Transcript FASEout: Fetal Alcohol Syndrome/Fetal Alcohol Effects

Fetal Alcohol Spectrum
Disorder: Best Practices
FASEout Project 2006:
www.faseout.ca
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People affected by FASD are
found within health, education,
justice and social service sectors
and receive inconsistent
messages and often inadequate
support
There is a clear need for a
collaborative approach to
implementing current Best
Practices
FASEout Project 2006:
www.faseout.ca
What are Best Practices?
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Meeting the needs of people who may be
affected by FASD and ensuring that
prevention of FASD is a component of
everyday service delivery
Statements based on scientific evidence
and/or on the perspectives of consumers,
expert practitioners and educators - Health
Canada (2001)
FASEout Project 2006:
www.faseout.ca
Best Practices (cont’d)
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In 2000, the Canadian Centre on Substance
Abuse undertook a Situational Analysis Project
on FAS/FAE for Health Canada
Literature reviews, research and national
program interviews were conducted and Best
Practices for FAS/FAE and the Effects of Other
Substance Use During Pregnancy (Health
Canada, 2001) was created
FASEout Project 2006:
www.faseout.ca
Best Practice Statements
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Best Practice statements were developed
for:
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Prevention
Identification
Intervention
FASEout Project 2006:
www.faseout.ca
Prevention
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Prevention activities address issues up to the
birth of the child
are intended to promote health and prevent
alcohol/drug use during pregnancy
prevent conception while substances are used
reduce harm arising from substance use during
pregnancy
FASEout Project 2006:
www.faseout.ca
Primary Prevention
Activities undertaken with a
healthy population in order to
maintain or enhance physical
and/or emotional health
FASEout Project 2006:
www.faseout.ca
Secondary Prevention
Activities aimed to address
a problem before it becomes
severe or persistent
FASEout Project 2006:
www.faseout.ca
Tertiary Prevention
Activities for individuals in
whom the condition has
already developed
FASEout Project 2006:
www.faseout.ca
Identification
 Activities
that involve screening,
referral and diagnosis of
newborns, adolescents or adults
affected by prenatal substance
use
FASEout Project 2006:
www.faseout.ca
Diagnosis
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Diagnosis is done by medical specialists in
conjunction with a multi-disciplinary team
including a pediatrician or medical doctor,
psychologist, social worker,
physiotherapist, occupational therapist and
speech therapist
FASEout Project 2006:
www.faseout.ca
Intervention
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Activities intended to prevent or reduce
the harm associated with the primary
and secondary disabilities
Intervention activities are specific to
infancy, childhood, adolescence and
adulthood
FASEout Project 2006:
www.faseout.ca
Best Practice Statements
Primary Prevention
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Limit the availability of alcohol
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Use warning labels and posters
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Develop school wide substance use
prevention programs as a means of
preventing or delaying substance use
among youth FASEout Project 2006:
www.faseout.ca
Best Practice Activities
Primary Prevention
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Public awareness campaigns
Warning signs and labels
Information dissemination
Public education workshops
Community-based projects
FASEout Project 2006:
www.faseout.ca
Best Practice Statements
Secondary Prevention
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Routine screening of all pregnant women for use
of alcohol in various settings, including justice,
housing and health
Training on FASD for physicians and health
professionals working with women who have
substance use problems
Use cognitive-behavioural intervention methods
with women with early-stage alcohol problems
FASEout Project 2006:
www.faseout.ca
Best Practice Statements
Tertiary Prevention
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Combine prenatal care with substance
abuse programming
Promote gender specific substance abuse
treatment programs
Advocate for services with a single point
of access addressing social and health
needs of pregnant women with substance
use problems
FASEout Project 2006:
www.faseout.ca
Best Practice Statements
Tertiary Prevention (cont’d)
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Intensive case management of service
Openness to intermediary harm
reduction goals
No evidence to support the use of
punitive measures, such as mandated
treatment
FASEout Project 2006:
www.faseout.ca
Best Practice Activities
Secondary and Tertiary Prevention
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Programming specific to women who are
pregnant and using substances
Routine screening to identify women who are at
risk of having a baby born with FASD
Women centred substance abuse treatment
programs for women who are pregnant
“One stop” programming
Home visitation case management
FASEout Project 2006:
www.faseout.ca
Best Practice Statements
Identification
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Diagnostic services enhanced through
specialized training, telemedicine and traveling
clinics
Routine screening of maternal alcohol use during
prenatal care
Supportive atmosphere when discussing
substance abuse problems with pregnant
FASEout Project 2006:
women
www.faseout.ca
Best Practice Activities
Identification
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Accessible multidisciplinary
diagnostic services
Standardized clinical guidelines
FASD - specific clinics
Psychosocial assessment services
Physician training specific to FASD
FASEout Project 2006:
www.faseout.ca
Best Practice Statements
Intervention - Infancy
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Use of a multidisciplinary team to address the range of
complex needs for infants affected by FASD
Long-term, stable living environments where caregivers
have FASD specific information, training and support
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Low staff-child ratio programming
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Access to early educational interventions
FASEout Project 2006:
www.faseout.ca
Best Practice Activities
Intervention - Infancy
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Infant development programs designed
specifically for infants with FASD (low
staff-child ratio, low sensory activities,
etc.)
Support for caregivers of infants with
FASD
Home visitation case management
FASEout Project 2006:
www.faseout.ca
Best Practice Statements
Intervention - Childhood
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Caregivers of children with FASD benefit from
ongoing support and advocacy for medical,
educational and psychological issues
Children with FASD benefit from an
Individualized Education Plan (IEP) involving a
range of collaborating professionals
FASEout Project 2006:
www.faseout.ca
Best Practice Statements
Intervention - Childhood
(cont’d)
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Learning environments should be adjusted for
children affected by FASD - calm, quiet, routine,
structure, etc.
Individualized curriculums should include a focus
on functional skills for independent living
(problem solving, social interacting, etc.),
behaviour management strategies and
developing realistic expectations of the child
FASEout Project 2006:
www.faseout.ca
Best Practice Activities
Intervention - Childhood
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FASD specific school programs - adjusted
curriculum and classroom requirements
Life-skills programs to include information
on the consequences of drinking during
pregnancy
Multidisciplinary case management teams
for ongoing support
FASEout Project 2006:
www.faseout.ca
Best Practice Statements
Intervention - Adolescence
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Adolescents benefit from basic
socialization and communication skills,
tailored vocational counselling and
employment supervision
Tailored programming for substance abuse
treatment, mental health services and
within the correction system
FASEout Project 2006:
www.faseout.ca
Best Practice Activities
Intervention - Adolescence
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Programming specific for youth affected
by FASD (job readiness, alternative
sentencing, supported employment,
alternative training)
Supportive housing for youth affected by
FASD (group homes)
Substance abuse treatment programs
designed for youth affected by FASD
FASEout Project 2006:
www.faseout.ca
Best Practice Statements
Intervention - Adulthood
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Consistent case management and
advocacy for adults (and their children)
Substance abuse programs,
employment training, mental health and
correctional services tailored for adults
affected by FASD
FASEout Project 2006:
www.faseout.ca
Best Practice Activities
Intervention - Adulthood
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Supportive living environments (external
brain managers)
Tailored employment programs
Programs within the correctional system
directed for adults affected by FASD
Support for family members supporting an
adult affected by FASD
FASEout Project 2006:
www.faseout.ca
Implementation Guide:
What is it?
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a guide based on principles from Health
Canada’s Best Practices and Situational
Analysis for FAS/FAE and the Effects of
Other Substance Use During Pregnancy
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(2001)
a step by step framework for policy and
practice modification
a modified lens for looking at FASD
FASEout Project 2006:
www.faseout.ca
Values Guiding our Work
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Hope…….
Respect…….
Understanding……..
Compassion………
Cooperation……….
(Adapted from the Saskatchewan FAS Coordinating
Committee Guiding Principles 2001)
FASEout Project 2006:
www.faseout.ca
Hope
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Recognize that at whatever point a
woman can stop or reduce her drinking
in pregnancy, there is hope for her to
have a healthier child
Acknowledge that no matter what,
supportive intervention is effective
FASEout Project 2006:
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Respect
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The abilities of individuals affected by FASD
The knowledge of those who parent individuals
affected by FASD
The rights and capabilities of women and their
partners to make obvious choices about their
health and that of their children
FASEout Project 2006:
www.faseout.ca
Understanding
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Stay open to new information and be aware and
reflective of your own attitudes and values
Inform yourselves about the issues and on-going
research
Avoid sensationalizing FASD
Be sensitive to the impact of a diagnosis on
an individual, theirFASEout
family
Projectand
2006: community
www.faseout.ca
Compassion
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Be sensitive to the needs of individuals
affected by FASD
Be open to learning people’s strengths and
challenges
Be sensitive to the situation of women
using alcohol
Be open to the individual process of
recovery
FASEout Project 2006:
www.faseout.ca
Cooperation
Recognize the importance of building
partnerships within communities in
addressing all aspects of FASD
FASEout Project 2006:
www.faseout.ca
Goals
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Prevent FASD
Assist in development of appropriate
policy and practice in relation to FASD
Best Practices
Increase community capacity to provide
care and support to those who are
affected by FASD
FASEout Project 2006:
www.faseout.ca
Objectives
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Reduce incidence of FASD through
increased awareness and knowledge
Train all staff regarding FASD and its
impacts on children and adults
Increase public education activities in
FASD prevention and intervention
FASEout Project 2006:
www.faseout.ca
Objectives (cont’d)
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Increase coordination between disciplines
to ensure proper diagnosis and referral for
services
Support individuals and families affected
by FASD
Develop a committee dedicated to
reviewing policy and practice in relation to
Best Practices
FASEout Project 2006:
www.faseout.ca
Methodology
Watch
Get help
Do
FASEout Project 2006:
www.faseout.ca
Watch - see the world
differently
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Become educated about FASD
Examine challenges to policy and practice
implementation and find strengths within
the organization and community
Make the paradigm shift required to view
services through the FASD lens
FASEout Project 2006:
www.faseout.ca
Education - Ask
Yourselves...
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Can you attend FASD conferences?
Can you train all staff about FASD?
Can you collect and review FASD
resources?
Can you discuss Best Practices with
families affected by FASD?
Can you educate community members
regarding FASD?FASEout Project 2006:
www.faseout.ca
Challenges and Strengths
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Is Federal or Provincial legislation limiting
FASD work?
Are costs prohibiting access to services in
your community?
Are consistent messages about alcohol
and pregnancy visible in your community?
Are FASD diagnostic services obtainable?
FASEout Project 2006:
www.faseout.ca
Challenges and Strengths
(cont’d)
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Are there already knowledgeable staff
regarding FASD in your organization?
Are there existing community
partnerships?
Do you have flexible programming?
Are there strong and committed family
members and support people for
individuals affected by FASD?
FASEout Project 2006:
www.faseout.ca
Paradigm Shift
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Need to change expectations that all
behaviour can be changed
FASD needs to be seen as an invisible
disability
Dependence is a factor of FASD
People with FASD need things to be
repeated many times and to be reminded
often
FASEout Project 2006:
www.faseout.ca
Paradigm Shift (cont’d)
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Individuals with FASD need to be informed
of their disability
Support people need to stay involved
Early diagnosis is key to accessing
appropriate services
Structure, supervision and simplicity
are key
Models of alternative justice should
be used
FASEout Project 2006:
www.faseout.ca
Get Help - to take on the
task
Form Partnerships
FASEout Project 2006:
www.faseout.ca
Partnerships
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Can you join or create a multidisciplinary
FASD committee?
Can you locate and refer to professionals
who have an understanding of FASD in
health, education, social work, mental
health, addictions, justice, employment
and housing?
FASEout Project 2006:
www.faseout.ca
Partnerships (cont’d)
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Can you locate positive role models for
FASD in your community?
Can you seek information from FASD
experts?
FASEout Project 2006:
www.faseout.ca
Do - the work needed
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Review existing policies and practices
and modify them with regards to FASD
Remain consistent with Best Practices
FASEout Project 2006:
www.faseout.ca
Modifying Policies and
Practice
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Can you develop an on-going Best Practice
committee within your organization?
Can you review FASD literature and
resources?
Can you review existing policies through
the FASD lens?
Can you hold on-going training sessions
on FASD for all staff?
FASEout Project 2006:
www.faseout.ca
Modifying Policies and
Practice (cont’d)
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Can you modify policies and practice?
Can you incorporate FASD awareness
into training for all activities?
Can you disseminate information to
partners in the area?
Can you act as a mentor to other
organizations?
FASEout Project 2006:
www.faseout.ca
Best Practices
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As organizations move through each statement
they can ask themselves which stage they are at
(watch, get help, do) and where their target
stage will be
Not all organizations will be able to reach the
“Do” stage for each Best Practice statement, but
knowing where to refer or get information is key
FASEout Project 2006:
www.faseout.ca
Action Plan
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Once organizations understand where they are
currently and what their goals are for the future,
Action Plans can be developed to reflect the
steps needed to achieve Best Practice
Short term and long term goals should be
established and reviewed on an on-going basis
FASEout Project 2006:
www.faseout.ca
Action Plan (cont’d)
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Action Plans change and develop as new
information is obtained and new programs
are developed
An FASD Best Practice Committee within
the organization and community is key to
ensuring that the issues are not ‘lost’
FASEout Project 2006:
www.faseout.ca
References
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Best Practices for FAS/FAE and the Effects of Other
Substance Use During Pregnancy (Health Canada, 2001)
2000, the Canadian Centre on Substance Abuse
undertook a Situational Analysis Project on FAS/FAE
Best Practices: Treatment and Rehabilitation for Women
with Substance Use Problems (Health Canada, 2001)
Preventing Substance Use Problems Among Young
People: A Compendium of Best Practices (Health Canada
2001)
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Enhancing Fetal Alcohol Syndrome (FAS)-related
Intervention at the Prenatal and Early Childhood Stages
in Canada (Canadian Centre on Substance Abuse, 2001)
FASEout Project 2006:
www.faseout.ca