to call it all FASD.) 

  5. 5.•Some experts estimate that about 1% of North Americans suffer from a fetal alcohol disorder - about four times as many people as those with AIDS/HIV. There are three to five times as many people with ARND as FAS. 

  6. 6.•Since 1973, the medical profession has known that alcohol in pregnancy impedes fetal brain development, affecting intelligence, learning skills and behaviour. 

  7. 7.•Persons with FAS have distinctive physical appearance and lower IQs, but have lower crime and addiction rates than those with ARND as they get earlier diagnosis and can be better protected by society and their parents. 

  8. 8.•Individuals with ARND may look normal and have seemingly normal intelligence, but their damaged brains can result in learning disabilities, impulsivity, lying, stealing, tantrums, violence and aggression, inability to predict consequences or learn from experience, lack of conscience, and being highly addictive.

  9. 9.•Most people with ARND look perfectly normal and are never diagnosed. Research indicates that a high percentage of homeless people, and at least 25% of juvenile and adult offenders suffer from undiagnosed FASD.

  10. 10.•Of individuals with ARND between the ages of 12 and 51,

    1. 1.◦95% will have mental health problems;

    2. 2.◦68% will have "disrupted school experience";

    3. 3.◦68% will experience trouble with the law;

    4. 4.◦55% will be confined in prison, drug or alcohol treatment centre or mental institution;

    5. 5.◦52% will exhibit inappropriate sexual behavior

  11. 11.•Of individuals with ARND between 21 and 51 : 

    1. 1.◦ more than 50% of males and 70% of females will have alcohol and

    2. 2.◦drug problems; 82% will not be able to live independently;

    3. 3.◦70% will have problems with employment

  12. 12.•Some researchers estimate that each individual with FASD costs society approximately $2 million in his or her lifetime, for health problems, special education, psychotherapy and counseling, welfare, crime, and the criminal justice system.

  13. 13.•During their lifetimes, the individuals with FASD now alive in Canada will cost the taxpayers about $600 billion, about the same as the current national debt. In the U.S., they will cost the taxpayers about $6 trillion.


FASD: Teaching Expertise, (UK) August 2008

Fetal Alcohol Syndrome Disorders (FASD) are regarded as the leading known cause of non-genetic intellectual disability in the Western world. Special Children discusses what schools can do when dealing with children dealing with this special educational need.

So-called ‘lifestyle illnesses’ are fast becoming the number one concern of politicians and health professionals. Professor Ian Gilmore, of the Royal College of Physicians, recently warned of ‘a tsunami of health-related harm’ if the government failed to take action on issues such as obesity and alcohol-related disease. Information released by the Department of Health in July, based on a new approach to counting alcohol-related hospital admissions, produced a figure of 811,000 in 2006 (accounting for 6% of all admissions) compared with 473,500 in 2002. Previously, researchers only counted the three most common types of alcohol-related diseases – alcoholic liver disease, alcohol poisoning and mental and behavioural disorders. This new approach counts 44 conditions caused by, or strongly associated with, alcohol consumption during pregnancy.

Buried in these figures are trends among the young that are also worrying policy makers. Cheap alcohol targeted at the youth market and the irresponsible selling of alcohol to under-age drinkers are partly to blame. So too is the way in which popular culture, from advertising to TV soaps, glamourises excess drinking. According to the recently launched Youth Alcohol Action Plan, while there has been an overall decrease in the proportion of young people drinking alcohol, there has been sharp increase in the amount consumed by those who do drink. The average weekly consumption of alcohol for 11- to 15-year-olds increased from five units in 1990 to more than 11 units in 2006. In April of this year, the Home Office announced that in a half-term clampdown it had confiscated 20,945 litres of alcoholic drinks (44,265 pints) from underage drinkers in an operation involving 39 forces in England and Wales. Twenty-five per cent of the 5,143 youngsters who surrendered alcohol to the police said they were aged 15 or under.

Much media coverage of under-age drinking inevitably focuses on the anti-social behaviour of youngsters fuelled by alcohol – a link explored in the Youth Alcohol Action Plan. But alcohol impacts at both ends of the education system in other ways. While there is now new evidence that drinking too much alcohol can impair adolescent brain development, there is also increasing evidence that children are being born with physical and neurological damage as a consequence of their birth mothers drinking during pregnancy. Children in this category suffer from a range of conditions grouped under the umbrella-term fetal alcohol spectrum disorders (FASD), at the centre of which is fetal alcohol syndrome (FAS) itself.

What is FASD?
In June 2007 the British Medical Association (BMA) published a guide to FASD for healthcare professionals. While the authors note that there has been a significant amount of research into FASD in Canada and the USA over the last 30 years, the situation in the UK, where the existence of FAS is still debated, is less encouraging. This lack of UK research is especially surprising in that although FAS – the most clinically recognizable form of FASD – is not considered a common condition; it is regarded as the leading known cause of non-genetic intellectual disability in the Western world. The reported worldwide incidence of FAS is 0.97 cases per 1,000, while a 2002 study estimated that in Western countries as many as nine per 1,000 live births involve children affected by a range of alcohol-related disorders.

The cause of these conditions is straightforward: alcohol readily crosses the placenta and as the embryo/fetus does not have a fully developed blood filtration system it can easily interfere with normal prenatal development. This disruption of normal developmental processes is thought to occur via multiple mechanisms activated at different stages of pregnancy. Hence, the quantity of alcohol consumed, how it is consumed (ie, over an extended period of time or via ‘binge drinking’) and at what stage of pregnancy, can all affect the embryo/fetus differently. While alcohol can affect prenatal development at any time, the embryo/fetus is especially vulnerable during the first and third trimesters. Other factors can also play a part in determining whether, and how, fetal damage occurs, including genetic makeup, the general health of the mother and environmental factors such as diet and stress. Particularly inconclusive is whether low-to-moderate levels of drinking have adverse effects on the embryo/fetus. However, the BMA guide states that current evidence is not robust enough to exclude any risk from low-to-moderate levels, and that evidence is continuing to emerge as to the possible effects of prenatal alcohol exposure at these levels.

Among the parts of the embryo/fetus that can be affected by alcohol are the brain and the central nervous system (CNS). Damage can be both intellectual and physical. However, it is the central nervous system that is at greatest risk as CNS cells have a lower toxicity threshold for alcohol. According to the BMA, ‘Damage to the brain is often, though not always, accompanied by distinctive facial abnormalities, physical and emotional developmental problems, memory and attention deficits, and a variety of cognitive and behavioural problems.’

                                                                                                                                          




 White Matter, The Brain's Connective Network Damaged By Prenatal Alcohol Exposure


One part of the prenatal brain that may be particularly sensitive to alcohol's effects is white matter, nerve fibers through which information is exchanged between different areas of the central nervous system. A recent study has demonstrated that alcohol consumption during pregnancy can alter the microstructural integrity of developing fetal cerebral white matter in the frontal and occipital lobes of the brain. These anomalies may help to explain the executive dysfunction and visual processing deficits that are associated with gestational alcohol exposure.

 

"The brain's white matter is made up of nerve bundles that transfer information between brain regions," explained Susanna L. Fryer, a researcher at San Diego State University's Center for Behavioral Teratology and corresponding author for the study. "Optimal white-matter integrity is thought to support efficient cognition. So the finding that prenatal alcohol exposure is associated with altered white-matter integrity may help explain aspects of the cognitive and behavioral problems that individuals with fetal alcohol spectrum disorders (FASDs) commonly face."


"Several studies of FASD within the last three years have used a new magnetic resonance imaging (MRI) technique called Diffusion Tensor Imaging (DTI) to examine the brain's connective network - also known as white matter - in ways not previously possible," added Jeffrey R. Wozniak, assistant professor of psychiatry at the University of Minnesota.


DTI, like other MRI techniques, yields measures of biological tissue status at the microstructural level, allowing scientists to see more subtle forms of damage in the prenatally exposed brain. "Yet despite their sophistication, currently available MRI tools are still very crude instruments with limited sensitivity," said Wozniak. "Abnormalities observed with these tools may represent changes to tens or even hundreds of thousands of brain cells. The fact that these relatively crude measures can actually show clear evidence of abnormalities should serve to highlight that these are actually very large-scale changes that have damaging consequences for the individual."


Fryer and her colleagues used DTI to assess white-matter microstructure in 27 youth, ranging from eight to 18 years of age. The youth were divided into two groups: with (n=15) and without (n=12) histories of heavy prenatal alcohol exposure.


"The brains of individuals with FASDs showed evidence of altered nerve fiber integrity at a microstructural level, even though total brain size was statistically equivalent between alcohol-exposed and comparison participants," said Fryer. "Also, within the alcohol-exposed group, we generally found that white-matter microstructure did not differ based on whether youth met criteria for a diagnosis of fetal alcohol syndrome (FAS). In other words, similar brain alterations and behavioral problems can occur because of prenatal alcohol exposure, with or without the facial features and physical growth insufficiency required to diagnose FAS."


"While previous studies had shown evidence of white-matter abnormalities in FASD, especially in the corpus callosum, a major bundle of white-matter fibers connecting the right and left halves of the brain," added Wozniak, "this study also showed abnormalities in other brain regions."


Those other regions included white matter tracts in the frontal and occipital lobes of the brain.


"Among other functions, the frontal lobes are important for planning and regulating behavior at an executive level," said Fryer. "Individuals with FASDs may exhibit problems with executive functioning, which can lead to difficulty inhibiting inappropriate or maladaptive responses, impaired attention regulation, and poor judgment and decision making abilities. The occipital lobes are important for processing visual information, and disrupted white matter coherence in these regions may relate to altered visual-spatial abilities in individuals with FASDs."


"One of the most commonly asked questions of researchers in this area is 'What level of alcohol exposure is safe?,'" noted Wozniak. "Unfortunately, this question is impossible to answer for a variety of ethical and scientific reasons. Even more unfortunate is the fact that the public and some physicians conclude without scientific evidence that alcohol consumption during pregnancy is safe as long as it is not 'too much.'"


Conversely, he added, data from imaging studies of this type and from neuropsychological studies of mental skills suggests that FAS is only the tip of the iceberg. "As the technology improves, it seems clear that increasingly subtle forms of brain damage and cognitive deficits will become evident among those exposed to lower levels of alcohol, those who would not have previously been diagnosed with FAS. In other words, one cannot define a 'safe' level of alcohol exposure for the fetus."


"It is likely the cognitive and behavior problems will be the most devastating to affected individuals, and costly to society," Fryer added.

 

Article adapted by Medical News Today from original press release.

----------------------------


Alcoholism: Clinical & Experimental Research (ACER) is the official journal of the Research Society on Alcoholism and the International Society for Biomedical Research on Alcoholism. Co-authors of the ACER paper, "Characterization of White Matter Microstructure in Fetal Alcohol Spectrum Disorders," were: Brian C. Schweinsburg of the Department of Psychiatry at the University of California, San Diego and the VA San Diego Healthcare System; Olivia A. Bjorkquist, Sarah N. Mattson and Edward P. Riley of the Department of Psychology, and the Center for Behavioral Teratology, at San Diego State University; Lawrence R. Frank of the VA San Diego Healthcare System, and the Department of Radiology at the University of California San Diego; and Andrea D. Spadoni of the San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology. The study was funded by the National Institute on Alcohol Abuse and Alcoholism.


Source: Susanna L. Fryer, M.S.

San Diego State University/University of California, San Diego

Jeffrey R. Wozniak, Ph.D.

University of Minnesota 


 

Prevention
FASD is obviously 100% preventable if pregnant women do not drink alcohol. However, the BMA guide notes that: ‘In the UK, there have been no universal strategies focused specifically on preventing these disorders.’ It is unclear whether this is because FASD are perceived to be a minor problem or because it is felt such strategies are ineffective. Having surveyed the available evidence, the BMA guide questions the effectiveness of alcohol education and health promotion campaigns outside of an overall strategy that has proved effective: making alcohol more expensive and limiting its availability. But, as the guide points out, such policies ‘have proved unpopular politically in the UK, and have not been used as part of the strategy to reduce alcohol-related harm.’

Available evidence also indicates low levels of understanding and knowledge of FASD among healthcare professionals, who are obviously the first point of contact for pregnant women. Matters are made worse by the vague and conflicting official advice pregnant women are given. Until recently, they were advised not to drink more than one or two units of alcohol once or twice a week. However, a recent YouGov survey of 1,429 drinkers in England carried out for the Department of Health found three-quarters of those surveyed did not know that a typical glass of wine contains three units of alcohol. In May 2007, the Department of Health revised its advice when it said that pregnant women or women trying to conceive should avoid drinking alcohol. Announcing the decision, deputy chief medical officer Dr Fiona Adshead said: ‘We have strengthened our advice to women to help ensure that no one underestimates the risk to the developing fetus of drinking above the recommended safe levels.’

Identification
While there are well-established diagnostic criteria for FAS, this is not the case for other pre-natal alcohol-related conditions. In the case of FAS, the diagnosis is based on the presence of a characteristic set of facial features combined with growth and neurocognitive deficits. The National Organisation for Fetal Alcohol Syndrome UK publishes a useful A5 booklet with a section on FASD characteristics, including an illustration showing the facial features that form part of the diagnosis.

hese include a small head circumference, an upturned nose, a flat nasal bridge, a thin upper lip and a smooth philtrum (the vertical groove between the nose and upper lip). Extensive diagnostic guidelines can also be downloaded from the Centers for Disease Control and Prevention (CDC) in Atlanta, USA. These guidelines were initially drawn up in 2003 because of a widespread failure by primary care providers and others who care for children to routinely or consistently identify individuals with FAS. The guidelines attribute this failure to four major factors: the absence of sufficiently specific and uniformly accepted diagnostic criteria; the fact that each of the symptoms has a broad range of differential diagnoses, making diagnosis more difficult; lack of knowledge and misconceptions among primary care providers; and a lack of diagnostic criteria to distinguish FAS from other alcohol-related conditions.

Not surprisingly, then, the BMA guide stresses that diagnosis requires skilled clinical differentiation and a good understanding of the nature of FASD and the diagnostic techniques involved in identifying the range of conditions.





What schools can do
Despite these difficulties, formal diagnosis of FAS at the earliest possible stage is crucial as it permits the implementation of early intervention and treatment programmes. While educational professionals are not in a position to make a diagnosis, they are well placed to make the initial identification. As the BMA guide explains: ‘The characteristic facial features, growth deficiencies and CNS manifestations associated with FAS commonly become evident during infancy. Infants affected by FAS may exhibit hyperactivity, poor fine-motor control, social naivety, and/or intellectual disabilities, and they may be irritable and fail to meet developmental milestones. Initial recognition can be made by the child’s parents, school teachers, social service professionals and healthcare professionals.’

Where a child is suspected of having FAS, an initial evaluation by a healthcare professional is necessary, followed by a full and thorough diagnosis where referral criteria are met. The BMA guide states that this should include ‘physical examination, intelligence tests, occupational and physical therapy, and psychological, speech and neurological evaluations.’ This requires that the necessary expertise in diagnosing and managing neurodevelopmental conditions exists at a national or regional level. Where it doesn’t exist, it clearly needs to be developed.

The special educational needs of children with FAS will differ depending on the severity of their condition. Hence they will need individually tailored learning programmes. According to NOFAS-UK, most children with FASD have developmental delays, although their IQ can cover the normal range (70–130). At primary school, children may exhibit short attention spans, poor coordination, have difficulty with both fine and gross motor skills and require a lot of one-to-one attention. Older children may have low self-esteem and show poor impulse control. Because of their developmental delay, seemingly normal teenagers may exhibit the behaviour of children half their age.

School staff can also play a part in informing older children and the local community about the risk inherent in drinking alcohol during pregnancy. In the case of secondary school children, issues to do with alcohol abuse should form part of the PSHE curriculum. In the case of the local community, use can be made of school events such as open days to display relevant literature and schools can participate in health awareness initiatives in their catchment areas.

For those wishing to find out more about FASD, regular training events are organized by NOFAS-UK.



Fetal Alcohol Spectrum Disorders: A Guide for Healthcare Professionals, British Medical Association, June 2007. This can be downloaded from the NOFAS-UK website (see above).
 




Campaigning for change

Susan Fleisher is just off the train from London and on her way into a meeting at Sunfield School in Clent. An American by birth, she still has an East Coast accent and a can-do manner, as you would expect of someone who has been both a teacher and a TV producer. It was the latter role that brought her to the UK 20 years ago, as the person responsible for packaging the Oprah Winfrey and Ricki Lake shows for Channel 4. It was while she was here that she adopted her daughter Addie, whose birth mother she knew was an alcoholic. What she wasn’t prepared for was the impact the mother’s drinking would have on Addie’s future.

‘She had learning difficulties, but she had tutors, all the best things. But nothing was working,’ Susan explains. ‘Then nine years ago I was at conference about adopted children and when they started talking about FAS, bells went off. She had seven of the eight traits mentioned and then they mentioned having a small head circumference… I had been to about eight bicycle shops and none of them had a children’s bicycle helmet small enough for my daughter.’

Diagnosing and dealing with FAS
Faced at long last with the possible cause of Addie’s learning difficulties, Susan took her to Great Ormond Street Hospital where they diagnosed FAS. ‘I went into a deep depression, thinking my daughter’s life outcome would be completely different, because she was this cute, bright toddler but delayed in everything,’ Susan confides. ‘Then I realised there were much bigger ramifications.’

Following Addie’s diagnosis, Susan moved her into special education. ‘I have to rave about the quality of people I have met in this country,’ she says. ‘I find better services here than my friends in America. The problem is funding, and resources are so stretched.’ Despite this, she says her daughter has received wonderful support, and as a result avoided many of the problems experienced by less fortunate FAS sufferers.

‘Everything turned around in our lives when I got the correct diagnosis. A lot of people say “Don’t give them a diagnosis; it has an alcohol label”. That’s true; it’s a terrible label. But these children need the right diagnosis, then they’ll get the right support and their lives will turn out much better.’

Improving awareness
Two further events changed Susan’s life forever.

Because of her job in television, the Avent bottle company approached her with an offer to fund an educational film on FAS. The end product – A Child For Life – is a 20-minute film that combines expert medical testimony with the moving stories of young people and their mothers whose lives have been changed irrevocably by pre-natal alcohol damage. At the same time, the National Organization on Fetal Alcohol Syndrome in the USA (www.nofas.org) asked Susan to establish a sister organisation in the UK. NOFAS-UK (www.nofas-uk.org) was launched in September 2003.

Today the charity occupies most of Susan’s available time and the TV career is a fond, if distant, memory. Since its inception, NOFAS-UK has campaigned to raise awareness of the dangers of FASD through publications, educational events and lobbying.

In September 2004, with Avent’s support, it distributed A Child For Life and an associated teaching pack to more than 4,600 secondary schools in the UK. Rights to the film have since been sold to a number of other countries including Australia, the Netherlands and Poland.

Through its contacts, NOFAS-UK has also succeeded in raising the profile of FAS with key policy makers. A meeting with Sir Liam Donaldson, chief medical officer for England, resulted in changes to Department of Health advice given to pregnant women. In the House of Lords, Lord Mitchell has battled successfully for the adoption of an Alcohol Labelling Bill that requires the drinks industry to display warning notices to pregnant women on bottles of alcoholic drinks. Susan hopes to continue these successes in September when she meets the secretary of state for children, schools and families, Ed Balls.

So what does she hope to achieve?
‘Basically I feel the government should do what the Avent bottle company did – offer A Child For Life to every single school. And it should be part of their PSHE curriculum. That would be a huge step in the right direction.’ NOFAS-UK is also running a pilot project called ZAP (Zero Alcohol in Pregnancy) with a school in the East End of London in which they train teen tutors to teach other teenagers about FAS. This she feels could be extended to other schools. She also thinks there is scope to work with parents through organisations such as PTAs.

With the increased focus on young people’s drinking habits, the time is right for the dangers of FASD to be taken more seriously. But Susan Fleisher knows that after five years of campaigning, moving FAS up the political agenda will require a concerted effort by all concerned.

 



  

Is Fetal Alcohol Spectrum Disorder Just Another "Disease of the Week?"


As there are so many worthy illnesses and disabilities, people sometimes ask why we want to single out FASD for an official day. Here are nine good reasons -- one for each month of pregnancy:

1. Fetal alcohol disorders are the largest cause of mental or intellectual disabilities in most industrial nations.[1]

2. FASD is more than a disability - it causes many of the expensive problems which plague governments, and all of us. On both a financial and personal level, we are all affected by the secondary disabilities of FAS and ARND: learning disabilities, early school drop-out, juvenile delinquency, poverty, chronic unemployment, sexual acting-out (promiscuity, early pregnancy, prostitution or sexual assault), mental illness, chronic depression leading to suicide, homelessness, violence, crimes against property, alcoholism and addiction.[2]

3. The general public, not to mention many professionals, know very little about either FASD, or the fact that no amount of alcohol in pregnancy has been established as safe for the fetus at any time.

4. Fetal Alcohol Spectrum Disorders have the largest incidence of any major birth defect. In Canada and the U.S., of 10,000 births, 3 out of 10,000 will have Muscular Dystrophy. There will be 4 with HIV infection, 4 with Cystic Fibrosis, 8 will be born with Spina Bifida, 10 with Down Syndrome. 20 will have Fetal Alcohol Syndrome, and another 100 will have Alcohol-related Neurodevelopmental Disorder (ARND), which will probably never be diagnosed.[3]

5. The secondary disabilities of people with FASD are costing the taxpayers far more than any other disability. Some economists have estimated that every individual with FASD will cost the U.S. taxpayers a minimum of $1.9 million in his or her lifetime.[4]

6. FASD is totally preventable. (This point is theoretical as we acknowledge that some women struggle with depression, alcoholism illness or partner pressure and abuse.)

7. People with FASD tend to have many children, who generally also have FASD. It is not unusual for a young woman with ARND to have given birth to four or five children damaged by alcohol or drugs by the time she is 21 -- and the cycle continues.[5]

8. There is no "inclusiveness" for people with FASD. In general, our society has very little compassion for those thousands of individuals whose damaged brains lead them to crime, homelessness, and addiction. Instead, we assume that they have chosen to behave as they do. Few people realize that the severely acting-out teenager, the addicted prostitute, the homeless beggar, or the man charged with killing his girlfriend's baby may all behave as they do as the result of brain damage caused by their mothers' drinking in pregnancy. For them, there is no freedom of choice.

9. We can beat FASD, just as we have beaten other health disorders. Prevention programs and treatment programs for alcoholic women could dramatically reduce the incidence of FASD. Early diagnosis and new techniques of therapy, medical treatment, education, and residential facilities, could allow people with FASD to lead productive lives, and save our nations billions of dollars that could be diverted for other disabilities.[6]

                                                                  





[1] Surgeon General's Advisory on Alcohol and Pregnancy, U.S. Surgeon-General, Washington, D.C., 1981.

[2] Fetal Alcohol Syndrome. Diagnosis, Epistemology, Prevention and Treatment, Washington Institute of Medicine, National Academy Press, Stratton, K., Howe, C., Barraglia (Eds.,) 1996.

[3] Understanding the Occurrence of Secondary Disabilities in Clients with Fetal Alcohol Syndrome (FAS) and Fetal Alcohol Effects (FAE), University of Washington School of Medicine, Department of Psychiatry and Behavioral Sciences, 1996.

 

[4] See above source.

[5] Fact sheet, Current Perspectives: Fetal Alcohol Syndrome, Alcohol-Related Effects, Dr. Calvin R. Sumner, M.D., West Virginia University, Department of Behavioral Medicine and Psychiatry (undated), quoting study from National Council on Alcoholism and Drug Dependence, (U.S.)

 

[6]  6. Multiply the 300,000 Canadians currently affected by FAS/E by $2,000,000 = $600 billion. Similarly, those 3 million Americans x $2 million = $6 trillion in their lifetimes.

 

                                                                                         


The Sensible Guide to a Healthy Pregnancy

This guide contains two pages about Alcohol and Pregnancy: p. 7 - 8
Alcohol and Pregnancy don't mix
IMPORTANT FACTS
THERE IS NO SAFE AMOUNT OR SAFE TIME
TO DRINK ALCOHOL DURING PREGNANCY

http://www.phac-aspc.gc.ca/hp-gs/guide_e.html
Government of Canada
healthypregnancy.gc.ca

PDF Version (1,2 MB - 50 pages)

The Sensible Guide to a Healthy Pregnancy captures key information about certain lifestyle choices you can make to help ensure a healthy pregnancy. It also contains a handy ten-month pregnancy calendar that you can personalize to help you keep track of what week of pregnancy you are in. Each month includes interesting facts, useful information and tips on a variety of pregnancy-related topics.

You can also order a print copy of this guide by calling 1 800 O Canada, (1 800 622-6232).

http://www.phac-aspc.gc.ca/hp-gs/guide_f.html
Grossesse en sante
grossesseenstante.gc.ca
Le guide pratique d’une grossesse en santé

 Version PDF (1,2 MB - 50 pages)

Le guide pratique d’une grossesse en santé capture les informations clés qui vous encourageront à faire des choix de modes de vie sains pour une grossesse en santé. Le guide comporte aussi un calendrier de dix mois que vous pouvez personnaliser pour vous aider à suivre l’évolution de votre grossesse.  Chaque mois comprend des faits intéressants, des renseignements utiles et des conseils sur une variété de sujets liés à la grossesse.

Vous pouvez aussi obtenir un exemplaire imprimé de ce guide en composant le
1 800 O Canada, (1 800 622-6232).

Si vous avez besoin d'aide pour accéder aux formats de rechange, tels que PDF, MP3 et fichiers WAV, visitez la section d'aide sur les formats de rechange.
 

 

THE FACE OF FASD




So-called, full-blown Fetal Alcohol Syndrome (FAS) is easily recognizable because of the typical facial dysmorphologies caused by the presence of alcohol in the womb during the first trimester while the limbs and organs are being formed. When there are only slight facial characteristics or other non-dominant physical abnormalities, another diagnosis is known as pFAS or Partial FAS.


However, researchers have estimated that 8 out of 10 individuals who are struggling with FASD will have ARND (Alcohol-Related Neurodevelopmental Disorder) and will often have the most difficult lives because they are unlikely to be diagnosed. They often appear normal and will usually have all the behavioural characteristics of a normal child and their disability may not be recognized until they enter school, if then.


Diagnosis is difficult because it generally requires a team of trained professionals and these teams are few and far between. Knowledge of the birth mother’s drinking during pregnancy is the usual starting point and this can be very difficult to determine when there is no history, especially if the mother is deceased or the child is adopted.


FASD Diagnostic clinics are needed desperately in order for birth, adoptive and foster families to understand what they are dealing with and to help them to allow their children to be the best they can be.


There are three individuals in the pictures on this page with some form of FASD -- could you spot them without professional guidance?

 

What are Fetal Alcohol Spectrum Disorders (FASD)?