Diagnosis
What does FASD stand for and What is the prevalence of FASD in Canada? (1-2%) or ( 4-5%)
Fetal Alcohol Spectrum Disorder.
FASD is a now diagnostic term in Canada, describing the range of effects that can occur in an individual who was prenatally exposed to alcohol.
Based on the most current research, the estimated prevalence of FASD in the general Canadian population is 4-5%.
True or false- Alcohol is passed from a mother's blood to the baby's blood through the placenta
True- Mom’s blood carries oxygen and nutrients to the placenta. The blood travels up the umbilical cord to the placenta and carries oxygen ( and in this case ethanol ) and nutrients back to baby
Guess the rate. How much higher a rate of Immune problems do those with FASD have than typically developing individuals? ( 10-50, 60-80, or 100 and higher)
142 times higher rates of immune problems for those with FASD especially in terms of chronic ear infections and asthma.
Name the brain domain impacted. A child may appear to lie but is actually filling in the blanks. Is this cognition, attention or memory.
Memory. This is called confabulation. Youth with FASD often fill in the blanks when unable to recall short term/ long term memories.
True or false- A child can receive an FASD diagnosis without their biological mother admitting to prenatal alcohol or substance use
False- Sometimes a diagnosis may have to be deferred and the term “At Risk for Neurodevelopmental Disorder & FASD, associated with prenatal alcohol exposure” may be used until a diagnosis can be offered. This is dependent on the bio mom's own disclosure of prenatal substance use.
Which part of the brain is more greatly impacted by FASD? The corpus callosum (Passes information from one side of the brain to the other) or the basal ganglia (Spatial memory, Determination, Prediction)
Corpus Callosum- One of the most consistent structural defects in people with FASD is the malformation of the corpus callosum.
Which is more likely a diagnosis for individuals with FASD- dementia or arthritis (Himmelreich, Lutke & Travis 2016)
Early onset Dementia- 104x more likely than the general populous versus arthritis which is 12x higher than the general population
Name the brain domain impacted. May repeat instructions or rules back to you but may not follow through. Attention, Language, Motor Skills
Language- specifically receptive language. Youth's expressive and receptive language is impacted.
True or false- Only small percentage of people exposed to alcohol in utero have “FASD With Sentinel Features” diagnosis.
True- These facial features form around days 17 – 22 of early pregnancy.
True or false- There is a different concentration of alcohol that is present in the mother’s bloodstream versus the baby's bloodstream
False. The baby gets as much alcohol as the mother gets. Because the baby's liver hasn't developed it results in higher levels of alcohol in the fetus for an extended period of time.
True or false- youth with FASD have strong interoceptive skills so they can sense when they feel sick/ or are in more pain than usual
False. Youth with FASD often do not have strong interoceptive skills. Additionally, as they experience chronic pain/ health issues their ability to detect new or more intense pain.
Name the brain domain impacted. Difficulty understanding cause and effect and controlling behavior. Executive functioning, Affect regulation or cognition
Executive functioning. Youth with FASD have impacted Lymbic systems which influence their executive functioning. The Lymbic system is one of the first parts of the brain to develop. It is a connection of many brain structures that help inform processes that all have to do with managing oneself and one's resources in order to achieve a goal.
True or False- FASD is a brain-based disability and therefore it primarily impacts a child's brain and cognitive functioning
False- FASD is more than a brain-based injury. A recent study revealed that it can impact the whole body. (Himmelreich, Lutke & Travis 2016)
True or false- Alcohol has more of an impact on the fetus than other teratogens (nicotine/ meth/ heroin)
True -teratogens (poisons) such as nicotine, heroin, crystal meth, etc., are able to pass the placental barrier as well, but do not have the ability to impact the fetus in the same devastating manner as ethanol.
Because of the physiochemical properties of alcohol (it is polar and small in size) it can easily diffuse from the maternal blood to the fetal blood through the interstitial space of the placenta.
In the first three weeks of conception which two systems are most impacted by prenatal alcohol exposure; Central Nervous system, Arms, Eyes, Heart, Genetalia and ears.
Central nervous system (including brain and spinal cord) and the heart. This alludes to why Hypothyroidism is 160x higher and Congenital Heart Defects is 23x higher for youth with FASD.
Name the brain domain impacted. May behave socially and emotionally younger than actual age. Adaptive behavior/ social skills, affect regulation, attention.
Adaptive Behavior/ Social Skills. Individuals with FASD do not have the ability to meet many of society’s age-based social expectations.
Fill in the blanks. A diagnosis of FASD requires testing of the following; Knowledge of family history, differential diagnosis, physical examination and ____ brain domains. (choose 8, 9 or 10)
10 Brain domains. The diagnosis of FASD requires severe impairment in at least 3 of these domains. Academic achievement, attention, cognition, Language, Memory, Neuroanatomy , executive functioning, social skills, motor skills and affect regulation
True or false- it is safe to drink small amounts of alcohol up to 17 to 20 days after conception.
False- There is no known safe amount of alcohol consumption during any point of conception/pregnancy.
True or false- We use the method of reteaching with youth with FASD because it is backed by neurobiology!
True- Research has determined that the brain has “plasticity” or the ability to change in response to experiences. When we reteach we assist youth with FASD in rewiring parts of their brain- memories and repeated experience can change a brain's physical structure. SO EXCITING!
Name the brain domain. Can be easily distracted difficulty paying attention and sitting still. Language, Neuroanatomy, or attention.
Attention. Up to 97% of children with FASD will also meet criteria for ADHD.