Skills for the Job: Foetal alcohol spectrum disorders
Susan Fleisher
Tuesday, October 28, 2014
Alcohol consumed during pregnancy can affect a child's development and cause disorders that require patient support.
What is foetal alcohol syndrome?
If women drink alcohol in pregnancy, there is a risk of their children being born with physical and mental disabilities known as foetal alcohol spectrum disorders (FASD). Experts still are not sure about the precise amount of alcohol that is safe to drink in pregnancy, but do know that drinking even moderate amounts can be harmful.
The Department of Health recommends that pregnant women should avoid alcohol altogether, but if they do opt to have a drink, it recommends they stick to one or two units of alcohol (equivalent to one small glass of wine) once or twice a week to minimise the risk to their baby.
How many children are affected?
The exact prevalence of FASD in the UK is not known. According to the World Health Organisation, one per cent of babies are born with alcohol-related birth defects.
In some countries, studies have found that between two and five per cent of children are born with alcohol-related birth defects.
What implications can there be?
When a pregnant woman drinks, the alcohol passes from their blood through the placenta and to their baby. Because a baby's liver is one of the last organs to develop fully, they cannot process alcohol very well. Too much exposure to alcohol can seriously affect their development.
Drinking in early pregnancy increases the risk of premature birth and low birth weight, while drinking in the second half of pregnancy can affect how the baby grows and develops. Drinking heavily during any stage of pregnancy can result in FASD. This can result in restricted growth, facial abnormalities, and learning or behavioural disorders.
Other characteristics, can include memory problems, hyperactivity, difficulty with abstract concepts (such as maths, time or money), poor problem-solving skills, difficulty learning from consequences, poor judgment, immature behaviour, poor impulse control and confused social skills.
There is no cure for FASD - it lasts a lifetime. However, if FASD is accurately diagnosed, early intervention and appropriate strategies can significantly improve the lives of those with the condition.
Sadly though, FASD is under-recognised and not easy to diagnose. As a result, those people do not receive the support and services they need. Many are punished for behaviours they cannot control or understand. They may have difficulty maturing, have very few friends and get taken advantage of by criminals.
There is a high incidence of FASD in the prison population. People with FASD can be victims of abuse and neglect and may become suicidal.
How can children affected by FASD be best supported?
Only a small percentage of people with FASD have any noticeable facial or physical features linked to the condition. As a result, when they exhibit abnormal, aggressive or nervous behaviours, they are thought to be intentional. In fact, much of the time they can't control or manage their behaviours. But teachers, peers and the public can perceive them as being "out of control".
If you know a child or young person has FASD, it is important to "age-down" your expectations. Generally, they are more immature in their development and act like a younger person. If you look at them like a younger person, their behaviour makes more sense.
You can help by simplifying tasks for them - they will very often have good long term memory, but may have problems with instructions and not be able to remember something you told them 20 seconds ago. The key is to give short instructions and repeat them. Ask for their feedback and keep repeating it to them and eventually it sinks in.
TOP TIPS
- Keep things simple - those with FASD can only handle small bits of information
- Avoid excessive stimulation
- Be mindful at all times that their short-term memory may be impaired
- Be patient
By Susan Fleisher, executive director, National Organisation for Foetal Alcohol Syndrome