The Implications of the Secondary Conditions of Fetal Alcohol Syndrome Disorders

Early Childhood Interventions October 28, 2015

Sophie Seibach has done an excellent job in outlining the major aspects of Fetal Alcohol Syndrome Disorders including definitions, incidents, and characteristics (http://bit.ly/1Pip1Px).   As we know, Fetal Alcohol Syndrome Disorder (FASD) is an umbrella term to describe conditions that can occur in a person whose mother consumed alcohol during pregnancy. The conditions can negatively impact a child’s physical, behavioral and intellectual development (National Organization for Fetal Alcohol Syndrome, 2014). Overall, FASD affects 2-5% of the US population (Petrenko, Tahir, Mahoney & Chin, 2014). Fetal Alcohol Syndrome Disorder is 100% preventable differentiating it from other developmental disabilities. If a woman does not drink alcohol during pregnancy or stops consuming alcohol once she knows she is pregnant, the effect of FASD will be non-existent or significantly lessened. A baby’s in-vitro brain development occurs throughout the entire pregnancy; therefore the sooner a mother stops drinking alcohol, the safer it will be for the child (CDC, 2015).

In the previous blog post about Fetal Alcohol Syndrome Disorder, Siebach discussed some of the potential characteristics of fetal alcohol syndrome disorder: intellectual disabilities, learning disabilities, poor impulse control, language deficits, memory deficits, and poor social adaptability.

This blog post will explore the secondary conditions associated with FASD. Secondary conditions are conditions that appear later in life as a result of FASD. These include high incidence of mental health conditions, disruptive school experience, issues with the law, and addiction to drugs and alcohol: 

  • 94% of individuals experience at least one mental health problem during their lifetime
  • 61% have disrupted school experience (suspended, expelled, dropped out)
  • 60% have encountered trouble with the law
  • 50% have been confined (e.g. jail, impatient psychiatric treatment)
  • 35% have alcohol or drug problems (Petrenko et al., 2014) 

These secondary conditions negatively affect the lives of people with FASD and act as barriers to full participation in society. These conditions can affect the individual, the family and greater society. For the individual a misdiagnosis of FASD can result in inappropriate interventions that do not specifically target the issues related to FASD. Another issue is the misinterpretation of the behaviors demonstrated by children with FASD, like inattention, distractibility as “willful behavior” (Petrenko et al., 2014).

People with little knowledge of FASD might think that people with the disorder can control their behaviors but choose not to. Petrenko et al. (2014) describe this as a “won’t v. can’t” mentality that can bring about harmful attitudes and stereotypes towards people with FASD. Some people with FASD who have been misdiagnosed or their behaviors misinterpreted develop maladaptive coping behaviors out of frustration. Families of people with FASD may also experience frustration and stress because of the challenges the child is experiencing Petrenko et al. (2014) reported the families express frustration by early misdiagnoses and issues related to the provision of services. Families report issues with qualifying for services, receiving high quality services and maintaining services. The complications faced by people with FASD also have a cost for society. On average, a person with FASD uses between 1.6-2.5 million dollars per year (CDC, 2015) for services and supports including medical, educational, and social service support. Furthermore, incarceration, addiction and school disruption have significant additional societal costs.

Recognizing FASD early and providing appropriate services may limit the detrimental effects of secondary conditions. Appropriate services will assist the child and family in managing behavior, reaching academic potential, and teaching compensatory strategies for successful participation in the community. The most important aspect of prevention is early diagnosis and recognition, as children who are diagnosed later in life are far less likely to benefit from services. We must also guarantee the availability of services that meet the need of the family and child. It is important that these services can be found within a family’s own community (Petrenko et al. 2014). This is particularly problematic for adults with FASD as, in general, the provision of services for adults with disabilities is poor. Finally, we must ensure that people with FASD live in a nurturing and stable environment that is non-abusive (Clarke & Gibbard, 2012).

Fetal Alcohol Syndrome Disorder is 100% preventable and it is extremely important that we work to raise awareness of the disorder in order to limit the number of people affected. However, it is important to support people with FASD currently and to work to reduce the secondary conditions that have such high costs for the individuals, families and society.

References

Clarke, M. E., & Gibbard, W. B. (2003). Overview of Fetal Alcohol Spectrum Disorders for Mental Health Professionals. The Canadian Child and Adolescent Psychiatry Review12(3), 57–63.

Center for Disease Control and Prevention. (2015) Fetal Alcohol Spectrum Disorder. Available from: http://www.cdc.gov/ncbddd/fasd/facts.html

Petrenko, C.L., Tahir, N., Mahoney, E.C., & Chin, N.P. (2014). Prevention of secondary conditions of fetal alcohol spectrum disorders: identification of systems-level barriers. Maternal Health Journal, 18(6):1496-505,

National Organization on Fetal Alcohol Syndrome. (2014). FASD: What Everyone Should Know. Available from:http://www.nofas.org/wp-content/uploads/2014/05/Fact-sheet-what-everyone-should-know.pdf

Emily Fletcher
Georgetown University’16