Theraphy helps a child with Fetal Alcohol Spectrum Disorder


Occupational therapist Janet Watkiss said she’s seen many babies affected by the alcohol their mothers drank while pregnant. Often, she said, the mother didn’t know she was pregnant when she was drinking. Only after the birth does she discover something seems wrong with her baby.

Ms. Watkiss, who’s worked with families for 13 years in Allegheny County, is employed by Therapeutic Early Intervention Services, one of the largest Pittsburgh-area providers of early intervention services, including help for babies affected by exposure to alcohol. Sometimes it’s a pediatrician who sees delays in the baby’s development. To receive services, the baby must have a medical diagnosis (in this case, fetal alcohol spectrum disorder) or, in other cases, specialists can determine that a delay exists.

A baby’s exceptionally fussy behavior might also bring a diagnosis of fetal alcohol spectrum disorder, Ms. Watkiss said, when no medical reason explains it.

“That impacts their attachment to their mom and dad,” she said. “It’s easy to love an agreeable baby.” This fussiness is more challenging than a “colicky” baby, she said.

“When there is substance exposure in utero, we see a lot of fussy babies that leads to this behavior. They can’t control their emotions.”

She and other therapists lately have seen more mothers using both alcohol and other substances in pregnancy. Treating drug-addicted babies has gotten a lot of attention, she said, but the word about alcohol exposure isn’t getting out.

“It seems it’s so much more accepted in general,” she said. She thinks if more women of childbearing age knew of alcohol’s effects, they’d be more likely to abstain.

Among concerns, Ms. Watkiss said physical therapists see muscle tone issues in babies with fetal alcohol exposure.

“They struggle with lifting their head. They really avoid tummy time, which is highly recommended during waking hours. A child with low tone really hates it; there’s more crying and more fussiness.” A therapist can focus on developing gross motor skills and help a baby achieve the milestone of sitting up, for example. Most babies can sit without support at about 8 months.

Ms. Watkiss said fine motor skills can be delayed. “Issues with reaching and grasping for objects, a lack of curiosity is a concern for therapists … being curious about their world. Facial regard to their mom, wanting to watch her and listen.”

Early intervention can help with sleep disturbances, not gaining weight and feeding problems, and age-related typical milestones, such as crawling, walking and using the early sounds of language.

After the first year, Ms. Watkiss said, therapists can gauge a child’s attention span. They can see if a child can learn how to dress and feed herself, for example, or look at books or play with a toy.

In children with fetal alcohol exposure, she said, “We see huge attention issues, poor self-regulation, self-soothing … they can’t cope.”

At 2 years, she said, children with poor coping skills rely on a caregiver to deal with getting a toy back, for example, and they might have long-lasting tantrums of 20 to 30 minutes.

An occupational therapist can help the family overcome sensory-processing disorders, Ms. Watkiss said.

“They have a hypersensitivity to sound, to light, to touch, taste, smells.”

Although the brain is still developing up to the age of 25, Ms. Watkiss said, much can be done before the age of 3.

“We try to come in and help that parent build a relationship with their own child,” she said, with parenting skills and information. “It’s a shared responsibility between us as early intervention specialists and the parents.

“We have to establish that rapport. … If there’s an insecure attachment or the parent and child aren’t bonding well, there’s usually a lot of trust issues with the parent: She’s had a lot of disappointment.… We tell her we’re not leaving; we’re with you, [and] we’re in it together.”

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