Student Spotlight: Harrison Grogan (University of Manitoba)

CanFASD Connect

We are pleased to introduce our first ever Student Spotlight: Harrison Grogan. Our Student Spotlight aims to highlight the unique research going on the field of FASD by student researchers across the country!

Harrison Grogan Harrison is a third year undergraduate student in the Faculty of Health Sciences at the University of Manitoba. He began working in the field of FASD as a Research Assistant under the supervision of Dr. Ana Hanlon-Dearman at the Manitoba FASD Centre.

A Health Diary for Caregivers of Children Ages 6-13 with FASD

Written by: Harrison Grogan & Dr. Hanlon-Dearman

FASD is complicated – parents know that with FASD, “every day is an adventure”. One person diagnosed with FASD can have a completely different selection of strengths and weaknesses compared to another person. These differences relate to the 10 brain domains which act as guidelines for diagnosing FASD. To obtain a diagnosis, a person must have severe…

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Drinking in pregnancy tied to subtle changes in babies’ faces

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Women who drink even a little bit of alcohol during pregnancy may be more likely than other mothers to have babies with slight facial abnormalities that have been linked to developmental problems, a recent study suggests.

When researchers examined data from facial images for 415 one-year-old children, they found subtle changes in babies’ faces mostly around the nose, eyes and lips associated with almost all levels of alcohol exposure regardless of whether drinking occurred only in the first trimester or throughout the pregnancy.

“We are surprised to see these differences in facial shape with low doses of alcohol exposure, which in our study was defined as two standard drinks on any one occasion and no more than seven in a week,” said lead study author Evelyne Muggli of the Murdoch Children’s Research Institute and the University of Melbourne in Australia.

“This means that any level of alcohol contributes to the way the face is formed and raises questions about the possible impact on brain development, which is the subject of further research,” Muggli said by email.

The facial changes found in the study are so subtle they aren’t visible to the naked eye, Muggli said. They can only be seen with sophisticated three-dimensional facial shape analysis, and they don’t necessarily mean that unborn babies have been harmed if mothers consumed some alcohol while pregnant, Muggli added.

But differences around the middle of the face and nose seen with alcohol exposure during pregnancy in the study resemble anomalies associated with fetal alcohol spectrum disorder, researchers report in JAMA Pediatrics.

Differences were most pronounced between children with no exposure to alcohol in utero and children with low exposure in the first trimester, particularly in the forehead, the study found.

Compared to children not exposed to any alcohol when their mothers were pregnant, kids with moderate to high exposure in the first trimester had differences in their eyes, mid-face and chin. Changes in the chin were also seen with binge drinking in the first trimester

Most women who do drink during pregnancy only drink a little bit and often stop once they realize they’re pregnant, limiting fetal alcohol exposure to the first trimester, Carol Bower of the University of Western Australia writes in an accompanying editorial.

Up to about one in 20 children may be affected by fetal alcohol spectrum disorder (FASD), which can lead to cognitive impairment including irreversible brain damage.

Children exposed to alcohol in the womb may have learning challenges such as deficits in memory or speech as well as behavior problems like hyperactivity.

The study wasn’t a controlled experiment designed to prove how or if different levels of alcohol exposure at different points in pregnancy might impact children’s faces, or cause specific developmental problems.

In addition, all of the children in the study were white, and it’s possible facial changes associated with alcohol exposure during pregnancy might look different in children from other racial or ethnic groups, the researchers note.

Even so, the findings add to a growing body of evidence on the fetal development effects of even low levels of alcohol consumption during pregnancy, said Heather Carmichael Olson, of the University of Washington School of Medicine.

“It is a substance that can change fetal development, and can be associated with lifelong changes in learning and behavior,” Carmichael Olson, who wasn’t involved in the study, said by email.

“If any amount of prenatal alcohol exposure can lead to physical changes in fetal development, as the current study suggests, so that it’s not just high doses or long-term drinking that have measurable effects, the safest advice that providers can give is that women who want a healthy pregnancy should avoid this biological risk factor if they are considering pregnancy or are pregnant,” Carmichael Olson added.

Retrieved from:  http://www.channelnewsasia.com/news/health/drinking-in-pregnancy-tied-to-subtle-changes-in-babies–faces-8934774

Life with a neurodisability goes beyond the brain

Emily Travis was 16 when she began to faint regularly.

Diagnosed with Fetal Alcohol Spectrum Disorder as a 12 lb., year-old infant, her health trajectory had been atypical from the start. But when Travis told her doctor she suspected the fainting was linked to her FASD, she was met with a dismissive response.

“I’d say, ‘I have fetal alcohol syndrome’ and the doctor would say, ‘that doesn’t affect your heart,’” Travis recalls. She was ultimately diagnosed with two heart conditions, severe scoliosis, growth hormone deficiency, and auditory processing and memory issues.

“They don’t understand that these things are secondary to our permanent brain damage,” she says.

Alone in her suspicions until 2013, Travis was 22 and attending International FASD conference in Vancouver, when she spoke with other young adults who were also experiencing a wide range of health issues. She, and two other young adults with FASD, Myles Himmelreich and C.J. Lutke, discussed conducting a survey looking at physical and mental health conditions in adults living with FASD.

With support from researchers—including Kids Brain Health Network Investigator Joanne Weinberg—they surveyed 541 adults who answered 260 questions on medical concerns in 25 different areas. Participants reported experiencing health issues at rates two-to-100 times higher than people do in the general population. Conditions ranged from autoimmune disorders such as lupus, celiac disease, and rheumatoid arthritis to coronary defects such as heart murmurs, sleep issues including apnea and night terrors, as well as early menopause and frequent miscarriages.

For Travis, Himmelreich and Lutke, who had complex health conditions starting in infancy, the results didn’t come as much of a surprise. Their results, published in 2017, a year after Centre for Addiction and Mental Health researcher Svetlana Popova and colleagues identified 400 health conditions associated with FASD, added to the evidence that alcohol exposure in utero doesn’t only affect the brain: it’s a whole-body disorder.

Increasing awareness of secondary conditions in autism
Rosemarie Jordan knows the terrain well. In addition to his diagnosis with ASD, her 7-year-old son has trouble sleeping and reacts to specific foods.

“We see a direct result when he’s eating certain foods versus others,” she says. “His body doesn’t seem to be able to tolerate certain things like dairy and processed foods, and what he eats really affects how he acts.” Her son “gets hyper” and out of control, sometimes reaching the point where he regurgitates his food.

It often takes him several hours to fall asleep, and until very recently he was prone to waking up throughout the night. Jordan is certain both of these issues are related to her son’s autism.

Their experiences mirror findings reported earlier this year in a report by Autism Speaks. Up to 70 per cent of children with ASD were said to experience some type of eating/feeding issue, and more than 50 per cent have one or more chronic sleep problems, including trouble falling asleep and prolonged night waking. These issues, described as behavioural insomnia, are common in other neurodisabilities as well. Kids Brain Health Researchers Penny Corkum and Shelley Weiss are evaluating a successful treatment designed for typically developing children as a strategy for sleep issues in children with autism, FASD, and ADHD.

A whole-body approach to diagnosis
Dr. Gail Andrew—medical director of the FASD clinical services at the Glenrose Rehabilitation Hospital and a consultant to the Glenrose Autism Clinic in Alberta—says her approach to diagnosing both disorders involves a complete assessment.

“I start with the head and I go down to the toes,” says Dr. Andrew. “It’s really detailed because you don’t want to miss something.”

The physical examination includes assessing hearing, eye sight, and dental hygiene, as well as asking how frequently the child gets sick and how consistent their bowel movements are. Andrew will then go on to inquire about mental health, which includes determining if there is any history of abuse or trauma.

One major commonality Andrew finds between children with FASD and ASD is an inappropriate use of medication.

“A lot of the presenting symptoms [of FASD and ASD] are dysregulated behavior. Caregivers are very frustrated, so they go to a family physician who only has a 10-minute window to take their history,” she says. “They simply don’t have time, and it’s so much easier to just reach for the prescription pad. Honestly, I don’t blame them, because they just want to be helpful.”

This scenario can persist into adult life. Through their survey, Himmelreich, Lutke, and Travis accumulated a 33-page list of medications prescribed to adults living with FASD to manage their secondary medical conditions.

Evidence of multiple co-occurring conditions in neurodisability has not yet been translated into widespread clinical practice. Himmelreich, Lutke, and Travis want to change that by publishing their survey. They hope to make an impact on the FASD community as well as physician awareness and training.

“We want to be involved in what information is going out there, because we are the ones that live with this every day,” says Himmelreich. “If you’re going to properly understand and accept us, you need to know what we’re dealing with. That means understanding that FASD isn’t something that just affects the brain, it’s something that affects our whole body.”

Image: Myles Himmelreich (l), C.J. Lutke (centre) and Emily Travis present their on their survey in progress in 2016.
Click this link to see a video of their presentation of their findings during a plenary session at the 7th International Conference on FASD 2017 in Vancouver.

Story reported by Vanessa Hrvatin

Retrieved from: http://www.neurodevnet.ca/news/life-neurodisability-goes-beyond-brain

LOOKING FOR CHILD AND YOUTH WORKER FOR EDMONTON AND AREA, WETASKIWIN, PANOKA AND RED DEER

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Unlimited Potential Community Services is committed to supporting Indigenous children, youth and families on their sacred path towards wellness. Unlimited Potential Community Services invite applicants with a good understanding of the Indigenous Culture, wisdom, history and issues faced by Indigenous Peoples. Our goal is to support each child and family to reach their full potential.

Click here to download:  Job Posting

Two Recent Approaches to FASD Diagnosis

The Prevention Conversation: A Shared Responsibility Project

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Over the last 50 years, a significant amount of research and clinical expertise has been devoted to characterizing the effects of prenatal alcohol exposure on the developing fetus. Simultaneously, a variety of systems and approaches have also emerged to provide diagnostic guidance for the related diagnoses.

Fetal Alcohol Spectrum Disorder (FASD) is now widely used to describe the resultant sequelae associated with prenatal alcohol exposure. Despite ongoing pressure to develop a consensus around diagnostic approaches for FASD, different multidisciplinary diagnostic systems continue to emerge.

Recently, significant differences in diagnostic sensitivity and specificity were revealed after comparing the 2005 Canadian diagnostic guidelines and the Diagnostic and Statistical Manual of Mental Disorders, 5th edition diagnosis Neurobehavioural disorder
associated with prenatal alcohol exposure (ND-PAE).

Although considerable overlap was identified between both sets of criteria, the neurobehavioural domains assessed for a ND-PAE diagnosis limited the identification of patients with FASD.

Similarly, two recent…

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Here’s Why Pregnant Women Shouldn’t Drink Alcohol Or Smoke

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As an expectant mother, you want your baby to be healthy. Some things you consume are good for the baby’s growth while some others like cigarettes and alcohol can be extremely harmful for the fetus. A baby receives food and oxygen through the placenta, which is attached to the umbilical cord. Tobacco smoke contains nicotine, arsenic, various tar products, and carbon monoxide which reaches the baby via this passage. Drinking alcohol during pregnancy can cause fetal alcohol syndrome (FAS). FAS is a group of mental and physical defects that may include, intellectual disability, heart defects, cleft palate, defects of the face, fingers, arms, and legs.Children with FAS often are hyperactive with limited attention spans and can suffer lifelong illness because of their mother’s use of alcohol.

Many studies have established that a pregnant woman’s smoking raises her child’s risk of disruptive behaviour disorders and of delinquency in the teen and young adult years, but its behavioural effects in early life have been been difficult to trace. However, researchers have revealed an association between a child’s in utero exposure to smoking and specific patterns of aberrant behaviour as a toddler, at school age, and as a teen and propose that these patterns form a continuum, united by an underlying theme of disrupted social information processing.

According to researchers from King’s College London and the University of Bristol, epigenetic changes present at birth in genes related to addiction and aggression, could be linked to conduct problems in children caused due to chemical changes in DNA methylation that turns our genes on or of particularly in genes.

Conduct disorder is a group of behavioral and emotional problems. Children with the disorder have a difficult time following rules and behaving in a socially acceptable way. They may display aggressive, destructive, and deceitful behaviours that can violate the rights of others. One of the genes which showed the most significant epigenetic changes is MGLL — known to play a role in reward, addiction and pain perception. Senior author of the study Dr Edward Barker said that children with early-onset conduct problems are much more likely to engage in antisocial behaviour as adults, so this is clearly a very important group to look at from a societal point of view.
Also Read: 8 Things To Avoid During Pregnancy

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Conduct problems might lead to children adopting antisocial behaviour
Photo Credit: iStock

The study used data from Bristol’s Avon Longitudinal Study of Parents and Children (ALSPAC) to examine associations between DNA methylation at birth and conduct problems from the ages of four to 13. They also measured the influence of environmental factors previously linked to early onset of conduct problems, including maternal diet, smoking, alcohol use and exposure to stressful life events and claimed that it can result in Aggressive/destructive behaviour, Dysregulated negative affect, characterised by persistent, uncontrolled outbursts of anger, stubborn defiance, marked by obstructive behaviour that persists and Low social competence, where the child misses social cues and exhibits low social interest or concern.

They found that at birth, epigenetic changes in seven sites across children’s DNA differentiated those who went on to develop early onset versus those who did not. Barker added that there is good evidence that exposure to maternal smoking and alcohol is associated with developmental problems in children, yet they don’t know how increased risk for conduct problems occurs.

Retrieved from: http://doctor.ndtv.com/pregnancy/how-prenatal-nicotine-and-alcohol-consumption-affects-children-1711583

Alcohol Consumption During Pregnancy May Cause Subtle Changes in Baby’s Face

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It is a known fact that alcohol consumption during pregnancy can cause harmful effects on the growth and development of the baby. The phase of pregnancy is crucial where what a woman eats and drinks, and the lifestyle she leads play a crucial role on the health of the baby. Women who drink even a little bit of alcohol during pregnancy may be more likely than other mothers to have babies with slight facial abnormalities that have been linked to developmental problems,suggests a recent study.

When researchers examined data from facial images for 415 one-year-old children, they found subtle changes in babies’ faces mostly around the nose, eyes and lips associated with almost all levels of alcohol exposure regardless of whether drinking occurred only in the first trimester or throughout the pregnancy.

“We are surprised to see these differences in facial shape with low doses of alcohol exposure, which in our study was defined as two standard drinks on any one occasion and no more than seven in a week,” said lead study author Evelyne Muggli of the Murdoch Children’s Research Institute and the University of Melbourne in Australia.
“This means that any level of alcohol contributes to the way the face is formed and raises questions about the possible impact on brain development, which is the subject of further research,” Muggli said by email.
The facial changes found in the study are so subtle they aren’t visible to the naked eye. They can only be seen with sophisticated three-dimensional facial shape analysis, and they don’t necessarily mean that unborn babies have been harmed if mothers consumed some alcohol while pregnant, Muggli added.
pregnancy

Women who drink even a little bit of alcohol during pregnancy can cause harm to the baby; Image credit: Istock

But differences around the middle of the face and nose seen with alcohol exposure during pregnancy in the study resemble anomalies associated with fetal alcohol spectrum disorder, researchers report in JAMA Pediatrics.

Differences were most pronounced between children with no exposure to alcohol in utero and children with low exposure in the first trimester, particularly in the forehead, the study found. Compared to children not exposed to any alcohol when their mothers were pregnant, kids with moderate to high exposure in the first trimester had differences in their eyes, mid-face and chin. Changes in the chin were also seen with binge drinking in the first trimester.
Most women who do drink during pregnancy only drink a little bit and often stop once they realize they’re pregnant, limiting fetal alcohol exposure to the first trimester, Carol Bower of the University of Western Australia writes in an accompanying editorial. Up to about one in 20 children may be affected by fetal alcohol spectrum disorder (FASD), which can lead to cognitive impairment including irreversible brain damage.
Children exposed to alcohol in the womb may have learning challenges such as deficits in memory or speech as well as behavior problems like hyperactivity.The study wasn’t a controlled experiment designed to prove how or if different levels of alcohol exposure at different points in pregnancy might impact children’s faces, or cause specific developmental problems.
In addition, all of the children in the study were white, and it’s possible facial changes associated with alcohol exposure during pregnancy might look different in children from other racial or ethnic groups, the researchers note.Even so, the findings add to a growing body of evidence on the fetal development effects of even low levels of alcohol consumption during pregnancy, said Heather Carmichael Olson, of the University of Washington School of Medicine.
“It is a substance that can change fetal development, and can be associated with lifelong changes in learning and behavior,” Carmichael Olson, who wasn’t involved in the study, said by email.
“If any amount of prenatal alcohol exposure can lead to physical changes in fetal development, as the current study suggests, so that it’s not just high doses or long-term drinking that have measurable effects, the safest advice that providers can give is that women who want a healthy pregnancy should avoid this biological risk factor if they are considering pregnancy or are pregnant,” Carmichael Olson added.

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