The Loop - e-news
National Organisation for Fetal Alcohol Spectrum Disorders Australia
[ Issue #29, February 2016 ]
More News
Dear Members & Supporters,
This month in “The Loop”

A focus this month was the release of the Center for Disease Control's recommendations on alcohol use in pregnancy and the message for women.  There was quite a reaction with published views from both sides of the table. NOFASD Australia maintains the message is backed by science, alcohol is toxic and the risk is real for all parents: If you are planning to be pregnant, don't drink alcohol; if you are planning to drink, plan to not fall pregnant.

At the end of March, we will launch the first NOFASD Australia online forum for parents and carers. This is a secure and moderated forum for participants to ask questions, share information and offer mutual parent support. Look for details on Facebook or on the NOFASD Australia website in the news section.  In April-May, we plan to launch a second online forum for service providers and then a third forum will follow in June for those who have completed our Train the Trainer workshops. 

Our network is growing and over the past two months, 45 new members have been welcomed. 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.
 
From My Desk...

On December 31st 2015, NOFASD Australia’s contract with the Australian Government under the Health System Capacity Development Fund was to end after 3 ½ years. Louise Gray, (NOFASD Chairperson) and I met with now Minister for Rural Health, Fiona Nash and her advisor to talk about how the organisation might continue. With great relief, NOFASD Australia accepted new funding under the Commonwealth FASD Action Plan which, in the interim, provides for a 6-month extension. Most important is continuing to receive contacts highlighting the successes and/or difficulties experienced by parents in the care role so that NOFASD Australia can continue to be the essential bridge between researchers, clinicians and the wisdom from lived experience.

 

While in Canberra, we also met with the Shadow Assistant Minister for Health, Stephen Jones who proposed meeting to inform himself on FASD and the lived experience. We contacted a parent and I am pleased to report that the wonderful parents from near Canberra took up this offer last month. Thanks so much Naomi. Feedback from parents is taken seriously and our website will undergo some changes to make it much more user friendly for our most important client group. In addition to responding to enquiries through the website and the 1300 306 238 helpline, we are working on other strategies to ensure wider access to support parents and families.

 

We have established a National Parent Advisory Group (NPAG) with representatives from across the country. NPAG provides direct advice to the NOFASD Australia Board through the co-chair of NPAG who is a Board member and issues of concern for parents are raised and discussed on agenda standing items including but not limited to: FASD as a diagnosed disability; education concerns; national FASD health promotion; updates on the NDIS; resource development; social media and any other items of current relevance. NPAG meets monthly by teleconference and as a parent, you are invited to raise an issue of concern through contact with staff on the 1300 306 238 number or email enquiries@nofasd.org.au and we will connect you with an NPAG member in your state or territory.

 

The need of Australian families was evident following the airing of the 4 Corners program on FASD last November. Many of the 200-plus calls we received from individuals, parents and/or family members in the days that followed had a similar theme with opening statements like 'I just watched 4 Corners and when I heard the stories, I thought they were describing me or my child.' What was confirmed too, was the number of adult children living with recognised risk but undiagnosed FASD and the tragic live experiences for this group of people and their families. Incomplete education, not able to maintain employment, failed relationships with family and friends, isolation, alcohol and other drugs dependency are sadly all too common stories. What we also heard were stories of loneliness and desperation, grief from unfair labelling, court cases and incarceration, children removed from care, risky behaviour.

 

It reminds us that FASD impacts on lives across the spectrum and we need to do more than concentrate our important efforts in improving diagnosis and services for children. Certainly the revised diagnostic criteria from Canada has embraced the lifespan impact of FASD. You can read more here.

 

Please read the profiles of the 16 NOFASD Australia ambassadors on the website, with two more to be uploaded in the near future. We are inviting ambassadors and others with an interest or care role in the FASD arena to share their thoughts in future editions of the newsletter.
 
Vicki

 

Of Special Interest

Pregnancy and Alcohol Questionnaire
This research study looks at factors which influence the alcohol consumption patterns of mothers during pregnancy. This study is being supervised by Dr Helen Correia at Murdoch University and Dr Nyanda McBride (National Drug Research Institute).
In Australia we are still learning about how to support women and families both during and after pregnancy. This study is focused on trying to understand how best to support women during their pregnancy by focusing on the role of family members and health professionals.

Your participation in this study is entirely voluntary.. All information is treated as confidential and no names or other details that might identify you will be used in any publication arising from the research. Please note that as the survey is anonymous, once you submit your answers, we cannot remove them.

Growing Up in Australia's Child Health CheckPoint
The Child Health CheckPoint is a new phase of the Growing Up in Australia study.  It is a special one-off physical health assessment offered to the 11-12 year old children participating in Growing Up in Australia.  The aim of the study is to learn more about the health of young Australians as they pass  through the 'checkpoint' between childhood and adolescence.  Information from the study will help researchers and policy-makers understand how a child's first decade determines their health as they approach the teenage years.

 

National & NZ News and Media

AUSTRALIA

Rates of Foetal Alcohol Spectrum Disorder in remote Indigenous communities decline
Despite significant concern about the effects of drinking alcohol during pregnancy, there's still little information about the prevalence of Foetal Alcohol Spectrum Disorder (FASD) in Australia. FASD is the most common preventable cause of intellectual impairment in the developed world.  Here in Australia, Dr James Fitzpatrick has seen first-hand the damage caused by the condition.  He's spent most of his career working in Western Australia's Kimberley region, establishing Patches Paediatrics in the remote Fitzroy Crossing. Now, he's opened a clinic in Perth to help the scores of city kids affected by FASD. 


Australian prison population grows 20 per cent in last decade

The Productivity Commission's report on government services on Friday revealed that the national adult imprisonment rate was about 190 per 100,000 people in 2014/15, compared to 158 in 2005/06.  The indigenous imprisonment rate per 100,000 Aboriginal and Torres Strait Islanders was higher, at 2196, compared to 139 per 100,000 non-indigenous people, it said. "It's reflective, partly, of changed community attitudes towards crime, which judges are absorbing and getting signals from Parliament on, " said Monash University Emeritus Professor Arie Frieberg. "All the evidence is that we're increasingly locking up the people with major drug (problems), mental impairment ... fetal alcohol syndrome..."

Drugs, booze killing new mums
Drug and alcohol misuse is now the most common cause of maternal death in Tasmania, prompting a leading specialist to call for targeted services for expecting mums. Obstetrician and gynaecologist Amanda Dennis chairs the state's maternal mortality committee and said data from recent years revealed a worrying trend - that drug and alcohol abuse and domestic violence had overtaken medical complications as the leading causes of maternal mortality. A health department spokesman welcomed a drop in the number of pregnant women drinking but said it was vital that the good work continued. "Public Health Services is continuing to work with the National Organisation for Fetal Alcohol Spectrum Disorder and local organisations to put in place measures to reduce alcohol consumption by pregnant women, including by training health professionals and targeted awareness-raising," he said.


NEW ZEALAND
Waikato DHB proposes to take action on fetal alcohol disorder
The Waikato District Health Board plans to submit a proposal to address fetal alcohol spectrum disorder, a condition that could affect 4000 people in the region the board covers. The disorder (FASD) has been described by medical professionals as one of New Zealand's biggest health problems, yet the Ministry of Health does not have a comprehensive plan to tackle the issue.  There is no New Zealand data on the prevalence of the disorder, but American data suggests it affects 1 per cent of the population.

Canadian experts on FASD visit New Zealand
Two Canadian experts are visiting New Zealand over the next fortnight to present a series of workshops on providing effective services to children affected by Fetal Alcohol Spectrum Disorder (FASD) and their families.  Non-government organisations Alcohol Healthwatch, Fostering Kids New Zealand and FASD-CAN are working together to present these workshops across the country to give professionals, caregivers and families an opportunity to access the very latest information and experience around research programmes and practical strategies for supporting children with FASD.

NZMA submission on Foetal Alcohol Spectrum Disorder (FASD) action plan
The NZMA is calling on the government to take action to modify New Zealand's "alcogenic" environment which promotes a culture of excessive drinking leading to Foetal Alcohol Spectrum Disorder (FASD).  The association argues that while doctors and other healthcare professionals have a key role in advising women who are pregnant or considering pregnancy against drinking alcohol, the government is in the best position to enact the "legislative, regulatory and policy measures" needed to change the country's drinking culture.

'It makes me feel like my brain's going to burst' - 46,000 Kiwis suffer from fetal alcohol disorder
Fetal alcohol spectrum disorder has the ability to cause problems from learning difficulties to violent emotional meltdowns. And for some 46,000 Kiwis, FASD is a daily battle which the Government will not recognise as a disability. Seven Sharp spoke to several families with a child suffering from FASD, including Alex and his mum Jackie, who drank while pregnant. The pair have been living with the lifelong health problem for all of Alex's young life. 

Resources & Multimedia

FOR PARENTS, CARERS & FAMILIES
Teens Growing up with Fetal Alcohol Syndrome
An episode of the "That Sober Guy" podcast with Dr Ira Chasnoff, president of NTI Upstream and a Professor of Clinical Pediatrics at the University of Illinois Collage of Medicine in Chicago. Dr Chasnoff is one of the USA's leading researchers in the field of child development and the effects of maternal alcohol and drug use on the newborn infant and child.


Jill Burke: 3 ways to get your difficult child to do what you want

Children with brain-based disorders often have associated behaviors that can drive parents nuts: a meltdown in the restaurant; kicking and screaming over something that seems ridiculously minor; impulsivity or rigidity that makes even the most mundane, routine tasks seem like endurance sports. The list goes on. Here Jill Burke provides some basic tips to help you regain a sense of control.

Always Remember the Brain: 30 Strategies for Parents of Children with a Fetal Alcohol Spectrum Disorder
People who have been exposed to alcohol in utero have brain differences that express themselves behaviorally. As parents of children with FASDs it's important to keep these brain differences in mind when caring for our children. Remembering brain differences and providing environmental change and accommodations to help support people with FASDs is called the neurobehavioral, or NB, approach. The scenarios and strategies in this article are examples of how to put this knowledge into action.

How To Discipline A Child with FASD
Parenting children with FASD is an uphill battle. This is especially true when it comes to discipline. How do you balance necessary consequences with a child who's brain lacks the executive functioning to understand.  If you know a child with an FASD, you know that typical discipline just doesn't work. In our home we are raising two sons diagnosed with ARND. Our sons were exposed to alcohol before birth. FASDs do not go away, and there is no way to heal the damage that has been done.  For a long time we parented these children the same way we parented our children who don't have a brain injury. We wound up frustrated and hopeless and our children ended up confused and angry. We know our job as parents is to teach our children the skills they will need to be successful adults. After a lot of research, and trial and error, we have come up with some strategies that have been effevtive with our sons.


FASD vs. ASD

Has your child with an FASD ever been diagnosed with an Autism Spectrum Disorder (ASD) or been in an ASD program in school? When Tanya Weinmeyer's son was four they gave him a diagnosis of PDD-NOS (Pervasive Developmental Disorder - Not Otherwise Specified). PDD-NOS is under the Autism Spectrum umbrella. In first grade, he received his FAS diagnosis. This article outlines some of the similarities, and the differences, between FASD and ASD.


FOR TEACHERS

School success with FAS(D)
Jeff Noble interviews Crystal Millions, who lives with FASD and currently attends university, about what's making her successful at school.

FASD is a disability
FASD is a physical disability, and NOT a behaviour issue.  The brain has been damaged by alcohol prenatally. Insight into teaching children with FASD.

FASD is People Podcast #1: Matt Sinclair
RJ & Adrienne talk to Matt Sinclair about his advocacy and teaching activities.  He talks about his sensory differences and Adrienne relates a story that happened when she was a teacher, where kids were judged as disrespectful for wearing their hoods up, but if seen a different way they could have been modifying their environment.  RJ tells his story of being diagnosed with FASD as an adult.


FOR SERVICE PROVIDERS

Fetal Alcohol Spectrum Disorders in Adults: Ethical and Legal Perspectives
This complete downloadable book, edited by Monty Nelson and Marguerite Trussler, in PDF and ePub format, includes chapters on ethical considerations and implications in FASD, clinical perspectives on criminal behaviour in FASD, judicial perspectives, social and policy issues, personal perspectives and stories. 

Developmental Timeline of Alcohol-Induced Birth Defects
Consumption of alcohol during pregnancy can result in a continuum of embryonic developmental abnormalities that vary depending on the severity, duration, and frequency of exposure of ethanol during gestation. Alcohol is a teratogen, an environmental agent that impacts the normal development of an embryo or fetus.  In addition to dose-related concerns, factors such as maternal genetics and metabolism and the timing of alcohol exposure during prenatal development also impact alcohol-related birth defects.

FOR LAW ENFORCEMENT & CORRECTIONS
Oral Language and Communication Factors to Consider When Supporting People with FASD Involved with the Legal System
Hand L., Pckering M., Kedge S., & McCann C., Fetal Alcohol Spectrum Disorders in Adults: Ethical and Legal Perspectives, 29 July 2015, doi: 10.1007/978-3-319-20866-4_9
Difficulties with oral language are always present for those with FASD. However, it is not always easy to appreciate where language skills are involved, as other areas such as cognition, behavior, social skills and emotional regulation frequently involve communication skills, and they can be hard to separate. At this level, skills are complex and interactive. However, improving communication skills can have spin-off effects on the other areas. This chapter outlines how communication skills are so often involved in the trouble that young people with FASD have with the law, and considers what advice is available to help with oral language problems.

Why People with FASD Fall for Manipulative Ploys: Ethical Limits of Interrogators' Use of Lies
Greenspan S. & Driscoll JH., Fetal Alcohol Spectrum Disorder in Adults: Ethical and Legal Perspectives, 29 July 2015, doi: 10.1007/978-3-319-20866-4_2
People with FASD are easily manipulated by others, and such social vulnerability is a major reason why they are so likely to get into serious legal and other forms of difficulty. Police interrogations are also manipulative, in that a detective is attempting to use various ploys - including deceptive statements - to persuade someone to do something he is initially reluctant to do, namely admit to having committed a criminal act.  In this paper, the authors use an audiotape of an actual interrogation of a young man with FASD who initially strongly denied guilt, to better understand the way interrogative manipulations (including lies) were used to break his will and get him to confess to a crime which he may or may not have committed.

International News and Media

CANADA

N.W.T. health care workers get rundown on new FASD diagnostic guidelines
A pediatrician and two psychologists specializing in diagnosing and treating FASD were in Yellowknife this week training health care workers on the new Canadian diagnosis guidelines released late last year. "It really addresses a lot of the previous gaps and inconsistencies," said pediatrican Dr. Hasu Rajani, who is part of a travelling FASD diagnostic team based in Alberta. Updated from 2005, the latest guidelines include new FASD symptoms and new screening questions for women who are pregnant.

Most Canadians drink alcohol, unaware of risk
The chief public health officer says almost 80 per cent of Canadians drink alcohol and many don't realize the risks of even light drinking.  "Drinking is such a normal part of life for many people, however alcohol is not harmless," said Dr. Gregory Taylor. ... About 3,000 babies per year are born with fetal alcohol syndrome caused when women drink during pregnancy, notes the report. Some 330,000 Canadians have cognitive impairments caused this way.

St. Amant moves ahead with $1-M donation
St. Amant is shifting to a health care centre, with nearly a million dollars in support.  A $950,000 donation from the Winnipeg Foundation will increase the centre's capacity to deliver services.  "As St. Amant shifts from one of the last developmental centres in Canada to a health-care centre, we as a community need to look at the web of support available and ensure we can help children and adults with developmental disabilities, autism, acquired brain injuries and fetal alcohol spectrum disorders to live healthy lives with the most comprehensive and person-centred services possible," St. Amant president John Leggat said in a release.

UNITED KINGDOM

Doctors call for better training and support to prevent, diagnose and manage fetal alcohol syndrome
In a revised BMA report, leading doctors call for better training and support to help healthcare professionals in the UK prevent, diagnose and manage fetal alcohol spectrum disorder (FASD), adn reduce the number of children affected each year.  Alcohol and Pregnancy: Preventing and managing fetal alcohol spectrum disorders highlights that despite FASD affecting between 2% and 5% of school-age children in Western Europe, there is still an unacceptable lack of support for those affected in the UK - with many going without diagnosis, or being misdiagnosed.


How foetal alcohol spectrum disorder affects the care system

Sam Lister and her partner Paul had never heard of foetal alcohol spectrum disorder.  But as experienced foster carers with 13 placements behind them, they new there was something wrong with their adoptive son Lee when he was just five-months-old. "He was floppy, he couldn't sit up. He just wasn't right," says Sam.  By the time Lee was two his behaviour was erractic. He was biting, spitting and showing compulsive habits. These are all typical symptoms of FASD.

How foetal alcohol spectrum disorder affects the care system
Sam Lister and her partner Paul had never heard of foetal alcohol spectrum disorder. But as experienced foster carers with 13 placements behind them, they knew there was something wrong with their adoptive son Lee when he was just five-months-old. By the time Lee was two his behavior was erratic. "Lee had a thing about locked cupboards and would constantly turn the lights on and off," Sam remembers. It took another two and a half years before her son, now aged six, was given an acurate diagnoses by a paediatrician. "My support workers held their hands up and admitted they didn't know anything about FASD."  Her story is far from unique, according to Julia Brown, founder of support charity the FASD Trust.

UNITED STATES OF AMERICA
FASD Center for Excellence to Close April 22, 2016
As of April 22, 2016, the Substance Abuse and Mental Health Services Administration (SAMHSA) Fetal Alcohol Center for Excellence (FASD CFE) will cease operations due to lack of funding. Congressionally authorized under the Children's Health Act of 2000, the FASD CFE has helped to greatly increase awareness of FASD, FASD-related services, and current research. The FASD CFE has contributed to SAMHSA's overall mission to reduce the impact of substance misuse and mental illness on America's communities.
NOFAS has issued an Action Alert, encouraging advocates to contact both SAMHSA and the Center for Excellence by 31 March 2016. Doing do will encourage continuing attention to the issue at the agency and could help justify the allocation of future resources. A lack of communication from advocates will likely ensure that there will be no further attention or investment for FASD at SAMHSA.


CDC's Message to Women About Alcohol Needs Nuance

Earlier this month, the Centers for Disease Control and Prevention (CDC) released a statement about the risk of alcohol exposure during pregnancy that began with the following: "An estimated 3.3 million women between the ages of 15 and 44 years are at risk of exposing their developing babies to alcohol because they are drinking, sexually active, and not using birth control."

CDC recommends alcohol screenings for all women to prevent birth defects
Some young women take exception to a Centers for Disease Control and Prevention campaign about consuming alcohol during childbearing years. But it is a caution that health care providers say is needed.  Western Kentucky University freshman Giselle Kessler of Louisville thinks the CDC is trying to place more restrictions on women with its recommendation to stop drinking alcohol if women are trying to get pregnant or could get pregnant.  "Just because I'm on birth control and I have the possibility of being pregnant doesn't mean like I have to limit myself and the things that I can do when I want to have fun," Kessler said. "Literally any woman can get pregnant, like even if she is on birth control or not."

Believe the CDC! Fetal Alcohol Syndrome is real and life-altering
Last week the Centers for Disease Control and Prevention released a report saying sexually active women not using birth control should also put a hold on drinking. The CDC report, released Tuesday, got right to the point. Alcohol use while pregnant can cause Fetal Alcohol Spectrum Disorder, "which are physical, behavioral, and intellectual disabilities that last a lifetime," the report authors said.  This is not news to me.  As an adoptive mom to three young adults living with permanent disabilities, I've lived with this stuff for two decades now. The disabilities my kids face are stunning, mind-numbing and never, ever can be discounted for more than an hour or two at a time.

Part 1: Children of alcohol abuse, and alcoholism
As we are in the throes of Children of Alcoholics Awareness Month, the following articles are written with the purpose to promote further awareness on the subject... a most serious subject which still exists in our communities and society as a whole.  When there is an alcoholic in the family, the whole family takes on alcoholism behaviors; their whole world revolves around the alcoholic. And the family members, in order to cope and survive, take on a number of roles that are very definitive and recognisable. Another aspect of alcoholism and the family: FASD. It is estimated that in excess of 30 million children are affected by alcoholism and other substances of addiction in the family setting, and when we look at adults reared in an alcoholic home the numbers are even more staggering.

Part II: Children of alcohol
Another major "sub-disease" of alcohol abuse and alcoholism (as well as the abuse and dependency on substances other than alcohol) among children is the Fetal Alcohol Syndrome (FAS), a diagnosed condition which in recent years has been changed to Fetal Alcohol Spectrum Disorders (FASDs). The concept of the Fetal Alcohol Syndrome was conceived and developed by Doctors David W. Smith and Kenneth L. Jones in 1973. There studies of 55,000 pregnancies in which 32 percent of the resultant births exhibited craniofacial, limb and cardiovascular defects associated with prenatal onset growth deficiency and development delay. Theirs was the first scientific study of the condition, and the first reported association between maternal drinking and child development.

Pregnant Women Put Babies at Risk With Alcohol
Drinking before and during pregnancy can cause lifelong physical, behavioral and mental problems for a child. Yet more than 3 million US women risk exposing their baby to alcohol, federal health officials reported.  An estimated 3.3 million women ages 15 to 44 who are sexually active are drinking and not using birth control. And, three in four women who want to get pregnant don't stop drinking when they stop using birth control, according to the US Centers for Disease Control and Prevention report.

Why the best way to prevent birth defects isn't about Zika
Given the media frenzy around Zika virus, one might assume a disease responsible for 10 times as many birth defects in the United States - that's one in 100 live births - would generate 10 times the attention in the media. Instead, that disease has slowly found its way to the back burner of our collective cognizance: fetal alcohol spectrum disorders (FASD). Some 40,000 babies are born each year with FASD, which include fetal alcohol syndrome (FAS) and other non-FAS neurological or developmental disorders caused by alcohol consumption during pregnancy.

Alcohol exposure during pregnancy affects multiple generations
When a mother drinks alcohol during pregnancy, even a small dose, she can increase the chances that the next three generations may develop alcoholism, according to a new study from Binghamton University. A research team lead by Nicole Cameron, assistant professor of psychology at Binghamton University, was the first to investigate the effects of alcohol consumption during pregnancy on alcohol-related behavior (consumption and sensitivity to the effect of alcohol) on generations that were not directly exposed to alcohol in the uterus during the pregnancy.

Whiteclay activists take concerns to liquor regulators, state leaders
Over the past 16 years, Nora Boesem and her husband, Randy, have taken in more than 150 foster children, nearly all of them from South Dakota's Pine Ridge Indian Reservation and suffering from fetal alcohol spectrum disorder.  The Newell couple has adopted or taken permanent custody of 12 of those children, including Donovan, who hung himself at the age of 15.  She said she blames his suffering on those who fed her son's mother the alcohol that poisoned him while he was in the womb.

Latest Research

FASD and Art Therapy: An Exploratory Review
The purpose of this paper is to review art therapy (AT) and its effectiveness as a treatment approach for individuals diagnosed with fetal alcohol spectrum disorder (FASD).  In 2008, Gerteisen explored the use of AT as a viable intervention model for individuals affected by FASD. This paper identifies applicable therapeutic AT approaches identified by Gerteisen's research.  

Impairment of motor skills in children with fetal alcohol spectrum disorders in remote Australia: The Lililwan Project
Lucas BR., Doney R., Latimer J., Watkins RE., Tsang TW., Hawkes G., Fitzpatrick JP., Oscar J., Carter M., & Elliott EJ., Drug and Alcohol Review, 16 February 2016, doi: 10.1111/dar.12375
This study aimed to characterise motor performance in predominantly Aboriginal children living in very remote Australia, where rates of prenatal alcohol exposure (PAE) are high. Motor performance was assessed, and the relationship between motor skills, fetal alcohol spectrum disorders (FASD) and PAE was explored. The study showed that almost 10% of children with FASD has significant motor impairment.  Evaluation of motor function should routinely be included in assessments for FASD to document impairment and enable targeted early intervention.


Ethanol induces cytostasis of cortical basal progenitors

Riar AK., Narasimhan M., Rathinam ML., Henderson GI., & Mahimainathan L., Journal of Biomedical Science, 19 January 2016, doi: 10.1186/a12929-016-0225-8 
The developing brain is a major target for alcohol's actions and neurological/functional abnormalities include microencephaly, reduced frontal cortex, mental retardation and attention-deficits.  Previous studies have shown that ethanol altered the lateral ventricular neuroepithelial cell proliferation. However, the effect of ethanol on subventricular basal progenitors which generate the majority of the cortical layers is not known.  The findings of this study demonstrate that ethanol impacts the expansion of basal progenitors by inducing cytostasis that might explain the anomalies of cortico-cerebral development associated with fetal alcohol syndrome.

Fetal Alcohol Syndrome in Sudden Unexpected Death in Infancy: A Case Report in Medicolegal Autopsy
Tangsermkijsakul A., The American Journal of Forensic Medicine and Pathology, 2016, doi: 10.1097/PAF.0000000000000215
Fetal alcohol spectrum disorder is a range of birth defects associated with prenatal alcohol exposure. Fetal alcohol syndrome (FAS) is the most serious form of FASD.  Infants with FAS are prone to death because of various physical abnormalities. Consequently, infants with FAS may be presented in the medicolegal investigation as a form of sudden unexpected death in infancy. The author reported a 6-month-old male infant who was found dead at home. The hisotry of maternal ethanol consmption during pregnancy was obtained. The infant was diagnosed with FAS at the autopsy because he was presented with postnatal growth retardation, multiple facial abnormalities, and abnormal brain structures, which met the criteria of FAS. The cause of death was severe aspiration pneumonia. The purposes of this case report are to show an uncommon manifestation of sudden unexpected death in infancy case for the forensic pathologists and to emphasize on the national healthcare problem.

Experiences in the Canadian Criminal Justice System for Individuals with Fetal Alcohol Spectrum Disorders: Double Jeopardy?
Pei J., Leung WSW., Jampolsky F., & Alsbury B., Canadian Journal of Criminology and Criminal Justice., January 2016, doi: 10.3138/cjccj.2014.E25
The study explored the experiences of individuals in the criminal justice system with a Fetal alcohol spectrum disorder (FASD) in order to identify possible ways to reduce the likelihood of re-entry into the criminal justice system. Semi-structured interviews were conducted to capture the voices of two participant groups: (1) individuals with an FASD, and (2) professionals who work with clients with an FASD. The study provides insight into the unique experiences of individuals in the criminal justice system with an FASD - with reference to both risk factors and relevant personal strengths.  Implications for practice are discussed, including suggestions for increasing support, awareness, and a focus on strengths.

The Influence of Extrinsic Reinforcement on Children with Heavy Prenatal Alcohol Exposure
Graham DM., Glass L., & Mattson SN., Alcoholism: Clinical and Experimental Research, 4 February 2016, doi: 10.1111/acer.12959
Prenatal alcohol exposure affects inhibitory control and other aspects of attention and executive function. However, the efficacy of extrinsic reinforcement on these behaviors has not been tested.  Alcohol-exposed children, children with ADHD, and controls completed a flanker tasks with 4 reward conditions. Results concluded that alcohol-exposed children, but not children with ADHD, had impaired interference control in comparison with controls, supporting a differential neurobehavioral profile in these 2 groups. Both clinical groups were equally affected by introduction of reinforcement, although the type of reinforcement did not differentially affect performance as it did in the control group, suggesting that reward or response cost could be used interchangeably to result in the same benefit.

Which women are missed by primary health-care based interventions for alcohol and drug use?
Roberts SCM., Ralph LJ.,Wilsnack SC., & Foster DG., Addictive Behaviors, 30 December 2015, doi: 10.1016/j.addbeh.201512.015
Women of reproductive age who binge drink or have alcohol-related problem symptoms (APS) and who do not use contraception are considered at risk of an alcohol-exposed pregnancy (AEP). In the US, efforts to prevent AEPs focus largely on delivering interventions in primary health care settings. While research suggests that these interventions are efficacious for women reached, it is unclear to what extent these interventions are likely to reach women at risk of AEPs. More than 40% of 956 women seeking pregnancy termination at 30 US facilities did not have a USOC (usual source of health care), with higher proportions among women with an APS, primary health-care based approaches to AEP prevention seem unlikely to reach the majority of women who have an APS and are at risk of an unintended pregnancy.

Association between alcohol consumption during pregnancy and risks of congenital heart defects in offspring: meta-analysis of epidemiological observational studies
Wen Z., Yu D., Zhang W., Fan C., Hu L., FengY., Yang L., Wu Z., Chen R., Yin K., & Mo X., Italian Journal of Pediatrics, 3 February 2016, doi: 10.1186/s13052-016-0222-2
This study explores the association between maternal alcohol consumption and/or binge drinking and congenital heart defects (CHDs), conducting a meta-analysis for more sufficient evidence on this issue.  Medline, EMBASE, and the Cochrane Library were searched from their inceptions to December 2014 for case-control and cohort studies that assessed the association between maternal alcohol consumption and CHD risk. Study-specific relative risk estimates were calculated using random-effect or fixed-effect models.  A total of 19 case-control studies and 4 cohort studies were included in the meta-analysis, which concluded that maternal alcohol consumption is modestly not associated with the risk of CHDs; however, further investigation is needed to confirm this conclusion.

Theory of Mind in Children with Fetal Alcohol Spectrum Disorders
Lindinger NM., Malcolm-Smith S., Dodge NC., Molteno CD., Thomas KGF., Meintjes EM., Jacobson JL., & Jacobson SW., Alcoholism: Clinical and Experimental Research., 4 February 2016, doi: 10.1111/acer.12961
Theory of mind (ToM) refers to the ability to understand and make inferences about other people's intentions, feelings and beliefs. Although children with fetal alcohol spectrum disorders (FASD) are known to have deficits in social-cognitive function, little is known about ToM in FASD. ToM ability was assessed using a developmentally sensitive ToM battery, including the reading the mind in the eyes (RME) test, a measure of mental inferential ability that has been found to be impaired in other clinical populations. IQ and executive functions (EF) were assessed as potential mediating variables. Findings suggest that deficits in higher-order ToM function may play a significant role in the social-cognitive behavioral impairment in FASD.

Improving Educational Outcomes in Fetal Alcohol Spectrum Disorder Through Interagency Collaboration
Boys CJ., Bjorke J., Dole KN., Dalnes C., Terwey S., & Chang P-N, Journal of Pediatric Neuropsychology, 4 February 2016, doi: 10.1007/s40817-016-0011-2
Children with fetal alcohol spectrum disorders (FASD) demonstrate a significant array of neurocognitive impairments including deficits in intelligence, attention, processing speed, executive functions, language functions, visual-spatial abilities, memory, and academic achievement.  Neuropsychological impairments in children and adolescents with prenatal exposure to alcohol follow a continuum from no identifiable effects at one end to pervasive impairments across areas at the other end.  Due to the continuum of impairments, interagency collaboration was developed to address the special educational needs of the children.  The current paper has several purposes: (1) to allow school district staff who were offered an opportunity to share their perspectives and expertise on FASD and special need issues facing their students diagnosed with FASD; (2) to identify the school and social challenges faced by students diagnosed with FASD; (3) to describe the collaborative interagency program and potential impact on classroom ecology; and (4) to determine if the interagency collaboration had an effect on intervention practices of educators within the classroom.

Developmental ethanol exposure-induced sleep fragmentation predicts adult cognitive impairment
Wilson DA., Masiello K., Lewin MP., Hui M., Smiley JF., & Saito M., Neuroscience, 15 February 2016, doi: 10.1016/j.neuroscience.2016.02.020
Developmental ethanol (EtOH) exposure can lead to long-lasting cognitive impairment, hyperactivity, and emotional dysregulation among other problems. In healthy adults, sleep plays an important role in each of these behavioral manifestations.  This study explored circadian rhythms (activity, temperature) and slow-wave sleep (SWS) in adult mice that had received a single day of EtOH exposure on postnatal day 7 and saline littermate controls. Results suggest that disruption of SWS and its plasticity are a secondary contributor to a subset of developmental EtOH exposure's long-lasting consequences.

Prenatal Alcohol Exposure, FASD, and Child Behavior: A Meta-analysis
Tsang TW., Lucas BR., Olson HC., Pinto RZ., & Elliott EJ., Pediatrics, March 2016 issue, doi: 10.1542/peds.2015-2542
FASD and prenatal alcohol exposure (PAE) are associated with behavioral difficulties, although there are no published systematic reviews that summarize and critique the literature. The objective of this meta-analysis was to describe the behavioral characteristics of children with PAE and/or FASD, assessed using the Achenbach Ssytem of Empirically Based Assessments for school-aged children with parent, teacher, and youth (self-report) forms. The meta-analysis reveals that FASD and PAE are associated with problematic behavior in many, but not all domains. This clearly affects families, and should be considered in clinical practice by providers.

Upcoming Events

AUSTRALIA/NEW ZEALAND

Australian Winter School – Brisbane, Queensland
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
DETAILS: APSAD Sydney 2016, to be held at Four Points Darling Harbour in central Sydney, will showcase high quality scientific research and lessons learnt from practitioners working in the field. APSAD Sydney 2016 will focus on emerging issues, new treatment, prevention, and policy approaches to the drug and alcohol field and will feature an impressive selection of international and national keynote speakers as well as concurrent session presentations, poster presentations, symposia, and workshops. 

INTERNATIONAL
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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