DEPARTMENT FOR COMMUNITIES FOETAL ALCOHOL SPECTRUM DISORDER (FASD) INFORMATION FOR PEOPLE WORKING WITH CHILDREN AND FAMILIES

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1 DEPARTMENT FOR COMMUNITIES FOETAL ALCOHOL SPECTRUM DISORDER (FASD) INFORMATION FOR PEOPLE WORKING WITH CHILDREN AND FAMILIES

2 FOREWORD I am pleased to provide you with this booklet which contains important information on Foetal Alcohol Spectrum Disorder (FASD). I hope the information contained in this booklet is used to raise awareness about the serious issue of FASD in our communities and to help change community attitudes and behaviours regarding alcohol consumption during pregnancy. Every community wants healthy children who thrive, experience success and find happiness. Until recently, parents, families, service providers and the wider community have been largely unaware of the serious impact maternal alcohol consumption during pregnancy may have on the unborn child, as well as the life-long effects faced by individuals affected by FASD. I hope this information will provide services and the general community with greater awareness to better understand the effects faced by children experiencing FASD. Hon Robyn McSweeney MLC Minister for Child Protection; Community Services; Seniors and Volunteering; Women s Interests 1

3 WHAT IS FASD? Foetal Alcohol Spectrum Disorder (FASD) is an umbrella term describing the range of effects that can occur in a foetus whose mother drank alcohol during pregnancy. These effects, which could have lifelong implications, may include: physical mental behavioural and learning disabilities. WHAT CAUSES FASD? FASD is caused by maternal alcohol consumption during pregnancy. The most extreme form of FASD is Foetal Alcohol Syndrome (FAS). The outcome is affected by a number of factors including the timing, dose and pattern of maternal drinking as well as other socio-behavioural factors. Therefore, not all foetuses exposed to alcohol in utero will be affected to the same degree. Source: Department of Health, Western Australia. Fetal Alcohol Spectrum Disorder Model of Care. Perth: Health Networks Branch, Department of Health, Western Australia;

4 EFFECTS OF ALCOHOL ON THE UNBORN CHILD Alcohol can harm a foetus in different ways at different times during pregnancy. Alcohol is a neurotoxin (poison) and a teratogen i.e. an agent that is known to cause birth defects and permanent brain injury in the foetus. Cell division begins immediately after an egg is fertilised. Alcohol consumption in the early stages of cell division can interrupt the healthy production of cells in the embryo before a woman is even aware she is pregnant. Maternal alcohol consumption may interfere with healthy foetal development, particularly in the areas of: growth normal growth of the foetus may be inhibited by alcohol exposure in utero facial features may develop abnormally the development of the brain permanent brain damage may result from alcohol exposure in utero. FASD IS PREVENTABLE: A planned, alcohol-free pregnancy, supported by a healthy diet and lifestyle, is the best approach to pregnancy. The National Health and Medical Research Council s guidelines recommend that for women who are pregnant or planning a pregnancy, not drinking is the safest option. SIGNS OF FASD IN INFANTS AND TODDLERS Infants low birth weight but not premature irritability sensitivity to light, noises and/or touch feeding problems failure to thrive. Source: National Organisation for Fetal Alcohol Syndrome and Related Disorders Toddlers memory problems hyperactivity lack of fear poor sense of boundaries impairment in gross or fine motor skills which may result in poor balance or clumsiness. 3

5 CHILDREN WITH FASD SOME OBSERVATIONS Children with FASD may have: poor growth developmental delay problems with vision difficulty remembering language and speech deficits poor judgement birth defects improperly formed bodies and organs social and behavioural problems low IQ difficulty sleeping high levels of activity and impulsivity a short attention span problems with abstract thinking difficulty forming and maintaining relationships. Source: Alcohol and Pregnancy Project. Alcohol and Pregnancy: Health Professionals Making a Difference. Perth: Telethon Institute for Child Health Research; 2007

6 BEHAVIOUR CHALLENGES CARING FOR CHILDREN WITH FASD Children with FASD: may experience difficulty following instructions can be easily confused and distracted tend to be impulsive can be easily irritated, leading to temper tantrums may repeat mistakes on many occasions may not recognise danger, leading to unsafe actions may have trouble distinguishing reality from fantasy can be easily led by peers. HELPING CHILDREN WITH FASD Many researchers agree that using the following strategies will support children affected by FASD. Observation: Look for the triggers of the child s challenging behaviour so these can be minimised or avoided to reduce the likelihood of the behaviour recurring. For example, over-stimulation from bright light and excessive noise may be triggers which can be anticipated and avoided. Structure: Children with FASD often respond positively to structure in both their physical and emotional environment. They benefit from regular routines and relatively static physical environments. It is helpful to ensure that consistency is maintained in the child s environment, e.g. look at how furniture is arranged and how routines are managed. Repetition: Children with FASD tend to take longer to develop the neural pathways necessary to master tasks and commit them to memory. Repeating information and instructions regularly is essential and needs to become part of the everyday communication style with the child. Consistency: Maintaining a regular routine and time schedule is helpful. Verbal, visual and physical cues can help children remember routines and assist with attention deficits. For example, pictures can be used to help remind a child of the bedtime routine. 5

7 Concrete concepts: Thinking abstractly is often difficult and affects a child s ability to understand the right way to behave or how to make appropriate decisions. Concepts need to be quite concrete - only give one instruction at a time and demonstrate the desired behaviour. Rewards and redirection: Praise and reward immediately after positive behaviour or a successful achievement reinforces the action and encourages the child to repeat it. Avoid punishment - diverting or redirecting the child is more effective as it enforces boundaries and rules. Supervision: Close monitoring is essential, as children who have been affected by FASD may have a developmental age much less than their chronological age. Modelling: Like all children, children affected by FASD benefit from seeing and practising appropriate behaviour and healthy social interactions. Adults need to provide opportunities for children to practice their social skills. Source: For further information visit or MAINTAINING A REGULAR BEDTIME ROUTINE IS HELPFUL 6

8 PREVENTING FASD Provide resources that inform individuals who are planning to start a family about the risks of drinking alcohol. Encourage women/mothers not to drink during pregnancy with practical lifestyle tips (see below). Be knowledgeable about what services are available in your local community. Encourage all women and men expecting a baby to access appropriate antenatal health care and support. LIFESTYLE TIPS FOR FRIENDS AND FAMILIES Provide non-alcoholic beverages for pregnant mums at parties or celebrations. Organise less alcohol-centred social gatherings (go out for a meal or movie instead of a night at the pub!). Educate friends and family who are unaware of the dangers of alcohol during pregnancy. Encourage partners to abstain from alcohol before and during the pregnancy. Women need to know that there is NO known safe amount of alcohol consumption during pregnancy. 7

9

10 RESOURCES, CONTACTS AND FURTHER READING Department for Communities Parenting WA The Parenting WA Line is a free 24/7 telephone service for support and information on any parenting issue for children pre-birth to 18 years. t: (08) or (country freecall) Parenting WA Library A free library for parents and carers with children pre-birth to 18 years. t: (08) or w: Department of Health, Western Australia Fetal Alcohol Spectrum Disorder Model of Care. Perth: Health Networks Branch, Department of Health, Western Australia; w: FASD Network WA A network of interested and involved parties that meet on a regular basis to promote and share information on FASD in Western Australia. Parenting WA Line (08) or (country freecall) National Organisations for Fetal Alcohol Syndrome and Related Disorders (NOFASARD) A nationwide service providing support for parents and carers of children or adults with FASD, information and advocacy about FASD. t: w: Telethon Institute of Child Health Research Wallet cards for women: No Alcohol in Pregnancy is the Safest Choice. To download or to order these resources, please go to the Telethon Institute for Child Health Research, Alcohol and Pregnancy and Fetal Alcohol Spectrum Disorder. w: Seventh-Generation Website By Carolyn Hartness, FASD consultant and educator based in the United States. w: 9

11 Alcohol and Drug Information Service The Alcohol and Drug Information Service is a statewide 24-hour free confidential telephone service providing information, referral, counselling, advice about alcohol and other drugs. t: (08) free call: w: Metropolitan Child Development Service Offers quality professional care for children with developmental concerns and their families. t: (08) w: Dr Anne Streissguth Streissguth AP, Barr HM, Kogan, J, Bookstein FL (1996) Understanding the occurrence of secondary disabilities in clients with Fetal Alcohol Syndrome (FAS) and Fetal Alcohol Effects (FAE). Final report to the Centers for Disease Control and Prevention (CDC), August. Seattle: University of Washington, Fetal Alcohol & Drug Unit, Tech Rep No Deb Evensen and San Lutke 8 Magic Keys: Developing Succesful Interventions for students with FAS. w: 10

12 Department for Communities t: (08) f: (08) w: Parenting WA Line Available 24 hours a day, 7 days a week t: (08) or Translating and Interpreting Services (TIS National): This document is available on request in alternative formats such as large type, audio type, compact disc or Braille. Publication: 07/10/CFS ISBN The information in this booklet is provided in good faith on the basis that the Government of Western Australia shall not be liable for any loss, damage and injury arising in connection with the provision of services and information included herein. Every reasonable effort has been made to ensure the information is accurate and up to date. The information contained is not intended as a substitute for professional consultation with a qualified practitioner. The resource list at the back of this booklet is provided for the reader s convenience and does not constitute endorsement of the information and services provided by these agencies.

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