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by Peggy Seo Oba, RDH, MPA, MBA
Executive Director of the Fetal Alcohol Syndrome Information Network
(since 1997)
Fourteen year member and
resource person for the FASLink (Fetal Alcohol Syndrome Listserv) http://www.faslink.org
Six Year Member Steering Committee, Eight Year
Trainer and Technical Assistant for the Fetal Alcohol Spectrum Disorders Center for
Excellence (SAMHSA and CSAP) http://fascenter.samhsa.gov/
2007 Member International Advisory Group for the
International Conference on Fetal Alcohol Spectrum Disorders sponsored by the
Interprofessional Continuing Education Division of the University of British Columbia.
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Fetal Alcohol Syndrome (FAS) is a type of neurological brain disorder that happens while
the baby is still in the mother's womb or even while she is breastfeeding. Depending on
when the pregnant women drinks, either on a regular basis or periodic bingeing and the
amount, her baby can be born with a range of brain disorders that run the gamut from mild
to very severe. Full FAS may manifest itself in the form of physical abnormalities,
Cerebral Palsy, epilepsy, learning disabilities and most importantly, it can lead to
severe behavioral problems.
The percent change in drinking in
Japan from 1970 to 1996 was an increase of 29.18 %; US drinking declined –9.48 %
during the same period (from the 1999 WHO Global Status Report on Alcohol).
The percent of Japanese women who
drink on a regular basis is 61% vs 66% for U.S. women (percentages are derived from a
1992 joint US-Japan study.) In 1991-1992,
Japanese women who died of chronic liver disease were 4.3 per 100,000 compared to 5.0 per
100,000 for women in the US (from a WHO Report in Alcohol and Women by Moira
Plant).
Full FAS occurs .2-2 times per 1,000
births in the US vs Japan's official total of 56 children (last reported in
1995). In 1993, the Japanese female
population was approximately 63,500,000 or roughly one-half of the US female population.
If 61% of women above the age of 15 and below the age of 41 (12,887,134) drink on a
regular basis and 76% (9,794,222) of Japanese women marry with an average fertility rate
of 1.5 children…at just 0.2 cases per 1,000 live births…in one generation, there
might be a minimum of 2,938 Japanese babies born with some degree of full FAS. At 2 cases
per 1000 live births, the number jumps to 29,382. .
Fetal Alcohol Spectrum Disorders, which includes full FAS as well as a wide range of
behavioral disabilities without the physical problems, may occur as high as 1 per 100 live
births. For Japan, that would translate to
146,913 cases of FASD.
The first report of only one
Japanese adult with FAS was made in October, 2004.
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In November of 1989, our family was blessed with the addition of a new niece. In the
beginning, Hiromi (not her real name) looked just like any other new baby. She came in at
3625 gm or just under 8 pounds at 8:18 in the morning. The Japanese hospital did not
measure her, so we do not know her length. We do know she had a great deal of hair and
slept a lot. The only other things she did were jerk her head and stretch backward with a
cry. And she would blink. She would blink about 9-12 times and then cry. Hiromi's cries
were a soft, "Ah, ah, ah" and the sound only lasted four or five seconds, with
the rest of her crying in a silent mouthing. She also had a limp right eye. It would close
and she would not be able to open it even if her left eye was wide open. As a toddler she
would not be able to open her eyes wide in surprise or to squint. We were to find out
later that these were all neurological signs that something was wrong. Later, there would
be a whole host of other mild but definite symptoms that pointed toward a particular
problem that was Fetal Alcohol Syndrome.
At one month of age, Hiromi's face was a dark red. She had rashes that circled her head
and body and ran up her nose. Her left arm seemed to be immobilized from the shoulder
down. When she played with her daruma (dah-roo-mah) or roly-poly doll, she would only bat
at it with her right hand. At three months, she began to smile (normally, smiling begins
at 6-8 weeks). She could only smile with the left side of her mouth. As she grew older,
she could only smile with her lower lip. Her abdomen was unusually swollen. Later research
would indicate her mother had been drinking while she was nursing and the baby's immature
liver could not metabolize the alcohol in her mother's breast milk. That is what caused
the swelling.
In April, when Hiromi was five months old, her mother had taken her to playground, dressed
in a white snowsuit. (Although Hiromi sweats a great deal, her mother thinks she is cold
and dresses her warmly even into late summer. We believe this is a problem with body
temperature control and is caused by the FAS. Her hands are wet, cold and clammy.) Her
mother had left her feet bare. It was then we noticed that Hiromi's feet looked more like
hands held in prayer. The soles of her feet faced each other and the toes pointed up. This
is a mild form of club foot called "eqinus vargus". Her hands also looked puffy
and there was a deep crease across the back of her thumb. As Hiromi grew older, her thumb
did not exactly oppose her fingers and this made handling objects rather difficult for
her. She dropped things constantly until the relatives started to say she was clumsy.
At six months, her mother started supplementing her own breast feeding with formula. She
said the doctor felt her milk was too "thin" and not providing the nutrients
necessary for a healthy baby. Hiromi only weighed 7250 gm or 16 pounds (normal is around
18 pounds) and she was very small. No one seemed to notice she had a weak suck and could
only nurse for a minute before getting tired.
We also had a chance to notice the shape of her head. From one side, her head was as round
as a musk melon and from the other side, it looked just like a football. It is to be
remembered that people's heads are not symmetrical and babies' head bones are still soft
but even changing her sleeping position did not seem to help. Her hair did not grow as
fast as other children's and when it did grow, it grew unevenly with the left side growing
longer than the right. She had her first haircut at 14 months of age. Her brother and
sister would not receive their first haircut until almost age two. Most babies have their
first haircut within the first year of life.
At times, it seemed she could not see across a room. When her father called to her from
behind the video camera, she would look up without recognition and pause with her hand in
the air. When she was older, she could not see her father walking across the empty parking
lot and would cry, "Papa, Papa?" while scanning the area for him.
When our daughter tried to play with her cousin, she would stare intently without any
reaction except to roll her head back and forth against her babyseat, wearing a little
bald spot in the back of her hair. This is the behavior of a "fragile" baby, a
term used by Dr. T. Berry Brazelton, a renowned child developmental expert. It meant that
Hiromi had an unusual sensitivity to sights/sounds. She was literally being overwhelmed by
sensory input; this condition is called Sensory Integration Dysfunction.
As she grew older, Hiromi had some more unusual problems. While sitting or standing, she
would often bow for no reason. She had a great deal of trouble grasping objects. If a toy
was handed to her, she had no problem but if she had to use her own hand/eye coordination,
she would have to grab three or four times before she could successfully make contact.
When playing with her feet, she would have to grab the left foot with the right hand and
then pass it to her left hand before she could grab the right foot and play with both
feet.
Her thumb and forefinger worked independently of the other fingers of her hand and she had
difficulty manipulating objects, especially if her hand were facing downward. Her method
of crawling was unusual. On one side she would crawl on her hand and knee but on the other
side she would be leaning on her hand but her knee was in the air with her foot on the
ground. It gave the impression of a lopsided bunny hop. When she was older, she also
tended to run with the right side of her body slightly ahead of the left side of her body.
She also could not sit in a chair without holding on to the arm or the table for balance.
At the age of nine months, she started staring. She would pause in the middle of an
activity, sag a little and stare. She would also come to have what we came to call her
"startle positions". Her eyes would open hugely, she would twist or jerk and
then turn back to look at us with a glazed look and then drool. She drooled so much that
her mother had ten bibs; she wore one of them all the time. Or her head would tilt from
side to side and her eyes would glaze and start to roll around. She made bizarre facial
grimaces and although the family would laugh at her "antics", she would rub her
face as if to make the "funny' faces go away. These "seizures" would only
last for a few seconds and disappeared around age six. (She still grimaces upon occasion;
if she is having seizures, her family is not disclosing this information to anyone.) At
the same time, her mother would note that she had few facial expressions.
Basically Hiromi was not far behind on the typical baby milestones. She turned over,
crawled, sat...all might have been a little late but they occurred within the normal
range. The social milestones were a little different. She smiled very late at three
months. The typical gurgling and giggling were never there. She was always a very quiet
baby. The playing with the hands in front of the face and the general alertness of looking
around and trying to participate with the family did not occur. Hiromi just sat and looked
at television. It was her favorite occupation. She played with boxes and toys but without
the intentness of the average child. She did not have a "lovie"...for her any
old towel would do. She did not go out of her way to interact with the adults in her life.
She showed very little curiosity and willingness to engage in activities with other babies
and her contact with animals was limited to staring at them.
Her physical appearance was also a bit unusual. At age three, a child's head is
approximately 1/3 of the length of her torso. By age 5, the length of Hiromi's head was
still about 1/2 the length of her torso...she still looked very much like a baby. Her arms
were so short that when she put them over her head, the fingertips just barely met. Her
shoulders seem to lack the deltoid muscle and often it seemed as if her shoulders were
only the bare bones beneath the skin. In contrast, her abdomen sagged as if there were no
muscle control at all.
Her abdomen had other strange characteristics. Although she was not ticklish in that area,
she could not bear to have tight clothes around her waist. She had little or no buttocks;
her legs appeared directly attached to her abdomen. Her legs looked muscular and strong
but the knees and ankles were extraordinarily small, giving her legs the look of
hourglasses. Another problem that was her inability to be toilet trained. At five years of
age, she was still having "accidents". Some of this could be related to her
problems with expressive language (ability to make us understand her). We were to find
that many children with FAS are incontinent. This
might be caused by weak muscles and/or problems with feeling or nerve sensations. She
simply cannot "feel' when she has to go and so cannot warn the family ahead of time
about her need. It may also be a matter of mental coordination, her brother has only
recently learned at age 6, to use the toilet standing up. (At age eight and a half, he was
still wearing diapers.)
Her balance was poor and the family would complain of her many accidents. At the
playground, she would look up if someone called her name and then she would fall. She
could not squint her eyes and when she played close to the sand it almost always got into
her eyes. She could not jump on a bed more than two or three times. She did not always
remember in which direction was her grandparent's house even though they were only two
blocks away.
She had difficulty with expressive language. She could not tell her father to push the
swing higher or her mother that she had to go to the bathroom. Her communication relied on
answering the correct question rather than telling others what she desired. She could not
blow out a birthday candle in less than eight tries and she preferred salty foods over
sweet ones. Her pronunciation of words is indistinct and often incorrect. Consonants are
especially hard for her to manage as the pronunciation involves the articulate use of the
tongue. At age three, she had over 13 cavities in her teeth, much of which was probably
related to her weak cheek muscles that did not push the food onto the teeth but instead
let the food sit in her cheeks up against her teeth.
At age fourteen, she could not find her way from one place to another unless she could
retrace her steps through familiar landmarks. She cannot count out the proper amount of
change to buy a train ticket. She still likes the children's cartoon shows and games and
does best when she plays with her brother and sister. She cannot handle the practical
aspects of day to day living.
In 1992, I read an article in the NATIONAL GEOGRAPHIC MAGAZINE that lead me to believe
that Hiromi and her younger brother and sister have full Fetal Alcohol Syndrome (FAS). I
believe Hiromi and her sister have what is termed the "hypo-active" type of
fetal Alcohol Syndrome, because of the constant and enduring description that they are
"good babies" and seldom cry. As they have grown, they are most often described
as quiet children. Her brother (the eldest of fraternal twins born in 1994) has the more
destructive type of FAS that compels him to destroy objects without responding to
reprimands. The family calls him "stubborn" but his behavior more closely
resembles the child with FAS who cannot respond to verbal commands because he does not
understand them. As he has grown older, he is subject to periodic rages which are quite
violent in nature but short lived. From a very early age he was also touching women on
their breasts and buttocks.
All the children are in school. Hiromi was performing below average scale in a highly
structured Japanese public school. For her middle and high school education, her parents
have moved her to a private school where her academic work has not improved. She has
graduated, however, and is attending a 4 year Hospitality College. Her brother is being moved to a private school
where his high level of activity can hopefully be handled by a lower teacher/student
ratio. The younger sister is doing well in school but dislikes crowds and will often shut
down when confronted by too much environmental stimulation. She was bullied in middle
school and finished with homeschooling. There are no special education classes or teachers
in Japan, except on the institutional level. If the children do not do well, they simply
will not pass onto high school.
Our family already has one teenager who has had two unplanned pregnancies; her first was
at the tender age of 14. We also have had one young thief who cunningly hid all her stolen
objects in her bedroom. My husband and I feel there may be as many as four more people in
our family who have Fetal Alcohol Syndrome. |
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Main FAS Characteristics
Full Fetal Alcohol Syndrome is characterized by problems
in three main areas:
1) Central Nervous System (CNS) problems which include behavioral problems, sensory
dysfunction, hyper/hypo-activity,
and learning disabilities as well as the other physical symptoms displayed by our niece.
2) Small size and/or weight, usually below the 5-10 percentile before and/ or after birth.
My nieces and nephew were small in utero. Their mother was hospitalized until the babies
started to grow. The babies were all delivered at normal birth weights but are very small
in comparison to their classmates. At age seven, my niece wore a size four and she can
still wear many of her clothes for 2-3 years.
3) A set of distinctive facial features that include the following:
a) Very small eye openings that only show the pupil of the eyes. This gives the child a
sweet, cartoon-like expression. (A 2010 report
by Dr. Sterling Clarren indicates that the length of the palprebral eye openings will
still fall within the normal range.)
b) The length of the eye when divided by the distance between the two should be about 80%
for Asians and some American Indians and about 90-95% for Caucasians and Afro-Americans. A
smaller percentage is considered to be a characteristic of FAS.
c) The philtrum or area between the bottom of the nose and the top lip line is long and
ungrooved.
d) The top lip line is flat and the top lip is very thin.
e) Microcephalia is where the circumference of the head is about 3% smaller than the
average child. An easy way top check this is to look at the face and draw an imaginary
line across the center. This is the normal eyeline. If the child's eyes are above this
line, her head should be measured by a medical professional to check for microcephalia.
Other signs include:
f) Small, short noses with no or little nasal bridge.
g) Micrognathia or a very small, pointed chin and tiny lower jaw. (This can lead to tooth
crowding as the child grows older. The jaw may also overgrow in adolescence.)
h) Ear anomolies that show large ears laying back, lowset, and/or ex-verted with the
ridges showing prominently on the outside of the ear, rather than being inside the ear.
(Railroad track ear).
i) Less frequently seen are malformed and/or malocclused teeth, unusual amounts of hair on
the face and body at birth, webbed fingers, crooked little fingers, small fingernails,
single creases across the palms of the hands, curvature of the back, deep dimples at the
base of the spine, hands that face forward instead of to the body, joint problems, and
hemangiomas or purple birthmarks. These children may also have strabismus (crossed eyes),
myopia (short-sightedness), increased ear infections, hearing difficulties and heart
problems.
Any one or two of these signs can be found among the NORMAL population and are felt to be
normal when seen independently of other FAS signs. It is only when several of these signs
are seen together with behavioral problems that a family should consider consulting a
specialist in the field of dysmorphology or genetics. The average children's pediatrician
is not trained to diagnose FAS.
The cause of Fetal Alcohol Syndrome is directly related to a mother's drinking during her
pregnancy. If a woman does not drink alcohol during her pregnancy and while she is
nursing, the baby will NOT have Fetal Alcohol Syndrome even if she herself has FAS or is
the child of an alcoholic.
Beer is the most toxic alcohol beverage to the developing fetus. And contrary to popular
belief, one 12 oz. (353 ml) can of beer contains as much pure alcohol as a 1.5 ounce shot
glass of hard liquor. A 4 oz. (117.7 ml) glass of wine, a half a small bottle of sake (125
ml), a 12 ounce (353 ml) wine cooler, an 8.4 ounce (247.3 ml)of malt liquor, a 3.5 ounce
(102.8 ml)of dessert wine, a 2.5 ounce (73.4 ml)of liqueur, and a 1.5 ounce (44.2 ml)of
brandy all contain as much pure alcohol as a 1.5 ounce (44.2 ml)shot glass of hard liquor.
The only difference is that beer, wine, sake and other drinks contain more non-alcohol
liquids and ingredients than hard liquor but that makes very little difference when the
alcohol is circulating to the baby in the mother's womb.
It take as little as two glasses (8 oz. or 235.5 ml) of any type of alcoholic beverage a
day (including beer and coolers) or four or more drinks on any one occasion (bingeing) to
produce a child with FAS. (A 2004 publication of the U.S. Centers for Disease Control has
now changed that to 3 or more drinks on any one occasion.) Drinking while nursing also
increases the chances that a child will have developmental problems.
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Factors that Influence FAS
Other factors that influence FAS are:
1) The older the mother the more likely the child will have FAS.
2) Long term, regular drinking (since the teens or early twenties) by either parent may
damage the reproductive cells before conception. Also, long term drinking produces a
higher tolerance for alcohol and a person can consume greater and greater amounts over
time and is more likely to produce a child with FAS even though the mother may be young.
3) If the mother is thin, the chances are that the alcohol is not eliminated from the body
with as great efficiency.
4) Any drink that a woman takes is roughly the equivalent of two drinks for a man. (Women
lack an enzyme to process alcohol and she has more body fat than a man so her absolute
weight is even less.)
5) The mother's other health problems such as eating disorders, overall nutrition, anemia,
liver function, etc. affect her baby.
6) Alcohol drunk before a meal or without food is more damaging than alcohol taken with a
meal which includes carbohydrates.
7) How a woman drinks, whether she sips or gulps and how she spaces her drinks also
influences the way the alcohol is metabolized by the liver. Slow sipping and spacing a
single drink out over an hour helps the liver to be more efficient.
8) Paternal drinking also influences fetal development but does not cause Fetal Alcohol
Syndrome. (There is a new area of research called epigenetics. It studies
the effect of environmental toxins such as alcohol on RNA, both male and female.
Therefore, it is suggested that both male and females refrain from drinking at least three
months prior to conception.)
The IQ of the child with Fetal Alcohol Syndrome may range from 40 to 130. Their learning
problems range from the extreme to almost none at all. These children may do well in
spelling and have nice handwriting. They may find reading difficult or be 2-3 grade levels
above average. Their greatest educational problem often lies in the area of mathematics.
This is because mathematics involves abstract thinking. Early proficiency in math may
level off drastically when the multiplication tables are introduced. Other learning
problems include the inability to follow sequential instructions and
hyper/hypo-sensitivity to lights, sounds, and touch in the school environment.
A child with FAS may have visual, hearing and/ or memory problems. What sounds normal to
us may sound high pitched, loud or off-key to them causing a great deal of discomfort or
confusion. Vision for a child with FAS may mean myopia or seeing only part of the visual
field. Their memory is also spotty. What is remembered one week may be forgotten the next
week and remembered again a month later. It is for this reason that children with FAS are
often thought to be "lazy" or "not trying".
A child with FAS may be capable of repeating instructions that are given to her but to
physically re-enact the instructions may prove to be an impossibility. It is important to
give visual clues on a step by step basis with the use of photos and/or re-enactments.
Failure at school or overstimulation during the day can cause frustration and anger.
Behavioral problems may range from something as simple as not being able to remember
things to the inability to tell right from wrong. Behavioral problems may start in early
childhood or suddenly appear during puberty.
Social relationships are difficult for children with FAS who do not recognize the verbal,
physical and implied social cues of others. They may stand too close, talk too close, not
follow the thread of the conversation, bring up subjects that are unusual and follow
other's examples too readily. Many children with FAS are intiallly engaging but often
cannot maintain relationships.
The child with FAS does not respond to punishment. The FAS mind cannot look far enough
into the future to recognize and fear the consequences of their actions. Verbal reprimands
and descriptions do not help a child who is visually and hands-on oriented. Problems in
one or more of these areas may lead a parent to believe the child is stubborn or
non-compliant without realizing the child is having difficulty processing verbal
instructions, is distracted from over-stimulation, has insufficient memory retrieval and
cannot comply rather than will not comply. Punishment without recognition of these
conditions may lead to more frustration on the child's part because she does not
understand why she is being punished, especially in the face of dealing with numerous
sensory and memory problems she neither recognizes nor understands enough to explain.
Dr. Ann P. Streissguth, a leading researcher in the field of FAS, says that the defining
characteristic of the child or adult with Fetal Alcohol Syndrome is the LACK OF GOOD
JUDGMENT and/or THE INABILITY TO UNDERSTAND THE CONSEQUENCES OF THEIR ACTIONS. This is
true even in the absence of the physical characteristics of the face and body. If behavior
is a problem with a child, it is always wise to examine the background for possible
alcohol abuse of the birth mother.
In the United States and Canada, the problem is at least recognized and early intervention
strategies have been developed for aiding the memory, reducing environmental stimulation,
and dealing with some of the frustrations of these children. But for the Japanese, the
recognition of FAS has yet to become a reality...the Japanese government does not even
provide for health warnings on their bottles and cans of alcohol. Six brewers have
voluntarily placed warnings on their products but other brewers and foreign brands are not
required to use warning labels. Young Japanese women are increasing their consumption of
wine and beer (beer being the most toxic to the fetus) at an earlier age and well into
their child-bearing years. Whatever the personal, social, or emotional issues, drinking is
becoming a way of life for the Japanese woman. And if she does have a problem with
drinking, there few organizations that would provide her with help and support. Alcoholism
and alcohol abuse are still considered to be personal problems in Japan and not a
neurological addiction that requires the medical and psychological help of a medical team
and a network of support from peers.
There are other conditions (the majority are genetic and there are tests that can detect
them) that resemble FAS and they should be explored and considered. But parents who drink
always run the risk of having a child with Fetal Alcohol Syndrome if they continue to
drink before conception, during pregnancy and while nursing.
The following are additional behavioral problems from "A Fetal Alcohol Behavior
Scale" published in the *Alcoholism: Clinical and Experimental Research* journal by
Dr. Ann P. Streissguth <http://depts.washington.edu/fadu>.
Behaviors in the Scale can include the following and are presented in order of frequency:
unaware of consequences of an action
poor attention (may not be true attention deficit disorder)
can't take hints
overreacts
mood swings
interrupts
poor judgment
likes to be the center of attention
loses things
overstimulated
fidgety
likes to talk
demands attention
often described as "...tries hard but..."
out of context
overly friendly
sleep problems
superficial friendships
hygiene problems
messy
touches people frequently
chats but no content
klutzy
poor manners
talks fast
physically loving
can't play team sports
difficulty performing even though can repeat instructions
unusual topics of conversation
inappropriate behavior at home
inappropriate behavior outside the home
repeats often
sensitive to noises
loud, unusual voice
problems with sexual function
Other Central Nervous System symptoms that have been reported by other researchers may
include:
mental retardation (IQs of these children can range from 40 to 130)
Cerebral Palsy symptoms
epilepsy symptoms
short term memory loss
intermittent long term memory problems
perseveration (does things over and over)
attachment disorder
speech and language problems
receptive language disorder
sensory integration dysfunction
disorderly conduct
has trouble learning new motor skills
fine motor skills are problematic
sensitive or insensitive to bright lights
has dry, flakey skin
distinct odor to self or room or clothes
stomach and/or bowel problems
unusual eye and hearing problems
problems with menstrual periods
may often be diagnosed as: ADHD, Asperger's. Autistic, Pervasive Developmental Delay, ,
Antisocial Personality, Hyperactivity, Borderline Personality Disorder.
Behavioral problems might be apparent at birth, start with schooling or may not appear
until the child begins puberty. The description of the parents often includes the phrase,
"There is something wrong but I just can't put my finger on it." Children with
full FAS are more easily recognized as having problems. Children with Fetal Alcohol
Effects (FAE)/Alcohol Related Neuodevlopmental Disorders (ARND)/partial FAS do not have
all of the physical signs of FAS but have most of the behavioral problems. The majority of
behavioral problems are not clearly evident until the child enters school.
From The August 1996 Final Report: Understanding the Occurrence of Secondary Disabilities
in Clients with Fetal Alcohol Syndrome (FAS) and Fetal Alcohol Effects (FAE). This report
may be ordered through the Fetal Alcohol and Drug Unit, University of Washington, 180
Nickerson, Suite 309, Seattle, Washington 98109-9112. Tel: 206-543-7155. Website:
http://depts.washington.edu/fadu
_________________________________________________________________________________________
*****"The most outstanding characteristics of FAS are bad judgment and the inability
to make the connection between an act and it consequences."*****
Dr. Ann Streissguth, University of Washington
______________________________________________________________________________
Note: Many researchers are now saying that
Secondary Disabilities might be primary in accordance with the initial damage to the cells
of the brain by the alcohol.
Secondary disabilities are defined as those disabilities
that a person is not born with and those disabilities that could be prevented or made less
severe through better understanding and practical intervention. In a study conducted by
the University of Washington on 473 clients, the following results were noted:
178 clients (almost 38%) were diagnosed with full FAS and had an average IQ of 79.
(In all evaluations, a score of 100 is considered to be normal)
Average Reading score was 78; Average Spelling score was 75; Average Math score was 70;
Average Adaptive Behavior Score was 61.
295 clients (over 62%) were diagnosed as having Fetal Alcohol Effects, most commonly
called FAE and medically referred to as Alcohol Related Neurodevelopmental Disorders and
had an average IQ of 90.
Average Reading score was 84; Average Spelling score was 81; Average Math score was 76;
Average Adaptive Behavior score was 67.
Of these clients, 415 were selected for a life history questionnaire and these were the
results: Mental Health Problems were by far the most prevalent secondary disability
experienced over the entire age sample (90%). (Ages 3-51 years).
The following results were found for those age 12 and older:
*Disrupted school experience (defined as having been suspended or expelled from school or
having dropped out of school) was experienced by 60% of the clients.
*Trouble with the law (defined as ever having been in trouble with authorities, charged or
convicted of a crime) was experienced by 60% of the clients.
*Confinement (including inpatient treatment for mental health problems or alcohol/drug
problems, or ever having been incarcerated for a crime) was experienced by almost 50% of
the clients.
90 clients age 21 and older were selected for questions about self sufficiency or
independent living skills.
80% of the clients, age 21 and older, were not self sufficient in the areas of *Getting
Dressed
*Using Public Transportation
*Personal Hygiene
*Staying Out of Trouble
*Structuring Leisure Time
*Cooking Meals
*Grocery Shopping
*Interpersonal Relationships
*Getting Medical Care
*Getting Social Services
*Making Decisions
*Managing Money
80% of the 90 adults age 21 and over were still having employment problems that dealt with
*Lying
*Problems with Supervisor
*Anger Management
*Unreliability
*Social Problems
*Poor Judgment
*Poor Task Comprehension
*Easy Frustration
***Clients with FAE or Alcohol Related Neurological Disorders have a higher rate of ALL
secondary disabilities except for mental health problems. Mental Health Problems were by
far the most prevalent secondary disability experienced over the entire age sample (94%).
(Ages 3-51 years).***
To read this in Japanese, please go to http://www.fasjapan.web.fc2.com
To read this in Chinese (Simplified or Traditional), please go to:
http://www.fasin.org
FAS in Spanish: http://www.cdc.gov/ncbddd/Spanish/fas/default.htm
FAS Center for Excellence: http://fascenter.samhsa.gov/
The FASD Center for Excellence in Spanish: http://fasdcenter.samhsa.gov/fasdsp/index.cfm
National Directory of Professionals, Treatment Centers and Support Groups for the United
States: http://www.nofas.org/resource/directory.aspx
National Directory for Canada: http://www.ccsa.ca
For help in diet, exercise and different types of therapy, please go to
http://www.betterendings.org/
For free brochures, please go to http://www.fasalaska.com
Slide show:
http://rsoa.org/lectures/07/index.htm
EDUCATIONAL RESOURCE SITES
Understanding Tests and Measurements:
http://www.wrightslaw.com/advoc/articles/tests_measurements.html
Characteristics of Students with FAS:
http://www.bced.gov.bc.ca/specialed/fas/charstu.htm
School Advocacy:
http://www.come-over.to/FAS/schooladvocacy.htm
IDEA:
http://www.come-over.to/FAS/IDEA97notes.htm
IEP Guide:
http://www.ed.gov/parents/needs/speced/iepguide/iepguide.doc
When Your Child Does Not Qualify for Special Education:
http://www.come-over.to/FAS/IDEA504.htm
Training Teachers about FAS/E:
http://www.come-over.to/FAS/teachertraining.htm
Array of Disabilities:
http://come-over.to/FAS/array.htm
Using the Vineland Adaptive Scales:
http://www.come-over.to/FAS/VinelandRationale.htm
Teaching Students with Fetal Alcohol Syndrome:
<http://www.bced.gov.bc.ca/specialed/fas/under.htm
http://www.edu.gov.mb.ca/k12/specedu/fas/pdf/4.pdf
http://www.education.gov.ab.ca/k_12/specialneeds/fasd/fasd.pdf
http://www.education.gov.yk.ca/publications.html (Making a Difference: Working with
students who have Fetal Alcohol Spectrum Disorders)
Vocational Rehabilitation Program:
http:www.come-over.to/FAS/WhatWorksForJohn.htm
Legal Issues:
http://depts.washington.edu/fadu/legalissues/lawarticles.html
http://njjn.org/media/resources/public/resource_383.pdf
Central Nervous System Abnormalities Associated with Fetal Alcohol Syndrome:
http://cdc.gov/mmwr/preview/mmwrhtml/rr541a2.htm
Alcohol Equivalents for Different Drinks:
http://www.iprc.indiana.edu/publications/iprc/factline/alcdoses.html#DOSES |
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Other FAS Links
University of Washington
Fascets
FASLink |
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