So, what is the problem with alcohol anyway?
For some children, behavioural and functional challenges are rooted in their exposure to alcohol during pregnancy.
For anyone working with children and young people, particularly those that have additional needs, some knowledge of Foetal Alcohol Spectrum Disorder is essential.
If we are to intervene intelligently we need to be aware of the possible causes. This is one…
3 things you need to know about FASD…
- Alcohol causes more damage to the developing foetus than any other substance.This includes marijuana, heroin, and cocaine (Institute of Medicine, 1996) because alcohol is a poison and a teratogen which disrupts the development of body organs.
- Alcohol passes freely over the placenta so when a mother drinks the baby drinks too. Many factors combine to elevate risk of harm, but binge drinking is particularly risky. A binge is 6+ units (Drinkaware) which equates to only TWO glasses of wine. The safest advice is:NO ALCOHOL = NO RISK
- Damage occurs often and much more easily than you may think. In the UK around 50% of all pregnancies are unplanned (British Pregnancy Advice Service) so a baby may be exposed to alcohol before a woman even recognises her pregnancy. Eurocare suggest that 79% of women continue to drink alcohol in pregnancy in the UK.
What is Foetal Alcohol Spectrum Disorder?
In the simplest terms FASD is a spectrum of behavioural, emotional, physical, and neurological traits that are caused by alcohol exposure on a developing foetus during pregnancy.
Some signs are evident from birth but some of the neurological traits will only be evident as the child ages into their late childhood and early teens.
The effects of prenatal brain injury vary greatly between individuals but can include:
- Attentional problems – inattention, hyperactivity, poor impulse control
- Learning difficulties – ranging from mild learning delays with time and maths concepts through to children classified as having global developmental and learning disabilities
- Immaturity – overall performance can be equivalent to that of children half their chronological age, but in some areas they will be age appropriate
- Language delays – early language delays, poor receptive language (e.g. slowness of processing verbal instructions), or a tendency to be overly verbal
- Movement problems – motor skills, coordination and balance anomalies may give rise to clumsiness and difficulties with completing physical tasks satisfactorily
- Behavioural and emotional regulation challenges – outbursts, rigidity, defiance, depression, anxiety, attachment issues and presenting as difficult to parent
- Social communication challenges – including difficulties with sustaining friendships, picking up non-verbal cues and understanding the subtleties of social interaction
- Memory issues – particularly with short-term and working memory (e.g. poor retention of more than one instruction at once)
- Executive functioning issues – lack of abstract reasoning and linking actions to consequences, poor problem-solving skills or creative thinking
- Sensory challenges – over and under sensitivity to the surrounding environment, adding to the distractibility issues and inattention
- Sleep disorders – difficulties falling asleep or may lie awake during the night
- Birth defects – eyesight, hearing, skeletal, facial anomalies, heart, limbs, etc. Around 10-15% of children have characteristic facial features associated with alcohol exposure
Not only are the effects of FASD pervasive and wide-ranging, they are common among children in the care system. Research suggests that 70% of children with FASD problems will enter the care system at some point in their lives.
So if you work with children with complex needs, you’ll be dealing with FASD somewhere along the line.
Implications for professionals…
Given the nature and common occurrence of alcohol-related problems in children’s development, there are implications for those of us working with them:
- Knowledge – we owe it to the kids we work with to stay informed about the effects of FASD and the likely indicators of its presence
- Assessment – we must embrace the possibility of FASD when making our assessments
- Links – we need to seek out and build links with specialists who can help us and families dealing with FASD