Transcript Prenatal Alcohol Exposure: Lifelong Impacts

Prenatal Alcohol Exposure:
Lifelong Impacts
YOLANDA ROSS, LBSW
LEAH DAVIES, LMSW
CENTRAL TEXAS AFRICAN AMERICAN
FAMILY SUPPORT CONFERENCE
MARCH 27, 2015
Welcome and
Thank you for coming!
Mental
Health
FASD
Support
Disability
Addiction
Choice?
Pregnancy
Health
Alcohol
Development
Knowledge
Yolanda’s Story
Understanding FASD
ALCOHOL USE AMONG
PREGNANT WOMEN
Women and Alcohol
 Studies show that women with alcoholism are up to
twice as likely as men to die from alcohol-related
causes such as suicide, accidents, and illnesses.
 Alcohol becomes more highly concentrated in a
woman’s body.
 Women who drink heavily are more prone to liver
disease, heart damage, and brain damage than
men.
 The code of silence around women and
substance abuse and women is harming
women and their babies.
The Numbers
 1 in 13 pregnant women drink (CDC, 2012)
 47% of Texas pregnancies are unintended (PRAMS, 2009)
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Approximately 68% for women aged 19 and younger
 44.3 % of Texas women report drinking any alcohol before pregnancy
(PRAMS, 2009)
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5.7 % reported drinking any alcohol during the 3rd trimester
 34% of pregnant adolescents (age 12-14) report using one or substance in
past 30 days (Salas-Wright, 2015)
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Most commonly used: Alcohol (16%)
 Most likely to report alcohol use during pregnancy in 2012 CDC MMWR
report:
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White
Between the ages of 35 and 44
College graduates
Employed
Drinking while pregnant?
 Women may be unaware that
they are pregnant
 Women may know other
women who drank during
pregnancy and who have
children who appear
outwardly to be healthy
 Women may use alcohol to
cope with difficult life
situations such as: poverty,
violence, isolation, despair or
depression
 Women may be struggling
with addiction.
STIGMA
FASD is not about the face,
it’s about the brain!
Wattendorf, D. MAJ, MC, USAF, and Muenke, M, National
Human Genome Research Institute, National Institutes of
Health, Bethesda, Maryland. Am Fam
Physician. 2005 Jul 15;72(2):279-285.
Prevalence
 Experts estimate that an FASD may occur in approximately 2-5%
of all live births. (May. P et al., 2014).
The chart below reflects national prevalence estimates for new cases of each of the listed health issues
40,000
35,000
30,000
25,000
20,000
15,000
10,000
5,000
0
Spina
Bifida
Down
Childhood
Syndrome Cancers
Diabetes
(Type 1)
FASD
 Thus, of the 380,000 or so infants born in Texas in 2011(DSHS),
approximately 7,600-19,000 may have been born with a disorder
within the FASD spectrum*.
Characteristics of FASD Due to Brain Damage
 Impaired executive
 Decreased visual focus
function
 Developmental delay
 Mental Health Issues
 Decreased/increased
Attention deficits
 Increased stress
response
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 Increased activity
 Sleep disturbances
response to noise or
stimulation
 Delayed speech
development
 Possible intellectual
disability
 Learning difficulties
FASD and well-being . . .
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Oppositional Defiant Disorder (ODD)
ADHD, ADD
Bipolar disorder
Intermittent Explosive Disorder
Autism Spectrum (including Asperger’s
Syndrome)
Reactive Attachment Disorder
Traumatic Brain Injury
Antisocial Personality Disorder
Conduct Disorder
Borderline Personality Disorder
Depression
Logic Model
Because FASD is a brain-based disability, seen mostly
in behaviors . . .
Then providing accommodations for people with an FASD
or other neurocognitive impairment is as appropriate,
effective and important as providing accommodations for
people with other physical disabilities
So what should we do?
• PREVENTION
• INTERVENTION
Prevention is key!
Referral to
Treatment
Brief
Intervention
(if positive)
Screening
(if necessary)
Shift in Thinking
From believing the individual
with an FASD…
To understanding the
individual possibly…
Won’t
Can’t
Annoying
Frustrated, challenged
Lies
Fills in the blanks
Irritable
Overstimulated
Trying to get attention
Needs contact, support
Inappropriate
Displays behaviors of a child, is
developmentally younger
IS the problem
HAS a problem
Adapted from Malbin, 2002
Developing Accommodations
Identify
what was
going on
just before
behavior =
the need
Ask:
What can I do
to help meet
this child in
his/her need?
Adapt
teaching
and/or
environment,
carefully
monitor
progress
So what works?
Hannah’s experience
 MHMRA of Harris County
 Early Childhood Intervention (ECI)
 Pasadena Independent School District (PISD)
 NOFAS
 University of Washington
 The Council on Alcohol and Drugs Houston
(Cradles Project)
 K.I.N.D.E.R. Clinic through Memorial Hermann
Hospital (No longer in existence)
 No Place Like Here
Strategies for Success
 Stable routine
 Limit (but provide,) choices and instruction
 Celebrate successes (even small ones)
 Teach social skills and emotions
 Provide supports in school (to individual, teachers,
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and classmates.)
Repetition!
Consistency
Use concrete language and explanations
Teach self-advocacy
What doesn’t work
 Rewards or punishments that
will happen “in the future.”
 Independence as a goal.
 Viewing inability to follow
through as a lack of
motivation.
 Zero Tolerance policies.
 Approaches that rely heavily
on verbal processing – like
MI.
“We must move from
viewing the individual
as failing if s/he does
not do well in a program
to viewing the program
as not providing what
the individual needs in
order to succeed.”
—Dubovsky, 2000
For more information
 The Texas Office for Prevention of Developmental
Disabilities http://www.topdd.state.tx.us

Leah Davies: [email protected]
 The CDC
http://www.cdc.gov/ncbddd/fasd/index.html
 The FASD Center for Excellence (SAMHSA)
http://www.fasdcenter.samhsa.gov/
Questions/Thoughts
There is also no safe time during
pregnancy to drink and no safe
kind of alcohol. We urge pregnant women
not to drink alcohol at
any time during pregnancy.”
– Centers for Disease Control and Prevention, 2011
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