The Loop - e-news
National Organisation for Fetal Alcohol Spectrum Disorders Australia.
[ Issue #28, December 2015 / January 2016 ]
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Dear Members & Supporters,
This month in “The Loop”

You may have noticed we didn't have a December newsletter.  With the busy-ness that is the "Silly Season", we made the decision to not publish a December newsletter and instead combine December and January together.

As a consequence, this is an issue packed full of useful content and articles of interest.  The focus for this newsletter was providing resources, particularly for families, parents, and carers.  We hope that you find them useful, and would love to hear your feedback as to how useful the resources are for you.

Faith's List has been created so that you can endorse your support for NOFASD Australia so the organisation can continue and ensure the voices of parents and families are represented, the potential and possibilities for those living with FASD grows and advocate for prevention.

 
Please consider encouraging a family member, a colleague, a friend or supporter to join the NOFASD Australia network. Keep informed about FASD in the news and link to national and international resources by receiving and sharing the NOFASD Community newsletter. As always, Join us on Facebook and Twitter for consistent updates about the latest news and events.
 
Until next time,
Terri Baran
Social Media & Administration Officer
 
NOFASD Australia does not necessarily agree with the articles below. They are provided for reference and interest purposes only.

 

 
Of Special Interest

MEDIA RELEASE: PATCHES Launches Perth Metropolitan FASD Clinics
PATCHES Paediatrics has commenced operation of Perth's first FASD diagnosis and treatment service. Having provided comprehensive multidisciplinary FASD clinics in Kimberley's Fitzroy Valley since 2014, PATCHES is now offering this service in Perth and outer metropolitan centres, including within the WA Justice system.
Since February 2015 PATCHES Paediatrics delivered ten day-long metropolitan FASD clinics in Mt Lawley, Armadale, and Cannington. A clinic schedule for 2016 has been published via the PATCHES website, and the service is open to receiving referrals from the Justice system, Child Protection Services, Schools and Health services.
Paediatrician and FASD researcher Dr. James Fitzpatrick stated that: "PATCHES specialised in improving access to FASD assessment and treatment among young people in hard to reach places, including remote Aboriginal communities in the Kimberley and Pilbara. So applying the PATCHES remote outreach model to the outer metropolitan and Justice system context is a natural extension of our service".


Diagnosing fetal alcohol spectrum disorder: New Canadian guideline
Diagnosing fetal alcohol spectrum disorder (FASD) is important to help children and adults, and their families, who have the disorder. A new Canadian guideline published in CMAJ (Canadian Medical Association Journal) provides recommendations for diagnosing FASD, specifically for multidisciplinary diagnostic teams. Since the publication of the last Canadian guideline in 2005, research in this area has evolved. The new guideline incorporates updated evidence for detecting and diagnosing FASD across the lifespan.

 
Diagnosis of fetal alcohol spectrum disorder is essential to improve outcomes for affected individuals and families, and to inform pre-pregnancy counselling to prevent future cases. This resource from the Canada Fetal Alcohol Spectrum Disorder Research Network is linked to the revised Canadian guidelines and is worth listening to. Dr. Valerie Temple is a clinical psychologist at Surrey Place Centre in Toronto, and Dr. Christine Loock is a developmental pediatrician at Children's and Women's Health Centre of British Columbia, with an academic appointment at UBC. It provides evidence-based recommendations for best practices in the diagnosis of this condition. In this podcast, two of the authors of the guideline explain the critical importance of three main areas for consideration of risk – adaptive and executive functioning what to look for in clinical practice.
Fetal Alcohol Spectrum Disorder (FASD) is caused by the consumption of alcohol during pregnancy. About half of all pregnancies are exposed to alcohol, and about 1% of the New Zealand population is estimated to have FASD as a result. FASD can be characterised by a range of problems such as intellectual and behavioural deficits, as well as irreversible damage to the brain and body. This discussion document outlines the Government's proposed approach for addressing FASD. It outlines a series of key principles, high level outcomes and potential action areas for the action plan, and seeks feedback on how we could do things differently. Closing date for submissions is Friday 26 February 2016.

 

Real Stories

On nearly losing a dad to a violent attack by a brother with FASD
"On January 2, 2014, my dad was attacked in his home, while resting on the couch, and beaten by my brother. I got the news late in the evening, around 11 p.m., when a doctor from the Sault Ste. Marie, Ont., Hospital called me at home in Yellowknife. He said my father sustained a serious head injury and wasn't likely to live. I was told to start making funeral arrangements. … I was given little information and only after I relayed the news to my siblings did I her that my brother, Ryan, was arrested in connection with my dad’s injuries. I knew right then what happened, and strangely enough, I wasn't the least bit surprised. … I knew Ryan was different from all the other kids our age but it was only when I was 13 or 14 that my parents told me he was born with FASD … His biological mother drank heavily while she was pregnant with him. My parents were aware of this but decided to adopt him regardless, obviously unaware that his condition would become increasingly worse as he grew older."

 
As a teen, Kathy drank alcohol while pregnant with her daughter, Karli. It was a perilous if unwitting mistake that has defined both of their lives. Karli is now 43 but is the developmental age of a first-grader. In the home she shares with her mother and stepfather, she collects dolls and purses, and pores over Hello Kitty coloring and sticker books. Karli has fetal alcohol syndrome, the result of alcohol exposure in utero. To Kathy, Karli's is simply a life snuffed of promise. "I adore my very sweet daughter," Kathy says. "She's a forever innocent child. But not a day goes by that I don’t ask myself, 'What if? What if alcohol hadn't been a part of my life?'"
When Kathy gave birth to Karli, doctors barely knew of the effects that alcohol consumption or even binge drinking had on a fetus. Even today, public awareness about alcohol consumption during pregnancy is limited. Social media posts and comments indicate that the Washington Post article was going overboard by warning that there is no safe amount of alcohol to consume during pregnancy. "Good grief. She didn't 'drink alcohol', she was an alcoholic who drank excessively! And smoked. There is a BIG difference. Journalists should know that and not sensationalise," one reader commented. The truth is that the article sensationalised nothing. Alcohol’s damage to a fetus can be just as insidious when another drinks lightly or moderately.
 
A Washington Post feature describing Kathy Mitchell's formative years and her devotion to her daughter Karli has cast light on the often hidden issue of FASD. Mitchell is being praised for her courage in talking about such personal family experiences. The overwhelming response to her story is from people recognizing the importance of ensuring that children are not exposed to alcohol before they are born. More importantly, some who had assumed otherwise realised through Mitchell's story that no woman ever intends to harm her baby.
 
"Three of the six children in our home live with the effects of fetal alcohol spectrum disorder. We dream for each to be happy, healthy and independent and for them to optimize their individual gifts and to learn without barriers. I bring strong personal bias to this topic – and I don't think that’s a bad thing. I spend a lot of time wondering about ways schools can improve the experience of all students who defy "typical"."

 

National & NZ News

Australia
Expert casts doubt on Gene Gibson murder confession, wants FASD assessment
A Western Australian man jailed for murder could be a victim of a miscarriage of justice, according to an internationally renowned neuropsychologist. Dr Valerie McGinn, an expert on brain damage caused by prenatal alcohol, has told the ABC's Four Corners that Aboriginal man Gene Gibson should be assessed for Foetal Alcohol Spectrum Disorder (FASD), a disability recognised as leading to wrongful conviction. Gibson has spent three years in prison after pleading guilty to the manslaughter of Broome man, Joshua Warneke, who was beaten to death in 2010 while walking home after a night out in the Kimberley town.


Australia put more people in jail than ever before in 2015 and it's costing taxpayers $2.6 billion
Kimmorley, S. 2015 in Business Insider Australia is worth reading in terms of the numbers of people in prison who may be living with undiagnosed FASD. Supreme Court judge Christine Wheeler is quoted in an interview with the ABC as saying, "There's money being wasted that could be spent better on other things, including crime prevention which would make us all safer in the first place. "It costs about $100,000… to send someone to jail for a year. So every time you send someone to jail for a year and they don't need to be there, that's a nurse you don't employ, it's a teacher you don't employ, it's a bit of road that doesn't get fixed, it's something that as a taxpayer you want that doesn't happen," she said


New Zealand

Judges and lawyers are changing the way they communicate to help mentally impaired defendants navigate the justice system. Youth Court Judge Tony Fitzgerald said awareness of neurological disabilities, including fetal alcohol spectrum disorder, was increasing within the justice system. Fitzgerald said the number of people with fetal alcohol spectrum disorder appearing before the courts was not changing, but it was being identified more. "It's only been in recent years that this awareness has developed. As soon as you start assessing for it and looking for it, it's there."
 
Prime Minister John Key has announced over $5 million worth of assets seized from criminals will be invested in anti-drug initiatives. A total of 13 initiatives will receive a share of the $5.105 million made available in the latest round of funding under the Criminal Proceeds (Recovery) Act. The initiatives to be funded from the seized assets include $1m for a package aimed at preventing, identifying and responding effectively to fetal alcohol spectrum disorders.
 
Marlborough residents are being encouraged to have their say on a government discussion paper on fetal alcohol spectrum disorder. The document was released by the Ministry of Health in December and contains information that will inform an action plan on the disorder to be released by the government in June. At present, New Zealand does not have a comprehensive strategy to address fetal alcohol spectrum disorder.
 
The government is looking for ways to deal with fetal alcohol spectrum disorder (FASD) and wants public input. It's caused by pregnant women drinking alcohol and Associate Health Minister Peter Dunne says an estimated 570 children are born with FASD each year. They suffer brain damage and are more likely to be difficult to parent, disruptive at school, come into contact with the criminal justice system and develop mental health and addiction problems.

Resources & Multimedia

FOR PARENTS AND CARERS
Carer Gateway

The Carer Gateway is a national online and phone service that provides practical information and resources to support carers. The interactive service finder helps carers connect to local support services. NOFASD Australia will be linking up with this website.


Implications of FASD for the Adoptive Family – NOFAS Webinar replay (Video)
Over one million children in this country [USA] per year are delivered to women who have used alcohol or illicit drugs during pregnancy. Children available for domestic adoption make up a large proportion of these children, and children adopted internationally add significant numbers to this population. This session will focus on the structural and functional changes that occur in the fetal brain due to prenatal exposure to alcohol, how those changes interact with environmental issues to affect the child’s ability to attach to his/her primary caregiver, and how the exposure impacts the child’s long term behaviour, learning, and social outcomes. Presented by Ira J. Chasnoff, M.D.


Tips for Parents with FASD - schedules
The Edmonton Fetal Alcohol Network has compiled a list of 16 tips for parents with FASD in dealing with their own children and scheduling.


5 things to know about dyspraxia
The article describes dyspraxia as a condition affecting "hand-eye co-ordination, special awareness (how your body is in space), fine and gross motor skills, processing information and some people can struggle with sensory overload."


Parenting Strategies that work with kids with FASD
A personal blog by Jenna Hill (USA) and resource from FASD Families: Supports and Resources for families caring for children living with FASD. Check copyright conditions on the website.


How schools avoid enrolling children with disabilities (Graham, Proctor & Dixon, 28 Jan 2016)
This article in The Conversation provides an interesting insight into which children are most affected and how schools get away with 'gatekeeping' enrolments (which often mean parents are advised to enrol in another school) and what can be done. The authors note:
While government schools receive some extra funding from the state to support children with learning difficulties and disabilities, private schools aren't entitled to this. This has led to the over-representation of students with a disability in government schools, particularly those in disadvantaged areas where parents have fewer options.

 
Progressing Parental Engagement in the ACT
The Progressing Parental Engagement in the ACT project underpins the ACT Government's commitment to delivering the best schools and the best education for children and young people. The project sees learning as a partnership in which all parents are valued and respected as children's first and most influential teachers. This fact sheet is one of many on the website and is called 'Engaging with families of a child with a disability' ACT.


Caregiver Curriculum on FASD 2014
A reminder on the availability of this online training for caregivers.


Dr. Ira Chasnoff on Teenagers and Growing up with Fetal Alcohol Syndrome (FASDs)
A podcast.


How to Make a Weighted Sensory Blanket


FOR TEACHERS
The Senate, Commonwealth of Australia "Access to real learning: the impact of policy, funding and culture on students with disability" January 2016
The full report is an outcome of an inquiry into current levels of access and attainment for students with disability in the school system, and the impact on students and families associated with inadequate levels of support. The report can be downloaded at the above link.


FOR SERVICE PROVIDERS
What social workers need to know about foetal alcohol spectrum disorders
Advice on consuming alcohol during pregnancy in the UK is woefully inadequate. Current guidance given by midwives is: "It is better not drink, but if you do, then 1 or 2 units, once or twice a week is alright". Recent research has suggested that the prevalence figure jumps alarmingly when considering children in care, with 27% identified, within a very small audit, as being on the spectrum. It is not surprising when we consider that 65% of children enter care due to neglect and abuse and a significant number of these will come from homes where alcohol plays a significant part. In common with the children in the wider community, FASD is an unrecognised condition in looked-after children with little awareness or training given to professionals.


FASD and Homelessness
Dr Dorothy Badry discusses current research and best practices around the subject of supporting individuals in Alberta, affected by FASD and homelessness.


Fetal alcohol spectrum disorder: clinical guideline for diagnosis across lifespan (Audio)
Diagnosis of fetal alcohol spectrum disorder is essential to improve outcomes for affected individuals and families, and to inform pre-pregnancy counselling to prevent future cases. This guideline from the Canada Fetal Alcohol Spectrum Disorder Research Network provides evidence-based recommendations for best practices in the diagnosis of this condition. In this podcast, two of the authors of the guideline explain the critical importance of three main areas which need consideration – adaptive, what to look for in clinical practice.


FOR LAW ENFORCEMENT AND CORRECTIONS
Forensic Scholars Today – Volume 1, Issue 3: FASD Special Edition
Forensic Scholars Today (FST) recognizes the importance of educating students and professionals on the complexities and misconceptions of FASD. As such, [they] are proud to present a Special Edition of [their] publication focusing on articles related to FASD. Includes articles such as "What Forensic Professionals Need to Know About FASD", "FASD in the Criminal Justice System: Invisible in Plain Sight", and "Social Dysfunction: A Key Deficit in Adults with Suspected and Confirmed FASD".


Fetal Alcohol Spectrum Disorder in Confinement Settings: A Review for Correctional Professionals
Brown J., Hesse ML., Wartnik A., Long-McGie J., Andrews T., Weaver M., Olson J., Burger P., Kolakowsky-Hayner SA., & Rohret B., Journal of Law Enforcement, 29 Dec 2015
Fetal Alcohol Spectrum Disorder (FASD) has been understudied within the context of corrective settings. Individuals with FASD who are confined to a correctional setting may be perceived as lazy, manipulative, irritating and self-defeating, especially when correctional staff lack an awareness and understanding of the disorder. The aim of this article is to present suggested approaches that correctional professionals should consider when interacting with inmates with FASD or suspected of having FASD as well as highlighting various factors that should be taken into account when someone with this disorder is serving a sentence within a confinement setting.


Australian Human Rights Commission Equal Before the Law: Towards Disability Justice Strategies – February 2014
A couple of years old now but worth reading beginning with the Foreword by Graeme Innes who writes:
The case for change is strong. Not only should Australians with disabilities - whether victims of crime, offenders, or participants in the criminal justice system - experience equal treatment before the law. But considerable economic savings can be made by preventing violence and providing early diversion and support.

International News and Media

Canada

Researchers at the Centre for Addiction and Mental Health (CAMH) have identified 428 distinct disease conditions that co-occur in people with Fetal Alcohol Spectrum Disorders (FASD), in the most comprehensive review of its kind. "We've systematically identified numerous disease conditions co-occurring with FASD, which underscores the fact that it isn't safe to drink any amount or type of alcohol at any stage of pregnancy, despite the conflicting messages the public may hear," says Dr. Lana Popova, Senior Scientist in Social and Epidemiological Research at CAMH, and lead author on the paper. "Alcohol can affect any organ or system in the developing fetus."
 
A recent study by researchers in Halifax shows that health labelling on alcohol bottles can affect consumers' perceptions of the products. The study, published in the Canadian Journal of Public Health, found that when an image and text health warning is placed on alcohol, positive perceptions of the products decreased. Rather than graphic images like the ones used in the study, Tim Stockwell, a psychology professor at the University of Victoria, says simple educational labels are more realistic: "Basic text warning about the kinds of problems, cancer, trauma, fetal alcohol syndrome, those kind of major things."
 
A deadly serious but almost invisible problem affects thousands of children in Manitoba and across the country. This problem is entirely preventable; yet we are afraid to take serious action to deal with it. This problem is one we should know more about; yet we are afraid to properly research it. … We need a more aggressive approach in cases where education fails to stop a pregnant woman from endangering her unborn child by reckless drinking and drug consumption.
 
The Ontario government is committed to supporting the safe and responsible sale, service and consumption of alcohol in the province. Ontario understands that selling alcohol is a public trust and with that trust comes a strong sense of social responsibility.
 
In their commentary on a December 2015 article written by Brian Giesbrecht, Ab Chudley and Sally Longstaffe agree that FASD is a disability and that prevention has not been successful. The authors reflect that researchers have been studying the genetic and epigenetic changes that may be associated with an added risk for FASD, the life circumstances that can affect the way genes are expressed - maternal stress, poor nutrition and negative experiences in early life are contributing factors to adverse outcomes in FASD. Further, they enforce the understanding that "Fetal alcohol syndrome is not a race-based disorder that affects only indigenous people. Prenatal alcohol use affects thousands of children in Europe, Africa and in all countries in which FASD prevalence studies have been undertaken." Importantly, Chudley and Longstaffe reaffirm the unfairness of blame on mothers and the alienating barriers and stigma created by the invocation of aggressive tactics and measures such as detaining pregnant mothers who drink.
 
This brief article explains that "a diagnosis can be particularly helpful when people are involved in the courts and their condition is not known." He adds, "We automatically assume competence. And we assume the behaviour we're seeing in front of us is wilful behaviour — so if they just tried harder, if they just listened more."
 
Ireland

Breaches of alcohol sponsorship and ads to become a criminal offence under new law

Criminal sanctions will be imposed for the first time for breaches of alcohol advertising, marketing and sponsorship under proposed legislation to be published today. The penalties will be outlined in the Public Health (Alcohol) Bill to be published by Health Minister Leo Varadkar after it was given the go-ahead by the Cabinet. Warnings in relation to harmful effects of alcohol consumption in general and during pregnancy will be included in all ads.

 

United Kingdom

Men and women should drink no more than 14 units of alcohol a week – the equivalent of six pints of average strength beer or seven glasses of wine – in order to keep their health risks low, new guidelines have recommended. The new guidelines for pregnant women have not been updated in England, Wales and Northern Ireland to be clear that no level of alcohol is safe to drink in pregnancy. Previously it was recommended that for women who had opted to drink, consuming no more than one or two units of alcohol would "minimise the risk to your baby".
 
Fresh worries have been raised over the amount of mothers who drink through pregnancy in light of figures which show St Helens has the fourth highest rate in the country for women admitted to hospital through alcohol related illnesses. Marie Rimmer, MP for St Helens South and Whiston sits on an All Party Parliamentary Group which has been looking into the current picture of Foetal Alcohol Spectrum Disorder (FASD). The parliamentary group found that the UK is lagging behind other developed countries in raising awareness of the condition and implementing effective services and strategies to confront the growing challenges posed by FASD.
 
MPs have highlighted the prevalence of children with foetal alcohol spectrum disorder in the adoption system and called for better training for social workers on the issue. The All-Party Parliamentary Group (APPG) on foetal alcohol spectrum disorder said it could be argued that adoption in the UK had become "predominantly a family finding service for children with FASD". The APPG highlighted a study in Peterborough which found that 75% of children referred to adoption medicals had a history of prenatal alcohol exposure, as did a third of children referred to a community clinic for looked-after health assessments.
 
Churches can do more to help parents of children born with Fetal Alcohol Spectrum Disorder, says a Christian campaigner. Julia Brown, from the FASD Trust, said that parents who adopt children are often unaware about the chances that a baby could have been born with FASD:
Children aged nought to four – little ones – you've got about a 75% chance or even higher of adopting a child with FASD, because children are often removed when they’re little, after birth or near birth because their mother has got a drug or alcohol problem.

 

South Africa

Alcohol toxic during pregnancy

There are more than 428 medical conditions, diseases or developmental problems related to foetal alcohol spectrum disorder. The sheer number of diseases that co-occur with the disorder show how serious any drinking in pregnancy is, said Leana Olivier, CEO of the Foundation for Alcohol-Related Research.

 

United States

Lawmakers fear rising drug use by moms to-be

More pregnant women are using illegal drugs in Arkansas, but lawmakers and child-welfare administrators said Thursday that there is no silver bullet to bring those rates down ... Reps. Sue Scott and Rebecca Petty, both Republicans from Rogers, agreed that it was worth exploring the addition of alcohol to the list of substances that are screen under Garrett's Law. "Fetal alcohol syndrome has a terrible effect."
 
Alaska children with fetal alcohol disorders become eligible for special education
Alaska children affected by fetal alcohol spectrum disorder are now eligible for special education and related services. The State Board of Education & Early Development adopted the new regulation during its meeting in Anchorage last week, according to a news release. The board also agreed to allow advanced nurse practitioners – not just doctors – to diagnose fetal alcohol spectrum disorders. The regulation change came at the request of health professionals and followed public comments that were largely supportive, according to a board memo from Education Commissioner Mike Hanley.

 

Latest Research

Drinking During Pregnancy and the Developing Brain: Is Any Amount Safe
Charness, Riley & Sowell (2016) "Drinking During Pregnancy and the Developing Brain: Is Any Amount Safe?" Trends in Cognitive Sciences, February 2016, Vol. 20, No. 2. (pp. 80-82)
A valuable discussion on research on light-to moderate drinking and the impact of negative research findings in popular media that "underestimate potential adverse outcomes and complicate decisions about risks versus benefits of light-to-moderate drinking during pregnancy."

Popova S., Lange S., Shield K., Mihic A., Chudley AE., Mukherjee RAS., Bekmuradov D., & Rehm J., The Lancet, 5 Jan 2016, doi:10.1016/S0140-6736(15)01345-8
Fetal alcohol spectrum disorder (FASD) is related to many comorbidities because of the permanent effects of prenatal alcohol exposure on the fetus. This study aimed to identify the comorbid conditions that co-occur in individuals with FASD and estimate the pooled prevalence of comorbid conditions occurring in individuals with FAS. The study identified 428 comorbid conditions co-occurring in individuals with FASD, spanning across 18 of 22 chapters of the International Classification of Diseases, tenth revision. The most prevalent conditions were within the sections of congenital malformations, deformities, and chromosomal abnormalities, and mental and behavioural disorders. The high prevalence of comorbid conditions in individuals with FASD highlights the importance of assessing prenatal alcohol exposure as a substantial clinical risk factor for comorbidity. The harmful effects of alcohol on a developing fetus represent many cases of preventable disability, and thus, alcohol use during pregnancy should be recognised as a public health problem globally.
 
Worldwide Prevalence of Fetal Alcohol Spectrum Disorders: A Systematic Literature Review including Meta-analysis
Roozen S., Peters G-JY., Kok G., Townend D., Nijhuis J., & Curfs L., Alcoholism: Clinical and Experimental Research, 4 Jan 2016, doi: 10.1111/acer.12939
Although fetal alcohol spectrum disorder (FASD) affects communities worldwide, little is known about its prevalence. The objective of this study was to provide an overview of the global FASD prevalence. A search was performed in multiple electronic bibliographic databases up to August 2015. Particularly high-prevalence rates of FASD were found in South Africa, Croatia, Italy, with a high prevalence of alcohol-related birth defects in Australia (10.82 per 1000). The worldwide pooled prevalence estimates are higher than assumed so far, largely explained by geography and descent. They therefore must be interpreted with caution. Clear guidelines on assessing FASD prevalence are urgently needed, and a first step towards these guidelines is presented.
 
Varadinova M., & Boyadjieva N., Pharmacological Research, 25 September 2015, doi: 10.1016/j.phrs.2015.09.011
The etiology of autism spectrum disorders (ASDs) still remains unclear and seems to involve a considerable overlap between polygenic, epigenetic and environmental factors. This study summarises the current understanding of the interplay between gene expression dysregulation via epigenetic modifications and the potential epigenetic impact of environmental factors in neurodevelopmental deficits. It also discusses the scientific controversies of the relationship between prenatal exposure to alcohol and alcohol-induced epigenetic dysregulations, and gene expression alterations which are associated with disrupted neural plasticity and causal pathways for ASDs. The review of the literature suggests that a better understanding of developmental epigenetics should contribute to furthering our comprehension of the etiology and pathogenesis of ASDs and fetal alcohol spectrum disorders.
 
Masotti P., Longstaffe S., Gammon H., Isbister J., Maxwell B., & Hanlon-Dearman A., BMC Health Services Research., 5 October 2015, doi: 10.1186/s12913-015-1113-8
The researchers conducted a consensus-generating symposium comprised of 60 experts from different stakeholder groups. Research questions addressed barriers and solutions to integration across systems and group-specific and system-wide research priorities. Results show that FASD capacity (e.g. training, education, awareness) needs to be increased in both medical and non-medical providers. There is a need to better integrate care for individuals and families living with FASD. Primary Care is well positioned to play a central and important role in facilitating and supporting increased integration. Research is needed to better address best practices and long-term individual and family outcomes following a diagnosis of FASD.
 
Popova S., Lange S., Burd L., & Rehm J., Alcohol and Alcoholism, 21 October 2015, doi: 10.1093/alcalc/agv117
This cost-of-illness study examined the impact of FASD on the material welfare of the Canadian society in 2013 by analysing the direct costs of resources expended on health care, law enforcement, children and youth in care, special education, supportive housing, long-term care, prevention and research, as well as the indirect costs of productivity losses of individuals with FASD due to their increased morbidity and premature mortality. The costs totalled approximately $1.8 billion. FASD is a significant public health and social problem that consumes resources, both economic and societal, in Canada. Many of the costs could be reduced with the implementation of effective social policies and intervention programs.
 
Godino A., Abate P., Amigone JL., Vivas L., & Molina JC., Neuroscience, 8 October 2015, doi: 10.1016/j.neuroscience.2015.10.004
The aim of this study was to analyse how prenatal binge-like ethanol exposure to a moderate dose during gestational days 17-20 affects hydroelectrolyte regulatory responses. This type of exposure has been observed to increase ethanol consumption during adolescence. Moderate prenatal ethanol exposure produced long-lasting changes in brain organisation, affecting basal activity of central extended amygdala nuclei, AVP neurons and the inhibitory areas of SA.
 
FASD Prevalence among Schoolchildren in Poland
Okylicz-Kozaryn K., Borkowska M., & Brzozka K., Journal of Applied Research in Intellectual Disabilities, 1 October 2015, doi: 10.1111/jar.12219
Prenatal Alcohol Exposure is a major cause of brain damage and developmental delay, but in Poland is rarely diagnosed and the scale of problem is not known. An active case ascertainment approach was applied to estimate the prevalence of FASD among 7-9 year olds. The results show that prevalence of FASD is not lower than 2%, including 0.4% of Fetal Alcohol Syndrome. Neurodevelopmental disorders associated with PAE are a serious challenge for the public health system. Development of procedures and services to diagnose and to support individuals affected by PAE and their families is an urgent need in Poland.
 
Donald KA., Fouche JP., Roos A., Koen N., Howells FM., Riley EP., Woods RP., Zar HJ., Narr KL, & Stein DJ., Metabolic Brain Disease, 29 November 2015, doi: 10.1007/s11011-015-9771-0
Neuroimaging studies have indicated that prenatal alcohol exposure is associated with alterations in the structure of specific brain regions. However, the temporal specificity of such changes and their behavioural consequences are less known. Here the brain structure of infants with in utero exposure to alcohol shortly after birth was explored via MRI images. Significantly decreased total gray matter volume was demonstrated for the alcohol-exposed cohort compared to healthy control infants. Regions that were significantly different were the left hippocampus, bilateral amygdala and left thalamus. These findings suggest the effects of prenatal alcohol exposure on brain growth is present very early in the first year of life, a period during which the most rapid growth and maturation occurs.
 
Alcohol consumption and binge drinking in early pregnancy. A cross-sectional study with data from the Copenhagen Pregnancy Cohort [PDF]
Iversen ML., Sorensen NO., Broberg L., Damm P., Hedegaard M., Tabor A., & Hegaard HK., BMC Pregnancy and Childbirth, 8 December 2015, doi:10.1186/s12884-015-0757-z
Since 2007 the Danish Health and Medicines Authority has advised total alcohol abstinence from the time of trying to conceive and throughout pregnancy. Since the introduction of the recommendation, no studies have examined pre-pregnancy lifestyle and reproductive risk factors associated with this behaviour in a Danish context. Data were collected from September 2012 to August 2013. Self-reported information on each woman’s socio-demographic characteristics, medical history, and lifestyle factors including alcohol habits was obtained from an electronic questionnaire filled out as part of the individual medical record. Results show that prevalence of weekly alcohol consumption decreased considerably during early pregnancy compared with pre-pregnancy levels. Nevertheless, one third of the pregnant women engaged in binge drinking.
 
Reid N., Dawe S., Shelton D., Harnett P., Warner J., Armstrong E., LeGros K., & O’Callaghan F., Alcoholism: Clinical and Experimental Research, 18 November 2015, doi: 10.1111/acer.12903
Individuals with fetal alcohol spectrum disorders (FASDs) can experience profound impairments and long-term adverse outcomes. This systematic review adopts a life span perspective providing an extensive analysis of the available literature. Conclusions from the review suggest there is a growing evidence for interventions that improve outcomes for early to middle childhood. However, a lack of research exists outside of this developmental period. This lack of research is concerning given the potential positive impact of early intervention, for individuals and, financially, for governments. In addition, the lack of interventions for adolescents and adults further highlights the widening developmental gap and the potential influence of secondary disabilities for this at-risk population.

 

May PA., de Vries MM., Marais A-S., Kalberg WO., Adnams CM., Hasken JM., Tabachnick B., Robinson LK., Manning MA., Lyons Jones K., Hoyme D., Seedat S., Parry CDH., & Hoyme HE., Drug and Alcohol Dependence, 31 Dec 2015, doi:10.1016/j.drugalcdep.2015.12.023
Prevalence and characteristics of the continuum of diagnoses within fetal alcohol spectrum disorders (FASD) were researched in previously unstudied rural, agricultural, lower socioeconomic populations in South Africa (ZA). Results show that very high rates of FASD exist in these rural areas and isolated towns where entrenched practices of regular binge drinking co-exist with challenging conditions for childbearing and child development.
 
The Impact of Prenatal Ethanol Exposure on Neuroanatomical and Behavioral Development in Mice
Abbott CW., Kozanian OO., Kanaan J., Wendel KM., & Huffman KJ., Alcoholism: Clinical and Experimental Research, 4 Jan 2016, doi:10.1111/acer.12936
In utero alcohol, or ethanol (EtOH), exposure produces developmental abnormalities in the brain of the fetus, which can result in lifelong behavioural abnormalities. Results from this study reveal long-term alterations to cortical anatomy, including atypical developmental cortical thinning, and abnormal subcortical development as a result of in utero EtOH exposure. Furthermore, offspring exposed to EtOH during the prenatal period performed poorly on behavioural tasks measuring sensorimotor integration and anxiety. Insight from this study will help provide new information on developmental trajectories of prenatal EtOH exposure and the biological etiologies of abnormal behaviour in people diagnosed with FASD.
 
Interhemispheric Functional Brain Connectivity in Neonates with Prenatal Alcohol Exposure: Preliminary Findings
Donald KA., Ipser JC., Howells FM., Roos A., Fouche J-P., Riley EP., Koen N., Woods RP., Biswal B., Zar HJ., Narr KL., & Stein DJ., Alcoholism: Clinical and Experimental Research, 4 Jan 2016, doi: 10.1111/acer.12930
Children exposed to alcohol in utero demonstrate reduced white matter microstructural integrity. While early evidence suggests altered functional brain connectivity in the lateralization of motor networks in school-age children with PAE, the specific effects of alcohol on the establishment of intrinsic connectivity in early infancy have not been explored. Sixty subjects received functional imaging at 2-4 weeks of age for 6-8 minutes during quiet, natural sleep. Although results are preliminary, findings suggest PAE may disrupt the temporal coherence in blood oxygenation utilization in intrinsic networks underlying motor performance in newborn infants. Studies that employ longitudinal designs to investigate the effects of in utero alcohol exposure on the evolving resting-state networks will be key in establishing the distribution and timing on connectivity disturbances already described in older children.
 
Khoury JE. & Milligan K., Journal of Attention Disorders, 3 Jan 2016, doi: 10.1177/1087054715622016
FASD and ADHD are associated with a range of neurocognitive impairments. Executive functioning deficits are a hallmark feature of both disorders. This meta-analysis was undertaken to disentangle the behavioural phenotype of FASD and ADHD by quantitatively differentiating executive functioning differences between these two groups. When compared with typically developing samples, the FASD and ADHD samples demonstrated significant executive functioning deficits. FASD samples experience significantly greater deficits when compared with ADHD samples. Results further our understanding of the cognitive differences between FASD and ADHD samples and have the potential to influence future basic research, assessment, and intervention.

 

Upcoming Events

AUSTRALIA/NEW ZEALAND

DATE: 13-14 April 2016
DETAILS: Piecing the puzzle together: Designing, developing and implementing evidence-based AOD services is the first of the workshop series in 2016. Mr Colin O’Driscoll, Dr Nicole Lee and Dr Joel Porter facilitate this two-day interactive workshop focused on envisioning, creating and implementing innovative alcohol and other drug (AOD) treatment services. This workshop will provide an update on the latest scientific information on substance misuse treatment and the implementation of evidence-based practices.


ATDC 2016 - Rethinking Prevention: A broader agenda – Hobart, Tasmania
DATE: 12-13 May 2016
DETAILS: The Alcohol Tobacco and other Drugs Council of Tasmania 2016 conference, Rethinking Prevention: A broader agenda, encourages presenters and delegates to discuss how we support and provide prevention, treatment and harm reduction interventions in the current environment and into the future. Recognising preventative approaches at all levels of our work is one aspect of rethinking prevention. The conference will explore how we prevent harm in multiple ways, not only dealing with substance use activity.

 
DATE: 19-20 May 2016
DETAILS: This conference, hosted by the Australian and New Zealand Mental Health Association, will include workshops, presentations and forums dedicated to sharing skills and understanding in the treatment of all addictive disorders including alcohol and other drugs, behavioural addictions, and the emerging field of online compulsive behaviour in both adults and children.
 
DATE: 30 October – 2 November 2016
 
INTERNATIONAL
7th National Biennial Conference on Adolescents and Adults with FASD – Vancouver, Canada
DATE: 6 – 9 April 2016
DETAILS: This interactive 2016 conference will provide an opportunity to be at the forefront of addressing these issues. We will leverage the experience of the diverse group of professionals, researchers, students, families and individuals with FASD who attend to stimulate the discussion of research, evidence for practice, models, and ideas to expand our knowledge of how we can sustain and enhance the lives of those with FASD.
 
DATE: 12-14 September 2016, plus training day for parents and professionals 15 September 2016
DETAILS: The 4th European Conference on FASD will be held at the prestigious campus of the Royal Holloway University, London. This conference brings together academics, educators, non-governmental organisations and charities, legislators and politicians, lawyers and individuals involved in the criminal justice system, birth and adoptive families alongside individuals who themselves have FASD; shared learning will help promote the understanding of this disorder in the UK, Europe, and internationally. The conference will cover a wide range of topics including prevention, social determinants, diagnosis, epigenetics, psychological profiles, behavioural management, education, prevalence, family support, criminal justice system difficulties, social care needs, practical management, pharmacology, and other cutting-edge research that may be submitted or invited.

 

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