News & Press
Fetal Alcohol Spectrum Disorders: The missing diagnosis
By Sue Gabriel
Psychiatric Nurse Practitioner, Ionia County Community Mental HealthT
racy (not her real name, but a real daughter of a friend in another state) is a 13-year-old gymnast, artist, music lover, animal lover, member of her church youth group and an all-around engaging young lady. She's polite with adults, helpful with students with "special" needs, and tries hard to keep up with her chore list at home. She wouldn't dream of using alcohol or other illegal substances. Why then are her adoptive parents called to school multiple times each week for her "bad behavior"? Why are they considering home-schooling, feeling the public school system has failed Tracy?
Tracy struggles with the life-long effects of having been prenatally exposed to alcohol. Her biological mother drank alcohol while pregnant with her. As a result, in spite of being very bright, with a normal IQ, Tracy struggles to focus, regardless of typical ADHD medications, to control her emotions, to follow multi-step directions and to learn from usual consequences. Her teachers do not see these "hidden disabilities" and feel that Tracy "just doesn't try hard enough," that her parents don't punish her sufficiently or that she's "just a trouble maker!" What those same teachers don't see is a young lady devastated by her challenges, who wants to understand, and is often overwhelmed by the ever increasing demands of middle school.
On Sept. 9, Gov. Rick Snyder signed a Certificate of Awareness joining others in the international fight to recognize Fetal Alcohol Spectrum Disorders (FASD) Awareness Day. The FASDs are the No. 1 cause of preventable intellectual disabilities (mental retardation) and learning disabilities in America, and are likely more common than autism. Its only cause is the mother consuming alcohol during pregnancy. It is 100 percent preventable when any woman of childbearing age that chooses to drink alcohol also recognizes she cannot have unprotected sexual activity. Conversely, if women are in a position to possibly become pregnant, or are pregnant — no matter where they are in the pregnancy — they should not drink. It's that simple. There is no known safe amount of alcohol, period.
People everywhere are becoming more and more concerned about environmental effects on pregnancy such as smoking, pollution, prescribed medications and illicit drugs on unborn children. People worry about microwaving baby bottles so as to not introduce possible chemicals into the baby's food/formula. There is concern about organic vs. non-organic milk supplies. What is often not realized is that the likely most damaging agent to a developing baby's brain is alcohol!
What are the Fetal Alcohol Spectrum Disorders? How does the alcohol that Tracy's biological mom drank during pregnancy continue to impact her today? FASD includes both Fetal Alcohol Syndrome that occurs during a very specific early stage of fetal development and is associated with specific physical features along with the behavioral and learning difficulties, and Fetal Alcohol Effects that incorporates the behavioral and learning challenges without the physical features. Since the brain develops throughout the entire pregnancy, depending on when the mother drinks alcohol will likely have impact on what areas of the brain may be impacted.
Over the next three weeks, I will discuss the physical/brain impacts of FASD, the developmental/educational impacts of FASD, and what can be done for those people already impacted by FASD.
Sue Gabriel, PMHNP-BC, is a Psychiatric Nurse Practitioner with Ionia County Community Mental Health and Assistant Clinical Director with Community Resource Alliance in St. Johns, working on an Illinois project helping persons with developmental challenges move from long-term care ("institutions") to community homes. In addition to direct care, Gabriel has been involved in local, state-level and national level groups to create new service delivery options such the design of temporary units of care to stabilize very medically fragile children for community placement, developed a model mental health clinic for adults with co-occurring developmental disabilities and mental health issues, programs for persons with disabilities and personality disorders, and addressing the complex needs of persons with disabilities as they age. She has a particular interest in assisting and recognizing the needs of those persons with Fetal Alcohol Spectrum Disorders (FASD).