"If you're trying to have a family, do not consume alcohol. If you want to drink and are sexually active, practice birth control".
H Jackson 2006, owner of The Alcohol Library
[Source: Yahoo Distillers & new_distillers messages]
Fetal alcohol syndrome (FAS) is a birth defect syndrome caused by the mother's intake of alcohol during pregnancy. The spectrum of alcohol-related diagnoses includes:
All of these birth defects are entirely preventable and can happen to anyone, regardless of age, race or socioeconomic status.
Alcohol's effects are more harmful to a fetus than those of all other drugs, including cocaine. When a woman drinks alcohol, it reaches the placenta in a few moments and passes through the growing fetus. The mother's body can break down one drink in approximately three hours, but alcohol stays in the fetus for much longer.
One drink = ½ ounce of absolute alcohol, which is contained
in one 12 oz.
beer, one 4 oz. glass of wine, or one mixed drink as
poured in a bar. Most
people drink at home where alcohol is not measured, so "1 drink" may actually be
2 drinks or more.
Alcohol is a teratogenic drug, which means it can cause birth defects when taken after conception. Different types of drinking affect the fetus in different ways. Binge drinking (consuming a large amount of alcohol in a short period of time) is more harmful than drinking the same amount over the course of a week because the mother's blood alcohol content is much higher.
The mother's health, amount of alcohol consumed, time during the pregnancy during which the alcohol was consumed, and her metabolism all affect the fetus in various ways. In addition, the regions of the developing brain and body that are affected by alcohol vary, depending on when the alcohol was taken into the mother's system.
Women who drink during pregnancy may give birth to a child with FAS/FAE, and may also have problems with their pregnancy, such as a miscarriage, a stillborn or premature baby.
Drinking during breastfeeding is also harmful for the baby.
[Source: http://www.fetalalcohol.com]
the
Brain
(Photo courtesy of
Sterling Clarren, MD)
Brain of a baby
Brain of baby with Fetal
not
affected by alcohol Alcohol
Syndrome
How Prenatal Alcohol
Exposure Affects Development of the Brain
FASD and the Brain
© 2000-2006 Teresa Kellerman
Alcohol is a
"teratogen" (substance that is toxic to the baby's developing brain). Damage can occur in various regions of the brain.
The areas that might be affected depend on which areas are developing at the
time the alcohol is consumed. Since the brain and the central nervous system
are developing throughout the entire pregnancy, the baby's brain is always
vulnerable to damage from alcohol exposure.
The regions of the brain that might be affected by prenatal alcohol
exposure in terms of ability to function include:
Corpus
Callosum - passes information from the left brain (rules, logic)
to the right brain (impulse, feelings) and vice versa. The Corpus Callosum in
an individual with a Fetal Alcohol Spectrum Disorder (FASD) might be smaller
than normal, and in some cases it is almost nonexistent.
Hippocampus - plays a role in memory function.
Cerebellum - controls coordination and movement, behavior and memory.
Basal Ganglia - affects spatial memory and behaviors like perseveration
and the inability to switch modes, work toward goals, and predict behavioral
outcomes, and the perception of time.
Frontal Lobes - controls impulses and judgment. The most noteworthy
damage to the brain probably occurs in the prefrontal cortex, which controls
what are called the Executive Functions.
Alcohol causes more damage to the developing fetus than any other
substance, including marijuana, heroin, and cocaine.
(Institute of Medicine, 1996)
Fetal Alcohol Spectrum
Disorders (FASD)
Executive Functions
of the Prefrontal Cortex
Effects of
alcohol exposure on behaviors related to executive functions of the prefrontal
cortex:
Ø inhibitions:
socially inappropriate behavior
Ø problem solving:
inability to figure out solutions spontaneously
Ø sexual urges:
inability to control sexual impulses, especially in social situations
Ø planning:
inability to apply consequences from past actions
Ø time perception:
difficulty with abstract concepts of time and money
Ø internal
ordering: like files out of order, difficulty processing information
Ø working memory:
storing and/or retrieving information
Ø self-monitoring:
needs frequent cues, requires “policing” by others
Ø verbal
self-regulation: needs to talk to self out loud, needs feedback
Ø motor control:
fine motor skills more affected than gross motor
Ø regulation of
emotion: moody “roller coaster” emotions, may withdraw or lash out
Ø
motivation: apparent lack of remorse, need external motivators
Ø
judgment – inability to make wise decisions
Alcohol Exposure by Trimester:
1. During the first
trimester, as shown by the research of Drs. Clarren and Streissguth, alcohol
interferes with the migration and organization of brain cells. [Journal of
Pediatrics, 92(1):64-67]
2. Heavy drinking
during the second trimester, particularly from the 10th to 20th week after
conception, seems to cause more clinical features of FASD than at other times
during pregnancy, according to a study in England. [Early-Human-Development;
1983 Jul Vol. 8(2) 99-111]
3. During the third
trimester, according to Dr. Claire D. Coles, the hippocampus is greatly
affected, which leads to problems with encoding visual and auditory information
(reading and math). [Neurotoxicology And Teratology, 13:357-367, 1991]
Not all damage from alcohol exposure is seen on
brain scans, as lesions might be too small to be detected, yet large enough to
cause significant disabilities.
Children do not need to have full Fetal Alcohol
Syndrome (FAS) to have significant difficulties due to prenatal exposure to
alcohol. According to research done by Drs. Joanne L. Gusella and P.A. Fried,
even light drinking (average one-quarter ounce of absolute alcohol daily) can
have adverse affects on the child's verbal language and comprehension skills.
[Neurobehavioral Toxicology and Teratology, Vol. 6:13-17, 1984] Drs. Mattson
and Riley in San Diego have conducted research on the neurology of prenatal
exposure to alcohol. Their studies show that children of mothers who drank but
who do not have a diagnosis of FAS have many of the same neurological
abnormalities as children who have been diagnosed with full FAS.
[Neurotoxicology and Teratology, Vol. 16(3):283-289, 1994]
Damage to the
brain from alcohol exposure can have an adverse affect on behavior. Alcohol exposure
appears to damage some parts of the brain, while leaving other parts
unaffected. Some children exposed to alcohol will have neurological problems in
just a few brain areas. Other exposed children may have problems in several
brain areas. The brain dysfunction is expressed in the form of inappropriate
behaviors. Their behavior problems should be viewed with respect to neurological
dysfunction. Although psychological factors such as abuse and neglect can
exacerbate behavior problems in FASD, we are looking primarily at behavior that
is organic in origin. When it comes to maintaining good behavior, it is not a
matter of the child "won't" but "can't."(Diane Malbin, MSW,
Trying Differently Rather Than Harder, )
Sometimes the
person's behavior is misinterpreted as willful misconduct (Debra Evensen,
www.fasalaska.com), but for the most part, maintaining good behavior is outside
of the child's control, especially in stressful or stimulating situations.
Behavior problems in children with FASD are often blamed on poor parenting
skills. While good parenting skills are required, even alcohol exposed children
raised in stable, healthy homes can exhibit unruly behavior. The most difficult
behaviors are seen in children who were prenatally exposed to alcohol and who
also suffer from Reactive Attachment Disorder.
Most children
with FASD have some attachment issues, may display inappropriate
sexual behaviors, show poor judgment, have difficulty controlling their
impulses, are emotionally immature, and need frequent reminders of rules. As a
result, many will require the protection of close supervision for the rest of
their lives.
© 2000-2006
Teresa Kellerman
www.fasstar.com
“Impulsivity
is when the space between the thought and the action is missing, where the frontal
lobes monitor the intentions of the rest of the brain. There is a gap in the thought
process and the person goes directly from thought to action.” FASD expert Dr. Susan Doctor, University of
Nevada, Reno.
(Psychological
signs of brain damage)
“The greatest obstacle our children with fetal alcohol disorders must overcome is chronic frustration from not being able to meet the unrealistic expectations of others.” – Dr. Calvin Sumner, nationally recognized expert.
|
|
|
|
|
|
Parenting Children affected by Fetal Alcohol Syndrome - A Guide for Daily Living Special British Columbia Ministry for Children and Families (MCF) edition [82 pgs] |
|
|
A strategies booklet to educate caregivers and the community in managing the behaviours associated with FASD. [60 pgs] |
|
|
Canada Govt. Education Board |
|
|
Teaching Students with Autism Spectrum Disorders, 2003 Book 9 of the Programming for Students with Special Needs series |
|
