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Fetal alcohol syndrome

Fetal Alcohol Syndrome

On any given day in the United States... 10,657 babies are born. (US Census

Bureau). Twenty of these babies are born with Fetal Alcohol Syndrome. Twenty may
seem as though it is not a lot, but when you compare it to the fact that this
number is more than HIV positive, Muscular Dystrophy, Spina Bifida and Down

Syndrome combine it creates a whole new parameter. Fetal Alcohol Syndrome is a
direct result of a woman’s competed disregard for the fetus. Fetal Alcohol

Syndrome (FAS, hereinafter), is a series of both mental and physical birth
defects that can include, but are not limited to, mental retardation,
deficiencies in growth, central nervous system dysfunction, behavioral
maladjustments, and craniofacial abnormalities. It is common knowledge not to
smoke or drink during pregnancy. Growth abnormalities can be significant and
also includes all three of the following respects of growth: weight, length and
head circumference. Most of the time the baby’s growth abnormalities are so
severe they need to be hospitalized because of obvious failure to survive. A
baby with craniofacial abnormalities can be recognized by their eyes in that
they are small with exaggerated inner epicanthic folds. (Health Visitor Nov.

1981) The bridge of the nose is normally poorly developed. The ears are often
large and simple in form. (Midwives Chronicle and Nursing notes) At first, when
the baby is delivered, the affected infant shows signs of alcohol withdrawal;
with signs that are much similar to delirium tremens in adults. They are often
anxious, have a weak grasp, poor hand-to-eye coordination and consistent
difficulty in feeding and sucking. People can not blame the mother’s for the
most part though. It is a common ignorance among the health care providers. Most
health care providers are untrained and unfamiliar with substance abuse issues
among pregnant women. FAS is widely misdiagnosed and or under diagnosed. Only
ten percent of medical schools require students to complete a course on the
proper diagnosis of individuals with alcohol and other drug addictions. Many
women do not receive proper pre-natal care, and a study performed by a National

Center for Health Statistics found that doctors appear less likely to tell a
pregnant black woman to quit drinking and or smoking than they would be to a
white woman. (The New York Times, January 19, 1994) As mentioned above, a baby
with FAS can suffer from many different birth abnormalities. These disabilities
will indeed last a lifetime. There is no amount of alcohol found to be safe to
consume during pregnancy. FAS is, however, 100% preventable when a woman
abstains from alcohol. FAS is the leading known cause of mental retardation.

Approximately, one out of 750 live birth are born each year with FAS. (The

Journal of American Medical Association, 1991) Thirty to 40% of the mothers who
drink "heavily" throughout pregnancy have the syndrome. FAS is not limited
to any one group, race, culture, or socio-economic background. Between one-third
and two-thirds of children in special education have been affected by alcohol in
some way. (The Journal of American Medical Association, 1991) Comparison of
children and adults with FAS shows that with the approach to adolescence, the
specific craniofacial features are not as noticeable as they are in infancy.

Average academic functioning of these children and adults does not seem to
develop beyond early school grade level. The short stature and small head (micro
cephalic), seem to be permanent. The most noticeable behavioral problems were
found to be with comprehension, judgment, and attention skills, causing these
adults born with FAS to experience major psychological and adjustment problems
for the rest of their lives. Numerous studies with animals, of experimental
alcoholism, where nutritional status has been well controlled, have shown that
the damage to the developing fetus, such as low birth rate CNS ( Central Nervous

System) impairment, etc. are caused by the direct consequence of the effects of
alcohol. In addition, some of these studies have shown a clear continuum effect;
the higher the blood alcohol of the mother, the greater the damage to the
developing fetus. Even though the direct connection between alcohol intake and
birth defects is now indisputable, there are other etiological factors
associated with maternal drinking that must also be considered as contributing
factors in an adverse pregnancy outcome. The most important of these secondary
factors is alcohol related malnutrition, as nutritional deficiencies occur
frequently with alcohol intake due to reduced appetite. Alcohol-induced zinc
depletion is particularly well documented. This has shown a positive correlation
with reduced zinc status and low birth weight and fetal malformations,
suggesting that inadequate zinc intake could also act independently as a
teratogenic agent. (Yearbook of Nutritional Medicine 1984-85) Many studies have
been performed on FAS. The University of Washington School of Medicine is the
leader in scientific research of FAS. The school/students have done many
controlled research study’s. A few will be discussed in the following pages.

The longitudinal Study on Alcohol and Pregnancy, Neuropsychological Analyses of

FAS/FAE Deficits, Parent-Child Assistance Program (P-Cap), and the FAS Follow-up

Program. The longitudinal prospective study evaluates adverse outcomes in young
adults who were pre-natally exposed to known levels and patterns of alcohol. The
basic hypothesis of this long-term study is that prenatal alcohol exposure
exerts an enduring dose-dependent influence on offspring across a life-span. One
of the many problems of misdiagnosis, and is shown in this study is that, the
birth rate of FAS children is nearly 1 per 100 births. The problem is this,
alcohol-affected children and adults are often denied services when they lack
the characteristic FAS face and or mental retardation as defined by a
standardized IQ score of less then 69. It is essential that these diagnosis’
become more accurate so that the consequences can be understood and that the
markers of clinically affected individuals be identified to support appropriate
diagnosis and intervention. The Neuropsychological Analyses of FAS/FAE deficits
study proposes to quantify and link the neuroanatomic and neuropsychological
abnormalities in people with brain damage caused by prenatal alcohol exposure.

As of present time there is no scientific way of measuring the amount of brain
damage caused by alcohol and its relation to the dysfunctional behavior of the
patient. FAS is a diagnostic category which is the only means of measuring
quantitative brain damage. People that suffer from FAS are often considered to
be in a different group that carries the diagnosis of ARND Alcohol Related

Neurodevelopment Disorders. What the researchers in this study are hoping to
conclude, is by using a new analysis method it will reveal a significant means
of differences in brain form between FAS groups and Control group that are not
simply due to micro cephalic and that are not detectable from the clinical
reading of an MRI. The researchers also believe that that a brain/behavior study
will find significant correlations between brain dysmorphology and
neuropsychological deficits, and that the associations will be strong enough to
suggest the nature and extent of brain damage in the individual case. Although
there are many cases each day of FAS, and seems almost hopeless for the children
born from ignorance, there is help. There are many programs out there one that
will be mentioned is P-CAP. P-CAP is Parent-Child Assistance Program (formally
known as Birth to 3). It started in 1991 in Seattle, WA. P-CAP is an
intervention model developed through federal funds to enable communities to
respond, through long term advocacy, to the problems of mothers who have abused
drugs or alcohol during pregnancy and to the needs of the children. This program
reaches out to those women who had little to no prenatal care, and are not
connected to community resources. The goals of P-CAP are simple. they are (1) to
assist clients in obtaining alcohol and drug treatment, staying in recovery and
resolving complex issues that might have risen during within the context of
their substance abuse; (2) to assure that the children are in a safe home with
these mothers and are receiving proper health care; (3) to link these mothers to
community resources for the professional services and education that will help
learn and maintain a healthy independent family life; (4) to demonstrate to
community services that positive work is being done to further the prevention of
future births of FAS. Typical mothers that are enrolled in this program are
characterized by poverty, upbringing by substance abusing parents, child abuse,
abusive adult relationships, and trouble with the law to name a few. Notably,
there have been no turnover among the paraprofessional staff for over five years
in a field which is known for hate rates of burnouts among personnel. I found
this letter in a publication, this shows the tremendous difference between a
client with limited mental abilities and a client with FAS: June 14, 1999 To:

President and Hillary Clinton, Twenty three years ago a young woman who was
pregnant was abandoned by her husband. She had no job, no money, no health
insurance and no family. Alone, she turned to alcohol for comfort. Eventually,
she returned to school. Got some good training and got a good job but all the
good things came too late for the child she was carrying during the time she was
relying on alcohol. This child was born with Fetal Alcohol Syndrome. Being a
single parent, this mom was not able to take proper care of a child who never
slept and was constantly ill. Eventually she was forced to place the child in an
institution for the mentally retarded. Fortunately, for the child in this story,
a friend at the institution told me about the new child at the school and asked
for my assistance. I had worked with hundreds of delayed children and was
confident that I could help this child gain the skills necessary to live with
her family again. I was naive. I had not met FAS head on before. I had had
wonderful success teaching children with other forms of mental retardation to
dress, eat and use the bathroom appropriately. This time it did not work the way

I thought it would. Sixteen years ago when this child came to live with us I
really thought I knew the answers. I now know that FAS is different the answers
are different. She has learned many good and wonderful things. She still cannot
dress, eat and use the bathroom appropriately for her age. The brain damage
caused by prenatal exposure to alcohol damages the brain's ability to
communicate within itself. This young woman has no appropriate sense of hot or
cold. If she looks at a thermometer outdoors, she can read the temperature but
cannot reason out what type of clothes she is to wear in hot weather or cold.

She needs constant guidance to make it from day to day without placing herself
at risk. Despite all that some of us have learned about FAS, we still find that
most teachers and school personnel do not recognize that this disability is
different from other forms of mental retardation. Despite all that has been
written about FAS, we find that more women are drinking while pregnant than
there were in 1992. Despite all the research by the medical profession, we find
that many, many doctors still cannot recognize FAS in their patients. Despite
the efforts made by social workers, therapists, and schools, we are finding that
approximately 40% of those in our state prisons are disabled by prenatal
exposure to alcohol. I cannot condemn the ignorance of others as I was once
ignorant myself. However I cannot see a healthy outcome for our country if we
continue in this mass ignorance. I am asking you to lend us your support in
turning the tide of ignorance concerning this disability. Sincerely, Delinda L.

McCann MA I found this quiz in a magazine, it is interesting to know what you
don’t really know about FAS. Do not feel intimidated by this test. It’s
purpose is to spread the knowledge of FAS. Most of the people who took and will
take this test do and will not score about a 50. 1) What is the leading known
cause of mental retardation in western civilization today? a. Down Syndrome b.

FAS c. FAE d. Cerebral Palsy e. Spina Bifida 2) What percentage of women of
child-bearing age drink alcohol (many before they realize that they are
pregnant)? a. 10% b. 20% c. 35% d. 50% e. 75% 3) What percentage of persons with

FAS/FAE attain independence in living and in employment? a. 10% b. 18% c. 35% d.

53% e. 67% 4) Which of the following alcoholic beverages contains the greatest
amount of alcohol? a. A 12 oz. can of beer. b. A 5oz glass of wine. c. One shot
of liquor. d. A 12oz. wine cooler. e. All of the above. 5) What is the most
debilitating aspect of prenatal alcohol exposure? a. Memory deficits. b. Growth
retardation c. Lack of impulse control d. Mental retardation with IQ below 70 e.

Attention Deficit Disorder (ADD) 6) How much does it cost each year to treat
infants, children and adults with FAS? a. Almost $1,000,000.00 b. Almost
$2,000,000.00 c. Almost $100,000,000.00 d. Almost $2,000,000,000.00 e. Almost
nothing, as expenses are incurred by private insurance. 7) Which of the
following women are at high risks for drinking during pregnancy? a. Women with a
college education. b. Unmarried women. c. Female students. d. Women in
households with * $50,000 annual income. e. All of the above 8) Of the following
secondary disabilities associated with FAS/FAE, which one is the most common? a.

Mental illness b. Trouble in school. c. Trouble with the law. d. Abuse of
alcohol and/or other drugs. e. Sexuality problems. 9) Which of the following are
protective factors for preventing secondary disabilities in FAS/FAE? a. IQ below

70. b. Early diagnosis. c. Eligibility for disability services. d. Stable home
environment e. All of the above. 10) In which of the following ways does alcohol
affect a man’s ability to father healthy children? a. Lowered levels of
testosterone that interfere with sexual performance. b. Reduced mobility of
healthy sperm at time of infection. c. Increased risk of inherited tendency
toward alcoholism. d. Possible adverse effects on DNA in sperm before
conception. e. All of the above. The answers to this quiz will follow at the end
of this paper. Patterns of alcohol use are changing with the changing times of
today, with more and more teenagers consuming alcohol on a regular basis. This
is a growing concern as research shows that, in recent years, regular alcohol
consumption has increased alarmingly among the female population; particularly
among younger women and teenage girls. Due to this vast rise in alcohol
consumption it is societies burden to put forth evidence and proof about the
dangers of alcohol consumption among women during their child-bearing years. In
order for society to accomplish this, three things must happen: 1) Local
education staff should implement the teachings of the dangers that alcohol can
cause not only normal consumption but while pregnant as well. 2) Pamphlets
should be regularly handed out among young women and teens, in hospital waiting
rooms, family planning clinics, schools, by the parents, dealing with the
adverse effects of alcohol. 3) Government officials should affix warning labels
on alcohol so they can be seen clearly . They should be similar to those that
are placed on cigarettes. The most salient point that can be made about alcohol
induced fetal damage is that it is 100% totally preventable, we can only hope
that education of this subject, on the part of both prospective parents, will
control the increasing problem. It is astonishing to know that this information
has been readily available for such a long time and no one seems to worry about
it. If we could effectively foster the simple fact that "mothering from
conception is direct mothering", and therefore everything that the mother
consumes during pregnancy the fetus consumes as well, some of these tragedies
could be more easily be avoided. Answers to the quiz above are as follows: 1. B

2. D 3. B 4. E 5. A 6. B 7. D 8. A 9. A 10. E Works Sited Streissguth, A.P.,

Barr, H.M., Bookstein, F.L., Sampson, P.D., & Carmichael Olsen, H. (1999).

The long-term neurocognitive consequences of prenatal alcohol: A 14-year study.

Psychological Science, 10(3), 186-190. Streissguth, A.P., Barr, H.M., &

Sampson, P.D. (1990) Moderate prenatal alcohol exposure: Effects on child IQ and
learning problems at age 7 1/2 years. Alcoholism: Clinical and Experimental

Research, 14(5), 662-669. Streissguth, A.P., Barr, H.M., &Sampson, P.D.
(1989). Neurobehavioral effects of prenatal alcohol. Parts I, II, and III.

Neurotoxicology & Teratology, 11(5), 461-507. Streissguth, A.P., Barr, H.M.,

Sampson, P.D., & Martin, D.C. (1986). Attention, distraction and reaction
time at age 7 years and prenatal alcohol exposure. Neurobehavioral Toxicology
and Teratology, 8(6), 717-725. Streissguth, A.P., Grant, T.M., & Ernst, C.C.
(1999). Intervention with high-risk alcohol and drug abusing mothers: II. 3 year
findings from the Seattle Model of Paraprofessional Advocacy. Journal of

Community Psychology, 27(1), 19-38. Grant, T.M., Ernst, C.C., & Steissguth,

A.P. (1996). An intervention with high-risk mothers who abuse alcohol and drugs:

The Seattle Advocacy Model. American Journal of Public Health, 86(12),

1816-1817. On any given day in the United States... 10,657 babies are born. (US

Census Bureau). Twenty of these babies are born with Fetal Alcohol Syndrome.

Twenty may seem as though it is not a lot, but when you compare it to the fact
that this number is more than HIV positive, Muscular Dystrophy, Spina Bifida and

Down Syndrome combine it creates a whole new parameter. Fetal Alcohol Syndrome
is a direct result of a woman’s competed disregard for the fetus. Fetal

Alcohol Syndrome (FAS, hereinafter), is a series of both mental and physical
birth defects that can include, but are not limited to, mental retardation,
deficiencies in growth, central nervous system dysfunction, behavioral
maladjustments, and craniofacial abnormalities. It is common knowledge not to
smoke or drink during pregnancy. Growth abnormalities can be significant and
also includes all three of the following respects of growth: weight, length and
head circumference. Most of the time the baby’s growth abnormalities are so
severe they need to be hospitalized because of obvious failure to survive. A
baby with craniofacial abnormalities can be recognized by their eyes in that
they are small with exaggerated inner epicanthic folds. (Health Visitor Nov.

1981) The bridge of the nose is normally poorly developed. The ears are often
large and simple in form. (Midwives Chronicle and Nursing notes) At first, when
the baby is delivered, the affected infant shows signs of alcohol withdrawal;
with signs that are much similar to delirium tremens in adults. They are often
anxious, have a weak grasp, poor hand-to-eye coordination and consistent
difficulty in feeding and sucking. People can not blame the mother’s for the
most part though. It is a common ignorance among the health care providers. Most
health care providers are untrained and unfamiliar with substance abuse issues
among pregnant women. FAS is widely misdiagnosed and or under diagnosed. Only
ten percent of medical schools require students to complete a course on the
proper diagnosis of individuals with alcohol and other drug addictions. Many
women do not receive proper pre-natal care, and a study performed by a National

Center for Health Statistics found that doctors appear less likely to tell a
pregnant black woman to quit drinking and or smoking than they would be to a
white woman. (The New York Times, January 19, 1994) As mentioned above, a baby
with FAS can suffer from many different birth abnormalities. These disabilities
will indeed last a lifetime. There is no amount of alcohol found to be safe to
consume during pregnancy. FAS is, however, 100% preventable when a woman
abstains from alcohol. FAS is the leading known cause of mental retardation.

Approximately, one out of 750 live birth are born each year with FAS. (The

Journal of American Medical Association, 1991) Thirty to 40% of the mothers who
drink "heavily" throughout pregnancy have the syndrome. FAS is not limited
to any one group, race, culture, or socio-economic background. Between one-third
and two-thirds of children in special education have been affected by alcohol in
some way. (The Journal of American Medical Association, 1991) Comparison of
children and adults with FAS shows that with the approach to adolescence, the
specific craniofacial features are not as noticeable as they are in infancy.

Average academic functioning of these children and adults does not seem to
develop beyond early school grade level. The short stature and small head (micro
cephalic), seem to be permanent. The most noticeable behavioral problems were
found to be with comprehension, judgment, and attention skills, causing these
adults born with FAS to experience major psychological and adjustment problems
for the rest of their lives. Numerous studies with animals, of experimental
alcoholism, where nutritional status has been well controlled, have shown that
the damage to the developing fetus, such as low birth rate CNS ( Central Nervous

System) impairment, etc. are caused by the direct consequence of the effects of
alcohol. In addition, some of these studies have shown a clear continuum effect;
the higher the blood alcohol of the mother, the greater the damage to the
developing fetus. Even though the direct connection between alcohol intake and
birth defects is now indisputable, there are other etiological factors
associated with maternal drinking that must also be considered as contributing
factors in an adverse pregnancy outcome. The most important of these secondary
factors is alcohol related malnutrition, as nutritional deficiencies occur
frequently with alcohol intake due to reduced appetite. Alcohol-induced zinc
depletion is particularly well documented. This has shown a positive correlation
with reduced zinc status and low birth weight and fetal malformations,
suggesting that inadequate zinc intake could also act independently as a
teratogenic agent. (Yearbook of Nutritional Medicine 1984-85) Many studies have
been performed on FAS. The University of Washington School of Medicine is the
leader in scientific research of FAS. The school/students have done many
controlled research study’s. A few will be discussed in the following pages.

The longitudinal Study on Alcohol and Pregnancy, Neuropsychological Analyses of

FAS/FAE Deficits, Parent-Child Assistance Program (P-Cap), and the FAS Follow-up

Program. The longitudinal prospective study evaluates adverse outcomes in young
adults who were pre-natally exposed to known levels and patterns of alcohol. The
basic hypothesis of this long-term study is that prenatal alcohol exposure
exerts an enduring dose-dependent influence on offspring across a life-span. One
of the many problems of misdiagnosis, and is shown in this study is that, the
birth rate of FAS children is nearly 1 per 100 births. The problem is this,
alcohol-affected children and adults are often denied services when they lack
the characteristic FAS face and or mental retardation as defined by a
standardized IQ score of less then 69. It is essential that these diagnosis’
become more accurate so that the consequences can be understood and that the
markers of clinically affected individuals be identified to support appropriate
diagnosis and intervention. The Neuropsychological Analyses of FAS/FAE deficits
study proposes to quantify and link the neuroanatomic and neuropsychological
abnormalities in people with brain damage caused by prenatal alcohol exposure.

As of present time there is no scientific way of measuring the amount of brain
damage caused by alcohol and its relation to the dysfunctional behavior of the
patient. FAS is a diagnostic category which is the only means of measuring
quantitative brain damage. People that suffer from FAS are often considered to
be in a different group that carries the diagnosis of ARND Alcohol Related

Neurodevelopment Disorders. What the researchers in this study are hoping to
conclude, is by using a new analysis method it will reveal a significant means
of differences in brain form between FAS groups and Control group that are not
simply due to micro cephalic and that are not detectable from the clinical
reading of an MRI. The researchers also believe that that a brain/behavior study
will find significant correlations between brain dysmorphology and
neuropsychological deficits, and that the associations will be strong enough to
suggest the nature and extent of brain damage in the individual case. Although
there are many cases each day of FAS, and seems almost hopeless for the children
born from ignorance, there is help. There are many programs out there one that
will be mentioned is P-CAP. P-CAP is Parent-Child Assistance Program (formally
known as Birth to 3). It started in 1991 in Seattle, WA. P-CAP is an
intervention model developed through federal funds to enable communities to
respond, through long term advocacy, to the problems of mothers who have abused
drugs or alcohol during pregnancy and to the needs of the children. This program
reaches out to those women who had little to no prenatal care, and are not
connected to community resources. The goals of P-CAP are simple. they are (1) to
assist clients in obtaining alcohol and drug treatment, staying in recovery and
resolving complex issues that might have risen during within the context of
their substance abuse; (2) to assure that the children are in a safe home with
these mothers and are receiving proper health care; (3) to link these mothers to
community resources for the professional services and education that will help
learn and maintain a healthy independent family life; (4) to demonstrate to
community services that positive work is being done to further the prevention of
future births of FAS. Typical mothers that are enrolled in this program are
characterized by poverty, upbringing by substance abusing parents, child abuse,
abusive adult relationships, and trouble with the law to name a few. Notably,
there have been no turnover among the paraprofessional staff for over five years
in a field which is known for hate rates of burnouts among personnel. I found
this letter in a publication, this shows the tremendous difference between a
client with limited mental abilities and a client with FAS: June 14, 1999 To:

President and Hillary Clinton, Twenty three years ago a young woman who was
pregnant was abandoned by her husband. She had no job, no money, no health
insurance and no family. Alone, she turned to alcohol for comfort. Eventually,
she returned to school. Got some good training and got a good job but all the
good things came too late for the child she was carrying during the time she was
relying on alcohol. This child was born with Fetal Alcohol Syndrome. Being a
single parent, this mom was not able to take proper care of a child who never
slept and was constantly ill. Eventually she was forced to place the child in an
institution for the mentally retarded. Fortunately, for the child in this story,
a friend at the institution told me about the new child at the school and asked
for my assistance. I had worked with hundreds of delayed children and was
confident that I could help this child gain the skills necessary to live with
her family again. I was naive. I had not met FAS head on before. I had had
wonderful success teaching children with other forms of mental retardation to
dress, eat and use the bathroom appropriately. This time it did not work the way

I thought it would. Sixteen years ago when this child came to live with us I
really thought I knew the answers. I now know that FAS is different the answers
are different. She has learned many good and wonderful things. She still cannot
dress, eat and use the bathroom appropriately for her age. The brain damage
caused by prenatal exposure to alcohol damages the brain's ability to
communicate within itself. This young woman has no appropriate sense of hot or
cold. If she looks at a thermometer outdoors, she can read the temperature but
cannot reason out what type of clothes she is to wear in hot weather or cold.

She needs constant guidance to make it from day to day without placing herself
at risk. Despite all that some of us have learned about FAS, we still find that
most teachers and school personnel do not recognize that this disability is
different from other forms of mental retardation. Despite all that has been
written about FAS, we find that more women are drinking while pregnant than
there were in 1992. Despite all the research by the medical profession, we find
that many, many doctors still cannot recognize FAS in their patients. Despite
the efforts made by social workers, therapists, and schools, we are finding that
approximately 40% of those in our state prisons are disabled by prenatal
exposure to alcohol. I cannot condemn the ignorance of others as I was once
ignorant myself. However I cannot see a healthy outcome for our country if we
continue in this mass ignorance. I am asking you to lend us your support in
turning the tide of ignorance concerning this disability. Sincerely, Delinda L.

McCann MA I found this quiz in a magazine, it is interesting to know what you
don’t really know about FAS. Do not feel intimidated by this test. It’s
purpose is to spread the knowledge of FAS. Most of the people who took and will
take this test do and will not score about a 50. 1) What is the leading known
cause of mental retardation in western civilization today? a. Down Syndrome b.

FAS c. FAE d. Cerebral Palsy e. Spina Bifida 2) What percentage of women of
child-bearing age drink alcohol (many before they realize that they are
pregnant)? a. 10% b. 20% c. 35% d. 50% e. 75% 3) What percentage of persons with

FAS/FAE attain independence in living and in employment? a. 10% b. 18% c. 35% d.

53% e. 67% 4) Which of the following alcoholic beverages contains the greatest
amount of alcohol? a. A 12 oz. can of beer. b. A 5oz glass of wine. c. One shot
of liquor. d. A 12oz. wine cooler. e. All of the above. 5) What is the most
debilitating aspect of prenatal alcohol exposure? a. Memory deficits. b. Growth
retardation c. Lack of impulse control d. Mental retardation with IQ below 70 e.

Attention Deficit Disorder (ADD) 6) How much does it cost each year to treat
infants, children and adults with FAS? a. Almost $1,000,000.00 b. Almost
$2,000,000.00 c. Almost $100,000,000.00 d. Almost $2,000,000,000.00 e. Almost
nothing, as expenses are incurred by private insurance. 7) Which of the
following women are at high risks for drinking during pregnancy? a. Women with a
college education. b. Unmarried women. c. Female students. d. Women in
households with * $50,000 annual income. e. All of the above 8) Of the following
secondary disabilities associated with FAS/FAE, which one is the most common? a.

Mental illness b. Trouble in school. c. Trouble with the law. d. Abuse of
alcohol and/or other drugs. e. Sexuality problems. 9) Which of the following are
protective factors for preventing secondary disabilities in FAS/FAE? a. IQ below

70. b. Early diagnosis. c. Eligibility for disability services. d. Stable home
environment e. All of the above. 10) In which of the following ways does alcohol
affect a man’s ability to father healthy children? a. Lowered levels of
testosterone that interfere with sexual performance. b. Reduced mobility of
healthy sperm at time of infection. c. Increased risk of inherited tendency
toward alcoholism. d. Possible adverse effects on DNA in sperm before
conception. e. All of the above. The answers to this quiz will follow at the end
of this paper. Patterns of alcohol use are changing with the changing times of
today, with more and more teenagers consuming alcohol on a regular basis. This
is a growing concern as research shows that, in recent years, regular alcohol
consumption has increased alarmingly among the female population; particularly
among younger women and teenage girls. Due to this vast rise in alcohol
consumption it is societies burden to put forth evidence and proof about the
dangers of alcohol consumption among women during their child-bearing years. In
order for society to accomplish this, three things must happen: 1) Local
education staff should implement the teachings of the dangers that alcohol can
cause not only normal consumption but while pregnant as well. 2) Pamphlets
should be regularly handed out among young women and teens, in hospital waiting
rooms, family planning clinics, schools, by the parents, dealing with the
adverse effects of alcohol. 3) Government officials should affix warning labels
on alcohol so they can be seen clearly . They should be similar to those that
are placed on cigarettes. The most salient point that can be made about alcohol
induced fetal damage is that it is 100% totally preventable, we can only hope
that education of this subject, on the part of both prospective parents, will
control the increasing problem. It is astonishing to know that this information
has been readily available for such a long time and no one seems to worry about
it. If we could effectively foster the simple fact that "mothering from
conception is direct mothering", and therefore everything that the mother
consumes during pregnancy the fetus consumes as well, some of these tragedies
could be more easily be avoided. Answers to the quiz above are as follows: 1. B

2. D 3. B 4. E 5. A 6. B 7. D 8. A 9. A 10. E Works Sited Streissguth, A.P.,

Barr, H.M., Bookstein, F.L., Sampson, P.D., & Carmichael Olsen, H. (1999).

The long-term neurocognitive consequences of prenatal alcohol: A 14-year study.

Psychological Science, 10(3), 186-190. Streissguth, A.P., Barr, H.M., &

Sampson, P.D. (1990) Moderate prenatal alcohol exposure: Effects on child IQ and
learning problems at age 7 1/2 years. Alcoholism: Clinical and Experimental

Research, 14(5), 662-669. Streissguth, A.P., Barr, H.M., &Sampson, P.D.
(1989). Neurobehavioral effects of prenatal alcohol. Parts I, II, and III.

Neurotoxicology & Teratology, 11(5), 461-507. Streissguth, A.P., Barr, H.M.,

Sampson, P.D., & Martin, D.C. (1986). Attention, distraction and reaction
time at age 7 years and prenatal alcohol exposure. Neurobehavioral Toxicology
and Teratology, 8(6), 717-725. Streissguth, A.P., Grant, T.M., & Ernst, C.C.
(1999). Intervention with high-risk alcohol and drug abusing mothers: II. 3 year
findings from the Seattle Model of Paraprofessional Advocacy. Journal of

Community Psychology, 27(1), 19-38. Grant, T.M., Ernst, C.C., & Steissguth,

A.P. (1996). An intervention with high-risk mothers who abuse alcohol and drugs:

The Seattle Advocacy Model. American Journal of Public Health, 86(12),

1816-1817. On any given day in the United States... 10,657 babies are born. (US

Census Bureau). Twenty of these babies are born with Fetal Alcohol Syndrome.

Twenty may seem as though it is not a lot, but when you compare it to the fact
that this number is more than HIV positive, Muscular Dystrophy, Spina Bifida and

Down Syndrome combine it creates a whole new parameter. Fetal Alcohol Syndrome
is a direct result of a woman’s competed disregard for the fetus. Fetal

Alcohol Syndrome (FAS, hereinafter), is a series of both mental and physical
birth defects that can include, but are not limited to, mental retardation,
deficiencies in growth, central nervous system dysfunction, behavioral
maladjustments, and craniofacial abnormalities. It is common knowledge not to
smoke or drink during pregnancy. Growth abnormalities can be significant and
also includes all three of the following respects of growth: weight, length and
head circumference. Most of the time the baby’s growth abnormalities are so
severe they need to be hospitalized because of obvious failure to survive. A
baby with craniofacial abnormalities can be recognized by their eyes in that
they are small with exaggerated inner epicanthic folds. (Health Visitor Nov.

1981) The bridge of the nose is normally poorly developed. The ears are often
large and simple in form. (Midwives Chronicle and Nursing notes) At first, when
the baby is delivered, the affected infant shows signs of alcohol withdrawal;
with signs that are much similar to delirium tremens in adults. They are often
anxious, have a weak grasp, poor hand-to-eye coordination and consistent
difficulty in feeding and sucking. People can not blame the mother’s for the
most part though. It is a common ignorance among the health care providers. Most
health care providers are untrained and unfamiliar with substance abuse issues
among pregnant women. FAS is widely misdiagnosed and or under diagnosed. Only
ten percent of medical schools require students to complete a course on the
proper diagnosis of individuals with alcohol and other drug addictions. Many
women do not receive proper pre-natal care, and a study performed by a National

Center for Health Statistics found that doctors appear less likely to tell a
pregnant black woman to quit drinking and or smoking than they would be to a
white woman. (The New York Times, January 19, 1994) As mentioned above, a baby
with FAS can suffer from many different birth abnormalities. These disabilities
will indeed last a lifetime. There is no amount of alcohol found to be safe to
consume during pregnancy. FAS is, however, 100% preventable when a woman
abstains from alcohol. FAS is the leading known cause of mental retardation.

Approximately, one out of 750 live birth are born each year with FAS. (The

Journal of American Medical Association, 1991) Thirty to 40% of the mothers who
drink "heavily" throughout pregnancy have the syndrome. FAS is not limited
to any one group, race, culture, or socio-economic background. Between one-third
and two-thirds of children in special education have been affected by alcohol in
some way. (The Journal of American Medical Association, 1991) Comparison of
children and adults with FAS shows that with the approach to adolescence, the
specific craniofacial features are not as noticeable as they are in infancy.

Average academic functioning of these children and adults does not seem to
develop beyond early school grade level. The short stature and small head (micro
cephalic), seem to be permanent. The most noticeable behavioral problems were
found to be with comprehension, judgment, and attention skills, causing these
adults born with FAS to experience major psychological and adjustment problems
for the rest of their lives. Numerous studies with animals, of experimental
alcoholism, where nutritional status has been well controlled, have shown that
the damage to the developing fetus, such as low birth rate CNS ( Central Nervous

System) impairment, etc. are caused by the direct consequence of the effects of
alcohol. In addition, some of these studies have shown a clear continuum effect;
the higher the blood alcohol of the mother, the greater the damage to the
developing fetus. Even though the direct connection between alcohol intake and
birth defects is now indisputable, there are other etiological factors
associated with maternal drinking that must also be considered as contributing
factors in an adverse pregnancy outcome. The most important of these secondary
factors is alcohol related malnutrition, as nutritional deficiencies occur
frequently with alcohol intake due to reduced appetite. Alcohol-induced zinc
depletion is particularly well documented. This has shown a positive correlation
with reduced zinc status and low birth weight and fetal malformations,
suggesting that inadequate zinc intake could also act independently as a
teratogenic agent. (Yearbook of Nutritional Medicine 1984-85) Many studies have
been performed on FAS. The University of Washington School of Medicine is the
leader in scientific research of FAS. The school/students have done many
controlled research study’s. A few will be discussed in the following pages.

The longitudinal Study on Alcohol and Pregnancy, Neuropsychological Analyses of

FAS/FAE Deficits, Parent-Child Assistance Program (P-Cap), and the FAS Follow-up

Program. The longitudinal prospective study evaluates adverse outcomes in young
adults who were pre-natally exposed to known levels and patterns of alcohol. The
basic hypothesis of this long-term study is that prenatal alcohol exposure
exerts an enduring dose-dependent influence on offspring across a life-span. One
of the many problems of misdiagnosis, and is shown in this study is that, the
birth rate of FAS children is nearly 1 per 100 births. The problem is this,
alcohol-affected children and adults are often denied services when they lack
the characteristic FAS face and or mental retardation as defined by a
standardized IQ score of less then 69. It is essential that these diagnosis’
become more accurate so that the consequences can be understood and that the
markers of clinically affected individuals be identified to support appropriate
diagnosis and intervention. The Neuropsychological Analyses of FAS/FAE deficits
study proposes to quantify and link the neuroanatomic and neuropsychological
abnormalities in people with brain damage caused by prenatal alcohol exposure.

As of present time there is no scientific way of measuring the amount of brain
damage caused by alcohol and its relation to the dysfunctional behavior of the
patient. FAS is a diagnostic category which is the only means of measuring
quantitative brain damage. People that suffer from FAS are often considered to
be in a different group that carries the diagnosis of ARND Alcohol Related

Neurodevelopment Disorders. What the researchers in this study are hoping to
conclude, is by using a new analysis method it will reveal a significant means
of differences in brain form between FAS groups and Control group that are not
simply due to micro cephalic and that are not detectable from the clinical
reading of an MRI. The researchers also believe that that a brain/behavior study
will find significant correlations between brain dysmorphology and
neuropsychological deficits, and that the associations will be strong enough to
suggest the nature and extent of brain damage in the individual case. Although
there are many cases each day of FAS, and seems almost hopeless for the children
born from ignorance, there is help. There are many programs out there one that
will be mentioned is P-CAP. P-CAP is Parent-Child Assistance Program (formally
known as Birth to 3). It started in 1991 in Seattle, WA. P-CAP is an
intervention model developed through federal funds to enable communities to
respond, through long term advocacy, to the problems of mothers who have abused
drugs or alcohol during pregnancy and to the needs of the children. This program
reaches out to those women who had little to no prenatal care, and are not
connected to community resources. The goals of P-CAP are simple. they are (1) to
assist clients in obtaining alcohol and drug treatment, staying in recovery and
resolving complex issues that might have risen during within the context of
their substance abuse; (2) to assure that the children are in a safe home with
these mothers and are receiving proper health care; (3) to link these mothers to
community resources for the professional services and education that will help
learn and maintain a healthy independent family life; (4) to demonstrate to
community services that positive work is being done to further the prevention of
future births of FAS. Typical mothers that are enrolled in this program are
characterized by poverty, upbringing by substance abusing parents, child abuse,
abusive adult relationships, and trouble with the law to name a few. Notably,
there have been no turnover among the paraprofessional staff for over five years
in a field which is known for hate rates of burnouts among personnel. I found
this letter in a publication, this shows the tremendous difference between a
client with limited mental abilities and a client with FAS: June 14, 1999 To:

President and Hillary Clinton, Twenty three years ago a young woman who was
pregnant was abandoned by her husband. She had no job, no money, no health
insurance and no family. Alone, she turned to alcohol for comfort. Eventually,
she returned to school. Got some good training and got a good job but all the
good things came too late for the child she was carrying during the time she was
relying on alcohol. This child was born with Fetal Alcohol Syndrome. Being a
single parent, this mom was not able to take proper care of a child who never
slept and was constantly ill. Eventually she was forced to place the child in an
institution for the mentally retarded. Fortunately, for the child in this story,
a friend at the institution told me about the new child at the school and asked
for my assistance. I had worked with hundreds of delayed children and was
confident that I could help this child gain the skills necessary to live with
her family again. I was naive. I had not met FAS head on before. I had had
wonderful success teaching children with other forms of mental retardation to
dress, eat and use the bathroom appropriately. This time it did not work the way

I thought it would. Sixteen years ago when this child came to live with us I
really thought I knew the answers. I now know that FAS is different the answers
are different. She has learned many good and wonderful things. She still cannot
dress, eat and use the bathroom appropriately for her age. The brain damage
caused by prenatal exposure to alcohol damages the brain's ability to
communicate within itself. This young woman has no appropriate sense of hot or
cold. If she looks at a thermometer outdoors, she can read the temperature but
cannot reason out what type of clothes she is to wear in hot weather or cold.

She needs constant guidance to make it from day to day without placing herself
at risk. Despite all that some of us have learned about FAS, we still find that
most teachers and school personnel do not recognize that this disability is
different from other forms of mental retardation. Despite all that has been
written about FAS, we find that more women are drinking while pregnant than
there were in 1992. Despite all the research by the medical profession, we find
that many, many doctors still cannot recognize FAS in their patients. Despite
the efforts made by social workers, therapists, and schools, we are finding that
approximately 40% of those in our state prisons are disabled by prenatal
exposure to alcohol. I cannot condemn the ignorance of others as I was once
ignorant myself. However I cannot see a healthy outcome for our country if we
continue in this mass ignorance. I am asking you to lend us your support in
turning the tide of ignorance concerning this disability. Sincerely, Delinda L.

McCann MA I found this quiz in a magazine, it is interesting to know what you
don’t really know about FAS. Do not feel intimidated by this test. It’s
purpose is to spread the knowledge of FAS. Most of the people who took and will
take this test do and will not score about a 50. 1) What is the leading known
cause of mental retardation in western civilization today? a. Down Syndrome b.

FAS c. FAE d. Cerebral Palsy e. Spina Bifida 2) What percentage of women of
child-bearing age drink alcohol (many before they realize that they are
pregnant)? a. 10% b. 20% c. 35% d. 50% e. 75% 3) What percentage of persons with

FAS/FAE attain independence in living and in employment? a. 10% b. 18% c. 35% d.

53% e. 67% 4) Which of the following alcoholic beverages contains the greatest
amount of alcohol? a. A 12 oz. can of beer. b. A 5oz glass of wine. c. One shot
of liquor. d. A 12oz. wine cooler. e. All of the above. 5) What is the most
debilitating aspect of prenatal alcohol exposure? a. Memory deficits. b. Growth
retardation c. Lack of impulse control d. Mental retardation with IQ below 70 e.

Attention Deficit Disorder (ADD) 6) How much does it cost each year to treat
infants, children and adults with FAS? a. Almost $1,000,000.00 b. Almost
$2,000,000.00 c. Almost $100,000,000.00 d. Almost $2,000,000,000.00 e. Almost
nothing, as expenses are incurred by private insurance. 7) Which of the
following women are at high risks for drinking during pregnancy? a. Women with a
college education. b. Unmarried women. c. Female students. d. Women in
households with * $50,000 annual income. e. All of the above 8) Of the following
secondary disabilities associated with FAS/FAE, which one is the most common? a.

Mental illness b. Trouble in school. c. Trouble with the law. d. Abuse of
alcohol and/or other drugs. e. Sexuality problems. 9) Which of the following are
protective factors for preventing secondary disabilities in FAS/FAE? a. IQ below

70. b. Early diagnosis. c. Eligibility for disability services. d. Stable home
environment e. All of the above. 10) In which of the following ways does alcohol
affect a man’s ability to father healthy children? a. Lowered levels of
testosterone that interfere with sexual performance. b. Reduced mobility of
healthy sperm at time of infection. c. Increased risk of inherited tendency
toward alcoholism. d. Possible adverse effects on DNA in sperm before
conception. e. All of the above. The answers to this quiz will follow at the end
of this paper. Patterns of alcohol use are changing with the changing times of
today, with more and more teenagers consuming alcohol on a regular basis. This
is a growing concern as research shows that, in recent years, regular alcohol
consumption has increased alarmingly among the female population; particularly
among younger women and teenage girls. Due to this vast rise in alcohol
consumption it is societies burden to put forth evidence and proof about the
dangers of alcohol consumption among women during their child-bearing years. In
order for society to accomplish this, three things must happen: 1) Local
education staff should implement the teachings of the dangers that alcohol can
cause not only normal consumption but while pregnant as well. 2) Pamphlets
should be regularly handed out among young women and teens, in hospital waiting
rooms, family planning clinics, schools, by the parents, dealing with the
adverse effects of alcohol. 3) Government officials should affix warning labels
on alcohol so they can be seen clearly . They should be similar to those that
are placed on cigarettes. The most salient point that can be made about alcohol
induced fetal damage is that it is 100% totally preventable, we can only hope
that education of this subject, on the part of both prospective parents, will
control the increasing problem. It is astonishing to know that this information
has been readily available for such a long time and no one seems to worry about
it. If we could effectively foster the simple fact that "mothering from
conception is direct mothering", and therefore everything that the mother
consumes during pregnancy the fetus consumes as well, some of these tragedies
could be more easily be avoided.

Bibliography

Streissguth, A.P., Barr, H.M., Bookstein, F.L., Sampson, P.D., &

Carmichael Olsen, H. (1999). The long-term neurocognitive consequences of
prenatal alcohol: A 14-year study. Psychological Science, 10(3), 186-190.

Streissguth, A.P., Barr, H.M., & Sampson, P.D. (1990) Moderate prenatal
alcohol exposure: Effects on child IQ and learning problems at age 7 1/2 years.

Alcoholism: Clinical and Experimental Research, 14(5), 662-669. Streissguth, A.P.,

Barr, H.M., &Sampson, P.D. (1989). Neurobehavioral effects of prenatal
alcohol. Parts I, II, and III. Neurotoxicology & Teratology, 11(5), 461-507.

Streissguth, A.P., Barr, H.M., Sampson, P.D., & Martin, D.C. (1986).

Attention, distraction and reaction time at age 7 years and prenatal alcohol
exposure. Neurobehavioral Toxicology and Teratology, 8(6), 717-725. Streissguth,

A.P., Grant, T.M., & Ernst, C.C. (1999). Intervention with high-risk alcohol
and drug abusing mothers: II. 3 year findings from the Seattle Model of

Paraprofessional Advocacy. Journal of Community Psychology, 27(1), 19-38. Grant,

T.M., Ernst, C.C., & Steissguth, A.P. (1996). An intervention with high-risk
mothers who abuse alcohol and drugs: The Seattle Advocacy Model. American

Journal of Public Health, 86(12), 1816-1817.

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