The Loop - e-news
National Organisation for Fetal Alcohol Spectrum Disorders Australia.
[ Issue #31, April 2016 ]
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Dear Members & Supporters,
This month in “The Loop”

In this April issue of The Loop, we introduce Emeritus Professor John Boulton to the "From My Desk" section.  Professor Boulton writes of the invisibility of FASD.

 

We have a jam-packed issue, with plenty of resources for all people who may be involved with someone affected by FASD, along with lots of recent news stories from Australia (including the NT Government's silence on its 14-month old report on FASD.  We also congratulate members of the FASD community on recent honours and recognitions.

 

In May, NOFASD Australia will present a webinar, 'An Introduction to Fetal Alcohol Spectrum Disorder.' The date is yet to be determined, but stay posted via our website's Upcoming Events page, and our Facebook page.

 

Also last month we opened our Forums for discussion about FASD. There's more information to come, so be sure you stay updated by signing up as a member. At the moment the forums are open to all registrations, but in future we will be looking at opening separate forums for Parents/Carers, as well as those who have been through our 'Training of Trainers' program, amongst others.

 

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...

This month we introduce Professor John Boulton.  Professor Bolton is the Emeritus Professor of Paediatrics at the University of Newcastle, where he was appointed Foundation Professor in 1980; a member of the Newcastle FASD Prevention working group; and national ambassador for NOFASD Australia.  Professor Bolton holds an honorary professorial appointment within the Centre for Values, Ethics and Law; an adjunct professorial affiliation at the University of Notre Dame in Broome, WA; and a professorial fellowship at the Telethon Kids Institute at UWA, Perth, WA. In 2011 he was awarded the Howard Williams Medal for his career contribution to Paediatrics by the Division of Paediatrics of the Royal Australasian College of Physicians. In 2015 Rural Health West awarded him the prize for his "Outstanding contribution to regional and remote health services in Western Australia".


When we see a child with an inherited cause of disability, it evokes sympathy to the parents because such conditions are the givens of the human condition in regards to the lottery of parenthood.
 
Nearly one quarter of women having their first child when older than 35 years, when the risk of Down syndrome increases rapidly. Amelioration of risk is then seen as a public good such that parents have less risk of their dreams for their family being dashed.
 
In contrast, invisible environmental toxins such as lead that cause devastating effects on a child’s development, for example from living near a lead smelter in Port Pirie or Boolaroo, cause understandable moral outrage because the individual can do little to mitigate the risk. It then falls into the political arena, with change being effected through social advocacy with a push for industry responsibility.
 
Yet hidden in plain sight is one entirely preventable cause of serious disability: fetal alcohol spectrum disorder.
 
FASD describes the range of social and intellectual disabilities caused through permanent damage to the brain of the embryo and fetus from the pregnant woman drinking alcohol. FASD includes the child with a small head from lack of brain growth, with a characteristic appearance of the face, and short stature through to the child who looks normal but has difficulty sitting still in class, understanding spatial relations of images and diagrams, and who does not seem to understand the effect of his behavior on other small children. Risk is high across gestation however highest risk is when the pregnancy is unconfirmed. In the first seven weeks of embryonic life the brain, face, and eyes form. As there is no test for the diagnosis such as a blood test or X-ray, all we can say is that no alcohol use is the only safe approach for parents planning a family, or who may be at risk of an unplanned pregnancy.
 
FASD is not a recently discovered condition but it has been almost invisible because of the failure to recognize the connection between alcohol as causal to the child’s presentation and because of the perceived shame parents will experience for their actions as causal to their child’s disability, even when the risk was not known or understood.
 
FASD has been neither understood nor recognized as affecting children in mainstream (non-Aboriginal) society. One of the roles of NOFASD is to generate discussion about this problem and in so doing, take away the shame for parents with an affected child.
Of Special Interest

Indigenous leader wins prestigious Desmond Tutu Reconciliation Fellowship

June Oscar

June Oscar AO, one of Australia's most energetic indigenous leaders, has won the Desmond Tutu Reconciliation Fellowship for 2016. This prestigious award celebrates individuals doing extraordinary work in reconciliation.  Chairman of the Fellowships, Dr. Charles Lane, said Ms Oscar was a worthy winner for her outstanding community health achievement in the Kimberley's Fitzroy Valley and influence in forging indigenous rights policy at all levels of government.  Former Governor-General Dame Quentin Bryce AD CVO will present this year's Desmond Tutu Reconciliation Fellowship award at the Melbourne Town Hall on 19 May 2016.

NOFASD Australia congratulates June for her fine work and  the award which is so well deserved. June is a NOFASD Australia Ambassador.

 

 Dr. Sterling Clarren Research Award - Dr. Angelina Paolozza

The Canada FASD Research Network is pleased to announce the selection of the recipient of the Dr. Sterling Clarren Research Award. The Award has been named in honor of Dr. Sterling Clarren to recognise his pioneering contribution and leadership in the field of FASD. The award is presented annually to an individual in recognition of a completed study that has made a substantial contribution to understanding the human dimensions FASD.

This year's recipient is Dr. Angelina Paolozza. Dr. Paolozza completed her PHD at Queen's University under the supervision of Dr. James Reynolds. She worked on a pan-Canadian, multi-site study funded by NeuroDevNet which investigated multiple research techniques to further the development of objective, low-cost, and high-throughput tools for large scale screening of clinical populations which may help streamline the diagnostic process.

 

Stigma

On 2 April World Autism Awareness Day was celebrated in ways big and small around the world. There were walks/runs/bake sales/educational ad campaigns. Mainstream schools wore blue for fellow students with autism. It's fantastic that a wider group of people are learning about the condition, that kids are being included in schools and other opportunities. But here is a thought: FASD is believe to be as prevalent as autism spectrum disorder. How many bake sales and walks/runs have you seen for FASD? How many kids with FASD do you know about in your child's school? A spectrum affecting as many as 2% of our children, and yet we as a society, as a community, ignore it. Why? Stigma. This isn't a condition with unknown origins. There is one cause for FASD. And it hits us hard, right in the gut of our pub culture.

 

How Women are Targeted to Drink More

Problematic drinking by women can be overlooked as they do not drink as much, or as often, as men. Yet alcohol has a greater effect on women. For biological reasons women cannot process alcohol as quickly or as efficiently as men. This means that for women, drinking is more hazardous, even when they drink the same amount as men. Along with more gender equality and the increase in disposable income, we have to factor in targeted marketing campaigns. Alcohol companies actively target females - girls an women - through advertising campaigns, low-calorie wine and beer, ready-to-drinks and alcopops. Enticements have changed - once upon a time men were rewarded for their hard work and hard-won thirst; now women are being targeted with supposedly diet-friendly alcoholic drinks.

National News and Media

Northern Territory urged to act on foetal alcohol spectrum disorder

The Northern Territory government is yet to implement a single recommendation from a report into the effects of foetal alcohol spectrum disorder, 14 months after it was handed down. A parliamentary select committee on action to prevent foetal alcohol spectrum disorder tabled its report in February 2015, and found the condition was doing "untold harm to children in the Northern Territory". The select committee's report make 26 recommendations including "alcohol management and support services, sexual health, pregnancy support, early childhood support and education services, and FASD diagnostic and support services".

 

NT 'missing point' on FASD treatment

The Northern Territory is "completely missing the point" on foetal alcohol spectrum disorder and dragging its feet in acting on its own report, an alcohol research group says. Last month in parliament, Health Minister John Elferink said he had mixed feelings about the report because it didn't really touch on the issue of child protection, and whether that began at some point in utero. He has previously suggested that pregnant problem drinkers could be locked up during their pregnancies to prevent them from harming their unborn child. But Caterina Giorgi, policy and research director at the Foundation for Alcohol Research and Education, says a punitive approach to dealing with FASD and potential pregnant drinkers "completely misses the point".

 

Inquiry warned of indigenous jail wave

Australia faces a "wave" of young Aboriginal people going to jail unless more is done to tackle drinking by pregnant women.  Social Justice Commissioner Mick Gooda told a Senate inquiry on Monday one of the keys to reducing indigenous jail rates was to get a better understanding of foetal alcohol spectrum disorder. It is estimated more than one in eight indigenous women drink at high-risk levels at least once a week, compared with five per cent in the general population. Mr Gooda said many young indigenous people started out in the criminal justice system simply because they did not understand a police instruction, which could stem from them having symptoms of FASD.

 

Indefinite detention of cognitively and mentally impaired people inquiry labelled 'predictable'

A senate inquiry into the indefinite detention of people with a cognitive or psychiatric impairment has already been written off by the Northern Territory Government as "predictable". The Corrections Minister John Elferink confirmed to the ABC there were currently 16 people in the NT who had been deemed unfit to enter a plea for their charges, and were indefinitely detained. In April 2016, 13 were being held in Darwin and Alice Springs' jails, and a further three were at a secure care facility immediately next to Alice Springs jail.

 

Out-of-Home Care Reform in Western Australia

On 22 April 2016, the Minister for Child Protection launched the Building a Better Future: Out-of-Home Care Reform in Western Australia, which will implement significant changes to the out-of-home care system in Western Australia.  This five-year Reform Plan provides the roadmap to improve the out-of-home care system to better meet the needs of children in out-of-home care. The goal is that children who need to enter care have the opportunity to thrive in their childhood and live full and happy lives.

 

Factcheck Q&A: does Australia have some of the highest rates per capita of fetal alcohol syndrome in the world?

Liberal MP Sharman Stone told Q&A that Australia has some of the highest rates per capita of FAS or FASD in the world. Is that right? When asked for a source to support her statement, Stone referred The Conversation to data from Australia's first ever prevalence study of FASD, the Lililwan project in the Fitzroy Valley of Western Australia. After the factcheck, research doesn't show Fitzroy Crossing has the highest rates per capita of FAS in the world ... but it is fair to say this sample has among the highest rates we know of.

 

Gold Coast Health keen to expand fetal alcohol spectrum disorder services Queensland-wide

Gold Coast Health is hoping to expand its specialist services for children with fetal alcohol spectrum disorder across Queensland. The director of community child health, Dr Doug Shelton, has discussed the proposal with Queensland Health Minister Cameron Dick. Dr Shelton helps run Queensland's only service for the disorder, which is caused by a baby's exposure to alcohol or drugs while in the womb.  He told Mr Dick, a statewide program could be run from the Gold Coast. Dr Shelton said the Health Minister committed to supporting the idea but had not discussed funding.

 

Australia, alcohol and the right policy

Alcohol consumption is at its lowest level since the 1960s, yet major health and social consequences are high. Policy interventions are unpopular, and striking the right balance is complicated, Michael Livingston writes. The statistics are repeated so often as to be almost meaningless - more than 5,500 deaths in Australia each year are attributed to alcohol consumption, along with more than 150,000 hospital admissions.

 

Mum's booze 'a factor in baby killing'

A teenager who had undiagnosed brain damage caused by his pregnant mother's drinking is trying to have his 10-year jail term for killing his three-week-old son reduced in a landmark Supreme Court appeal case. Submissions in the Court of Appeal yesterday revealed that despite constant contact with welfare authorities since he was aged six, the teenager was not diagnosed with foetal alcohol spectrum disorder until he became involved in a Telethon Kids Institute study while serving his term of detention at Banksia Hill. The boy was aged 15 when he fatally based his infant son at Bunbury Regional Hospital in February 2014. The boy's lawyer, Karen Farley, said expert reports indicated that the boy had been suffering a significant cognitive defect and Judge Reynolds had not been informed of the disorder at the time of sentencing.

 

Indigenous youth with fetal alcohol spectrum disorder need Indigenous-run alternatives to prison

In recent weeks, the case of Rosie Anne Fulton, a young Northern Territory Indigenous woman with foetal alcohol spectrum disorder, has again attracted media attention. Rosie was imprisoned for 21 months in Eastern Goldfields Regional Prison in Western Australia after being found unfit to stand trial on charges of reckless driving and motor vehicle theft. Since her release in 2014, Rosie has been in and out of prison, without stable accommodation. Her guardian, former territory police officer Ian McKinlay, says the lack of appropriate government support means Rosie will once again be 'abandoned to a perilous existence and imprisonment'.  Rosie's case highlights how the system is failing Indigenous people with foetal alcohol spectrum disorder.

 

One in five kids in remote communities has FASD

Children in remote communities are suffering from disabilities caused by their mothers drinking at a rate dramatically higher than previously reported, with one in five affected by fetal alcohol spectrum disorders, according to a new report. The published rate from the only Australian population study in Western Australia's Fitzroy Valley is one in eight, but that was a conservative figure.  NACCHO in partnership with Menzies School of Health Research and the Telethon Kids Institute have developed and implemented a flexible, modular package of FASD Prevention and Health Promotion Resources to reduce the impacts of FASD on the Aboriginal and Torres Strait Islander population.

 

Principals taking extreme measures to help kids in need

Most of the nation's principals are siphoning funds from other areas of their school's budget to help students with disabilities, Australia's biggest school survey reveals. The Australian Education Union's State of Our Schools 2016 report, released earlier this month, surveyed 9,324 principals, teachers, and support staff. The survey found that nationwide a significantly higher proportion of principals reported having to use funds from other budgeted areas in 2016 (87%) than in 2015 (84%) to assist students with a disability. 

 

The day I quit drinking - straw, camel, back!

Chris Appleford writes: There are pivotal moments in everyone's lives, key points when your very existence changes forever. For many the decision to quit drinking alcohol is one of them, and it certainly was for me. In 2012, my wife had given birth to our son 48 hours earlier, yet I was the one who needed to rest for the afternoon. It wasn't right and I knew it, but I just couldn't help it, I needed the sleep.  When the hangover had subsided I reflected on the events of the previous day. It was the only time I was ever going to bring my first child home from hospital, a momentous day in any new parent's life. Yet I ... slept for the afternoon while Sarah did all the work. 

 

New jobs for North QLD as first families get NDIS funding

Hundreds of jobs are set to flow into Townsville and North Queensland, with the first Queensland families starting to receive funding and services under the National Disability Insurance Scheme (NDIS).  Disability Services Minister and Minister Assisting the Premier on North Queensland Coralee O'Rourke met with one of the families today at Kith and Kin's Townsville office to celebrate the NDIS's biggest milestone in Queensland to date.

Resources

FOR EVERYONE

Caring for Country Kids

Presentations from the keynote speakers at the Caring for Country Kids Conference held on 17-19 April 2016 can be streamed online from the conference's website.

June Oscar & Emily Carter's presentation can be viewed here.


RealWell

RealWell is an initiative based at Griffith University that is dedicated to promoting the wellbeing of children. RealWell makes available simple and practical tools to cultivate community-wide understanding and advancement of children's social and emotional wellbeing. The resources are designed with schools and community agencies in mind. The aim is to support school and community efforts to measure children's wellbeing and take positive action based on their data to help children flourish.


FASD & Stigma: Damaged Angels Can Fly

A woman's decision to consume alcohol during pregnancy is highly stigmatized. This video takes a rare and respectful look at one individual's experiences throughout her pregnancy and after.

 

The Kid from Kraznoyarsk: Adopted from Siberia

The Healing Power of Neurofeedback/Biofeedback Three:  Dr. Stephen Larsen, Ph.D. of Stone Mountain Counseling Center discusses the Neurofeedback treatment of "Christina" for ADHD, Attachment Disorder and Fetal Alcohol Syndrome with her Mother and Grandmother: Ann and Cecilia and Clinician Alexandra Linardakis on May 12th 2012 at the Stone Mountain Counseling Center in New Paltz New York.

 

FOR SERVICE PROVIDERS

Stay Strong & Healthy FASD

A series of short videos produced by New South Wales Health.  Directed towards supporting Aboriginal people in NSW to reduce the harms caused by alcohol and drugs, but an effective resource for all.

 

Listening to the voice of the child: An inclusive approach to ethical problems in pediatrics

Children and youth are commonly excluded from discussions and decisions that affect them. It is frequently stated that children and youth are incapable of understanding complex matters and that their exclusion "protects" them. Yet, there is growing evidence that young people's capacities are systematically underestimated and exclusion may be experienced as harmful rather rather the protective.  This webinar reviews this issue and proposes concrete strategies for promoting better inclusion of young people in matters that affect them.  Presented by Dr. Franco A. Carnevale.

 

FOR TEACHERS AND OTHER EDUCATORS

Meeting the Needs of Students with FASD and ADHD

A recorded webinar from University of Alaska Fairbanks eLearning & Distance Education. 

 

Supporting Students with Fetal Alcohol Spectrum Disorders (FASD)

A key to supporting students with Fetal Alcohol Spectrum Disorder (FASD) is having a good understanding of FASD and how individuals with FASD are impacted. This resource provides an explanation of FASD, its impact on the brain as well as explores behavioural patterns in students with FASD. Strategies for designing classroom instruction and routines to support students with FASD are also highlighted.  The resource was developed by Dr. Jacqueline Pei and her colleagues, Stephanie Hayes and Alethea Heudes.

Module Two explores the difference between brain structure and brain function and provides educators with strategies for becoming active problem solvers.

Module Three explores behavioural patterns and how prenatal exposure to alcohol impacts the brain's ability to regulate mood, emotion and reactions to stress.

 

FOR LAW ENFORCEMENT AND CORRECTIONS

Fetal Alcohol Spectrum Disorders: Implications for Juvenile and Family Court Judges

Thirty years ago, Judge Leonard P. Edwards wrote "Juvenile court judges are the gatekeepers for systems which incarcerate society's children and place society's children in foster care." As gatekeepers, juvenile and family court judges make decisions that carry lifelong implications for a child, such as whether a child is ruled delinquent or should be removed from or reunited with a parent. Cases in which a child, a parent, or both may have FASD are particularly complicated. For children and adults who become involved in the court system, the permanent brain damage associated with FASD can undermine their ability to understand and participate in judicial proceedings, weigh actions against consequences, and comply with decisions of the court.

International News and Media

CANADA

Social Work Research Project Weaves Together Women's Stories

Faculty of Social Work Associate Professor Dorothy Badry is an expert in fetal alcohol spectrum disorder and is using that knowledge for preventative programming and research.  Research has led to many thought-provoking outcomes at the university, and a project recently completed by the women of the Parent Child Assistance Programs (PCAP) of Alberta in collaboration with the Faculty of Social Work's Dorothy Badry has concluded, not with a traditional research poster to showcase findings, but with the depiction of their reflections on supportive mentoring using a unique template: a quilt. PCAP is a program for women who may be facing various obstacles or challenges, including substance use disorders like FASD and trauma. The women are matched with a mentor who stands alongside her to help them live a healthy lifestyle for and with their children. 


KPDSB Fetal Alcohol Spectrum Disorder program applauded at Toronto symposium

Keewatin Public School's Transitions North program and its teachers received high praise for their work last month during a conference in Toronto. Mike Dean, Transitions North classroom teacher, and his education assistant Nicole Downey, were humbled when they received a standing ovation after presenting at the Biennial Fetal Alcohol Spectrum Disorder Ontario Network of Expertise Symposium. "They were blown away ... at the progress of these kids and I get a little emotional when I think about where the students are now compared to where they were when they came in," said Dean.

 

Proposed bill takes FASD into account when sentencing offenders (Audio)

Yukon Liberal MP Larry Bagnell has tabled a private member's bill, C-235, aimed at stopping what he calls the "revolving door" of people with Fetal Alcohol Spectrum Disorder winding up before the courts over and over. FASD affects people of all backgrounds, but it's an issue of particular importance for indigenous Canadians, and one the Truth and Reconciliation Commission specifically cited for attention and action. 

 

Call to action by Fetal Alcohol working group

The Ontario government has initiated 25 cross-ministry roundtable sessions to facilitate dialogue amongst service providers. Out of these sessions, a provincial Fetal Alcohol strategy is being developed; it is set to launch this month. Maryann McConnell-Post and Betty Ann Cornelius have been instrumental in spearheading the call for action, which seeks more consolidated support mechanisms for families coping with the long-term effects of fetal alcohol syndrome [sic] disorder. "I have reached out to over twenty organizations, making telephone calls and sending emails," said Maryann, an educator, who is hoping that the provincial strategy will result in initiatives to bridge local gaps. "Over the years I have watched other communities obtain funding, but year after yar, I see little action taken in our region."

 

FASD test for Edmonton child still under review: health official

An Alberta hospital official says a final decision has not been made on whether an 11-year-old Edmonton girl will get a test for fetal alcohol spectrum disorder, something the girl's aunt has been fighting for. The official said Friday documentation has not yet been received which may confirm the mother drank during pregnancy. Under health system rules, a person cannot be assessed for FASD without confirmation of pre-natal drinking. "We have not received any of the reports back," said Dr. Gail Andrew, medical director for the Glenrose Rehabilitation Hospital's FASD clinical services. "We are going to do the best to get all these records. It does take some weeks to get the information."

 

New approach to youth rehabilitation focuses on reconnecting communities and culture

Through an Aboriginal Lens, a pilot project from the Native Courtworker and Counselling Association of British Columbia, is working towards creating a better future for youth with a holistic approach. A community knowledge gathering was held on March 31 and April 1 at the Chief Joe Mathias Centre in North Vancouver to raise awareness and support. The project aims to help at-risk aboriginal youth with fetal alcohol spectrum disorder who have come in contact with the criminal justice system. The approach keeps youth rooted in their culture and community whenever possible by providing support with culturally appropriate resources.

 

SCOTLAND

Newborn babies tested for alcohol after shock research shows 42 per cent of mums drink while pregnant

Newborn babies in Scotland are being tested for alcohol after researchers found signs that pregnant mothers from all walks of life are drinking regularly. Hundreds of infants at the Princess Royal Maternity Hospital (PRM) in Glasgow are having samples collected and then analysed for molecules which stay inside unborn children when their mothers drink. Early results suggest up to 42 per cent of mothers consume some alcohol while pregnant, with around 15 per cent drinking more than one or two small glasses of wine a week.

 

SOUTH AFRICA

"If they understood, they would have stopped drinking"

Two months into her pregnancy Johanna, a 17-year-old Vredenberg resident, was still drinking alcohol. No one had yet told Johanna the effects alcohol could have on her unborn child. If she had known what Foetal Alcohol Spectrum Disorder is, she says, she would have chosen not to drink those first two months. Over six percent of children in the West Coast are born with FASD, according to a three-year study commissioned by the Western Cape Department of Social Development (DSD). The study was completed on 31 March and focused on the Saldanha Bay district municipal area.

 

De Aar makes headway in prevalence of fetal alcohol spectrum disorder

The Northern Cape's De Aar region has made a turnaround from 13 years ago when it had the highest reported rate of fetal alcohol spectrum disorder (FASD) in the world. "We have never seen anything like this. It was a huge success that was realised from the awareness programmes we ran after the 2003 findings," Leana Olivier, CEO of Foundation for Alcohol Related Research (FARR), said on Monday.  This came as the Western cape department of social development, in partnership with the foundation undertook a three-year feasibility study in 2013 centred on 1,535 students in the West Coast region. 

 

High level of foetal alcohol syndrome found in Saldanha Bay

A study commissioned by the Western Cape Department of Social Development (DSD) found that over 6% of children in the West Coast are born with Foetal Alcohol Spectrum Disorder, reports GroundUp. The findings, presented at a press conference on Monday, come after a three-year study in partnership with the Foundation for Alcohol Related Research (FARR). 1,452 of 1,535 grade one learners in the area underwent medical examinations. Focused on the Saldanha Bay district municipal area, the study was the first of its kind to target the prevalence of FASD in a fishing community.

 

UNITED STATES OF AMERICA

Recognizing and responding to fetal alcohol disorders

The Brooke-Hancock Family Resource Center held a hands-on training event discussing fetal alcohol spectrum disorders on Wednesday [March 30th]. It's a growing problem within the state of West Virginia. Health care professionals and people who personally know someone who suffers from the effects of fetal alcohol spectrum disorders attended the event. "The purpose of the event is to increase the awareness in regards to the signs and symptoms of fetal alcohol spectrum disorders and give them some ideas that they can do to prevent the disorder from occurring," said Carole Scheerbaum, WVU extension agent.

 

Pregnancy and Policy: Who Decides? Time to Stop Focusing on Fear and Shame

Fetal alcohol spectrum disorders are completely preventable. FASD is a public health issue where prevention is our best approach. The question remains: How do we prevent FASD while preserving a person's autonomy before and during a pregnancy?  With 1 in 10 people drinking during pregnancy, the solution is more complicated than simply asking people to abstain from alcohol use while pregnant. Almost 50 percent of all pregnancies in the US are unplanned, which can delay pregnancy awareness. In order to address the complexity of FASD, we must understand the very important intersections between access to contraception and education about alcohol's effects on the fetus.

Latest Research

Sleep Changes Seen from Fetal Alcohol Exposure May Explain Learning, Mood Problems

Sleep changes associated with fetal alcohol exposure may explain learning and mood problems, according to recent findings published in the journal Neuroscience.  Exposure of a developing brain to binge levels of alcohol results in a permanent fragmentation in slow-wave sleep, with the extent of the fragmentation influencing the severity of related cognitive disorders, according to study authors. "We have known for a long time that sleep fragmentation is associated with impaired cognitive function, attention and emotional regulation," Donald Wilson, PhD, a professor in NYU Langone's Departments of Child and Adolescent Psychiatry and Neuroscience and Physiology, and a member of the NKI, said in a news release. "Our study shows for the first time that binge alcohol exposure early in life results in long-lasting slow-wave sleep fragmentation, which, in turn, is associated with learning problems."


A Comparison Among 5 Methods for the Clinical Diagnosis of Fetal Alcohol Spectrum Disorders

Coles CD., Gailey AR., Mulle JG., Kable JA., Lynch ME., Jones JL., Alcoholism: Clinical and Experimental Research, 29 March 2016, doi: 10.1111/acer.13032

Despite the prevalence of FASD and the importance of accurate identification of patients, clinical diagnosis may not be consistent across sites due to the heterogeneous nature of FASD and the characteristics of different diagnostic systems used. Compared here are five systems designed to operationalize criteria recommended for the diagnosis of effects of prenatal alcohol exposure (PAE). We determined the extent of consistency among them as well as factors that may reduce intersystem reliability. Results from the study suggest problems in convergent validity among these systems, as demonstrated by a lack of reliability in diagnosis. Absence of an external standard makes it impossible to determine whether any system is more accurate, but outcomes do suggest areas for future research that may redefine diagnosis.


Attention and Working Memory Training: A Feasibility Study in Children with Neurodevelopmental Disorders

Kerns KA., Macoun S., MacSween J., Pei J., & Hutchison M., Applied Neuropsychology: Child, 6 April 2016, doi: 10.1080/21622965.2015.1109513

This study investigated the efficacy of a game-based process specific intervention for improving attention and working memory in children with FASD and Autism Spectrum Disorder (ASD). The Caribbean Quest (CQ) is a 'serious game' that consists of five hierarchically structured tasks, delivered in an adaptive format, targeting different aspects of attention and/or working memory. Pre- and post-test analyses revealed significant improvement on measures of working memory and attention, including reduced distractibility and improved divided attention skills.  Additionally, children showed significant gains in performance on an academic measure of reading fluency, suggesting that training-related gains in attention and working memory transferred to classroom performance. Preliminary results support this game-based process specific intervention as a potentially effective treatment and useful tool for supporting cognitive improvements in children with FASD or ASD, when delivered as part of an overall treatment plan.

 

Prospective Memory Impairment in Children with Prenatal Alcohol Exposure

Lewis CE., Thomas KGF., Molteno CD., Kliegel M., Meintjes EM., Jacobson JL., & Jacobson SW., Alcoholism: Clinical and Experimental Research, 30 March 2016, doi: 10.1111/acer.13045

Prenatal alcohol exposure (PAE) is linked to impaired performance on tests of retrospective memory, but prospective memory (PM; the ability to remember and act on delayed intentions) has not been examined in alcohol-exposed children.  This study investigates event-based PM in children with heavy PAE and the degree to which associations between PAE and PM are influenced by IQ, executive functioning (EF), retrospective memory, and attention deficit/hyperactivity disorder (ADHD). Children with FAS/PFAS made more PM errors than either HE or Control children. PAE was negatively related to PM performance even after adjusting for sociodemographic confounders, EF, and retrospective memory. This relation was only partially mediated by IQ. PAE was related to ADHD, but ADHD was not related to PM performance.  This is the first study documenting PM impairment in children with heavy PAE and identifies a new domain of impairment warranting attention in diagnosis and management of fetal alcohol spectrum disorders.

 

Caregiver needs and stress in caring for individuals with fetal alcohol spectrum disorder

Bobbitt SA., Baugh LA., Andrew GH., Cook JL., Green CR., Pei JR, & Rasmussen CR., Research in Developmental Disabilities, 6 April 2016, doi: 10.1016/j.ridd.2016.03.002

Individuals with FASD experience neurodevelopmental impairments and adverse outcomes, which can result in stress on the caregiver. However, there is little research on the needs of caregivers supporting individuals with FASD and whether they are associated with caregiver stress.  125 caregivers of individuals with FASD completed a survey with questions adapted from the Family Caregiver Survey and the Perceived Stress Scale. The study concluded that caregivers of individuals with FASD have multiple areas of need and concern, and experience high levels of stress.  Reducing demands on caregivers and providing resources may help reduce caregiver needs and stress, particularly for those caring for adolescents and adults, and those with lower incomes.

 

Dysregulation of the Cortisol Diurnal Rhythm following Prenatal Alcohol Exposure and Early Life Adversity

McLachlan K., Rasmussen C., Oberlander TF., Loock C., Pei J., Andrew G., Reynolds J., & Weinberg J., Alcohol, 1 April 2016, doi:10.1016/j.alcohol.2016.03.003

The hypothalamic-pituitary-adrenal (HPA) axis is impacted by a multitude of pre- and postnatal factors. Developmental programming of HPA axis function by prenatal alcohol exposure (PAE) has been demonstrated in animal models and in human infants, but remains understudied in older children and adolescents. Moreover, early life adversity (ELA), which occurs at higher rates in children with PAE than in non-exposed children, may also play a role in programming the stress response system. The results of this study complement findings from research on human infants and animal models showing dysregulated HPA function following PAE, lending weight to the suggestion that PAE and ELA may interact to sensitize the developing HPA axis. The presence of protective factors may buffer altered cortisol regulation, underscoring the importance of early assessment and interventions for children with FASD, and in particular, for the many children with FASD who also have ELA.

 

Adolescent Cholien Supplementation Attentuates Working Memory Deficits in Rats Exposed to Alcohol During the Third Trimester Equivalent

Schneider RD., & Thomas JD., Alcoholism: Clinical and Experimental Research, 3 April 2016, doi:10.1111/acer.13021

Children exposed to alcohol prenatally may suffer from behavioral and cognitive alterations that adversely affect their quality of life. Animal studies have shown that perinatal supplementation with the nutrient choline can attenuate ethanol's adverse effects on development; however it is not clear how late in development choline can be administered and still effectively reduce the consequences of prenatal alcohol exposure. Results indicate that adolescent choline supplementation can attenuate some, but not all, of the behavioral deficits associated with early developmental alcohol exposure. The results of this study indicate that dietary intervention may reduce some fetal alcohol effects, even when administered later in life, findings with important implications for adolescents and young adults with fetal alcohol spectrum disorders.

 

Meta-Analysis of Gene Expression Patterns in Animal Models of Prenatal Alcohol Exposure Suggests Role for Protein Synthesis Inhibition and Chromatin Remodeling

Rogic S., Wong A., & Pavlidis P., Alcoholism: Clinical and Experimental Research, 20 March 2016, doi:10.1111/acer.13007

Prental alcohol exposure (PAE) can result in an array of morphological, behavioral, and neurobiological deficits that can range in their severity. Despite extensive research in the field and a significant progress made, especially in understanding the range of possible malformations and neurobehavioral abnormalities, the molecular mechanisms of alcohol responses in development are still not well understood. 10 microarray data sets of gene expression after PAE in mouse and rat models were assembled, consisting of samples from a total of 63 ethanol (EtOH)-exposed and 80 control animals. Conclusions demonstrates that existing studies, despite superficial dissimilarity in findings, share features that allow us to identify a common core signature set of transcriptome changes in PAE. This is an important step to identifying the biological processes that under lie the etiology of fetal alcohol spectrum disorders.

 

Ethanol Toxicity During Brain Development: Alterations of Excitatory Synaptic Transmission in Immature Organotypic Hippocampal Slice Cultures

Gerace E., Landucci E., Totti A., Bani D., Guasti D., Baronti R., Moroni F., Mannaioni G., Pellegrini-Giampietro DE., Alcoholism: Clinical and Experimental Research, 3 April 2016, doi:10.1111/acer.13006

The developing brain is particularly vulnerable to alcohol: Drinking during pregnancy can lead to a number of physical, learning, and behavioral disorders in the newborn. It has been demonstrated that immature and mature brain tissues display a differential sensitivity to ethanol (EtOH) toxicity and that cerebral structure and function are diversely impaired according to the stage of synaptic maturation. Results indicate that prolonged incubation with EtOH and its subsequent withdrawal from the medium induce an impairment of excitatory synaptic transmission and possibly an incorrect formation of neuronal circuits in developing hippocampus in vitro, which is suggestive of mechanisms that may lead to mental retardation in fetal alcohol spectrum disorders.

 

Alcohol, Methamphetamine, and Marijuana Exposure Have Distinct Effects on the Human Placenta

Carter RC., Wainwright H., Molteno CD., Georgieff MK., Dodge NC., Warton F., Meintjes EM., Jacobson JL., & Jacobson SW., Alcoholism: Clinical and Experimental Research, 3 April 2016, doi: 10.1111/acer.13022

Animal studies have demonstrated adverse effects on prenatal alcohol exposure on placental development, but few studies have examined these effects in humans. Little is known about effects of prenatal exposure to methamphetamine, marijuana, and cigarette smoking on placental development.  Alcohol exposure was related to decreased placental weight and a smaller placenta-to-birthweight ratio.  [It was also] associated with increased risk of placental hemorrhage and a decreased risk of intrauterine passing of meconium, a sign of acute fetal stress and/or hypoxia. Given the growing body of evidence linking placental abnormalities to neurodevelopmental deficits, these findings may be important in the long-term teratogenic effects of prenatal alcohol and drug exposure.

 

Alcohol Use During Pregnancy is Associated with Specific Alterations in MicroRNA Levels in Maternal Serum

Gardiner AS., Gutierrez HL., Luo L., Davies S., Savage DD., Bakhireva LN., & Perrone-Bizzozero NI., Alcoholism: Clinical and Experimental Research., 3 April 2016, doi: 10.1111/acer.13026

Given the challenges of confirming prenatal alcohol exposure (PAE) during pregnancy using currently established biomarkers of alcohol consumption, we examined whether serum microRNAs (miRNAs) may serve as stable biomarkers for PAE. Alterations in the levels of specific circulating miRNAs have been associated with various disease states and in animal models of fetal alcohol spectrum disorder.  Serum was collected at the time of admission for delivery from 14 subjects who reported more than one binge-drinking episode or more than 3 drinks/week during pregnancy and 16 subjects who reported abstinence during pregnancy and tested negative for 5 ethanol biomarkers. False discover rate-corrected analyses of covariance revealed that 55 miRNAs were significantly altered between the 2 groups, suggesting that serum miRNAs could be useful as biomarkers of alcohol exposure.

 

Dietary Nutrient Intake in School-Aged Children with Heavy Prenatal Alcohol Exposure

Nguyen TT., Risbud RD., Chambers CD., and Thomas JD., Alcoholism: Clinical and Experimental Research, 25 March 201, doi: 10.1111/acer.13035

Nutrition is an important factor that affects brain development. Nutritional deficiencies can exacerbate alcohol's damaging effects. Conversely nutritional supplementation can serve a protective role against alcohol damage and may prove to be a worthwhile intervention strategy.  This study investigated dietary intake in school-aged children with heavy prenatal alcohol exposure to understand their nutritional status, compared to a national sample of typically developing children and Dietary Reference Intakes. Alcohol-exposed children exhibited poorer nutritional status compared to the typically developing sample.The findings are consistent with prior studies investigating nutritional intake in preschoolers with FASD, indicating that these children are vulnerable to nutritional inadequacies.  As several nutrients are important for cognitive development, targeted interventions in clinical populations might be effective in boosting outcomes. Thus, further clinical investigation into the role of nutrition in improving cognitive outcomes is warranted.

 

Alcohol Consumption during Pregnancy: Analysis of Two Direct Metabolites of Ethanol in Meconium

Sanvisens A., Robert N., Hernandez JM., Zuluaga P., Farre M., Coroleu W., Serra M., Tor J., & Muga R., International Journal of Molecular Science, 22 March 2016, doi: 10.3390/ijms17030417

Alcohol consumption in young women is a widespread habit that may continue during pregnancy and induce alterations in the fetus. This study aimed to characterize prevalence of alcohol consumption in parturient women and to assess fetal ethanol exposure in their newborns by analyzing two direct metabolites of ethanol in meconium. During admission, socio-demographic and substance use during pregnancy were assessed using a structured questionnaire and clinical charts. Meconium analysis was performed by liquid chromatography to detect the presence of ethyl glucuronide (EtG) and ethyl sulfate (EtS). EtG was present in all meconium samples, and EtS was undetectable in the majority of samples. Only three women (6%) reported alcohol consumption during pregnancy in face-to-face interviews. Prevalence of fetal exposure to alcohol through detection of EtG and EtS was 42.% and 16.7% respectively. Prevention of alcohol consumption during pregnancy and the detection of substance use with markers of fetal exposure are essential components of maternal and child health.

 

Monthly Estimates of Alcohol Drinking During Pregnancy: United States 2002-2011

Alshaarawy O., Breslau N., & Anthony JC., Journal of Studies on Alcohol and Drugs, 22 March 2016, doi:10.15288/jsad.2016.77.272

Taking a step beyond prior alcohol research on pregnancy trimesters, [the researchers] produced pregnancy month-specific drinking estimates for women in the United States in order to shed light on time variations of alcohol drinking during pregnancy, as might be determined by alcohol dependence. The results suggest pregnancy's possibly protective constraints on drinking can be seen as early as Month 2. Considerable variability of drinking prevalence (%) before Trimester 1 ended was observed, with no appreciable variation across Months 4-9. A possibly alcohol dependence effect on drinking persistence is seen when the contrast is made in relation to expected values for pregnant women without alcohol dependence. A possibly ameliorative pregnancy effect on alcohol use and HED, with variation in drinking prevalence across the months of the first trimester was detected. Alcohol dependence mgiht be affecting drinking persistence among pregnant women, but this effect cannot account for the drinking persistence observed here.

Upcoming Events

WEBINARS

The Relationship Between FASD And ADHD

DATE: 19 May 2016 (4am - 5am AEST)

DETAILS: Learning objectives of this webinar are: Recognise the association between prenatal exposure to alcohol and the development of ADHD; Understand complicating factors in the diagnosis and treatment of ADHD in children with prenatal alcohol exposure; Learn skills to be an active participant in ensuring appropriate treatment and optimal outcomes for children with ADHD and FASD.  Presented by Gwendolyn Messer, M.D.  Dr. Messer works with a multidisciplinary team at Children's Research Triangle to provide comprehensive evaluations for children with developmental or behavioral concerns, including children who have been prenatally exposed to drugs or alcohol or who have suffered trauma. In addition, Dr. Messer provides medical management for children with complex ADHD and other behavioral disorders. She is committed to raising awareness about FASD and has presented locally and nationally to professionals and parents on topics related to FASD, ADHD, and domestic and international adoption.

 

AUSTRALIA

NT Alcohol & Other Drugs Workforce Conference - Darwin, Northern Territory

DATE: 8 - 9 June 2016

DETAILS: AADANT is pleased to host the 2016 NT AOD Workforce Conference: two days of practical hands on training and professional development opportunities in practice areas that have been identified by the sector as requiring more support.  The full Workshop Program is now available for viewing.


SARRAH National Conference for Rural and Remote Allied Health Professionals - Port Lincoln, South Australia

DATE: 27 - 29 October 2016

DETAILS: "It takes a village to raise a child" is a tradtional African proverb and the theme for the 2016 SARRAH National Conference for Rural and Remote Allied Health Professionals. In rural and remote life and work, our "village" has never been more important than it is today. We live in a rapidly evolving environment and we are faced with a myriad of both challenges and opportunities each day.  Navigating these changes can be daunting - collaboration, innovation, partnerships and supports are necessary to prepare our communities for a vibrant, sustainable future.  At the 2016 SARRAH National Conference, delegates will have the opportunity to explore how the village approach can be applied to rural and remote health outcomes.

 

INTERNATIONAL

European Conference on FASD 2016 - London, England

DATE: 12 - 14 September 2016 (plus training day for parents and professionals 15 September)

DETAILS: The 4th European Conference on Fetal Alcohol Spectrum Disorders 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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