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FAS Fetal Alcohol Syndrome
Confirmed exposure to maternal alcohol Facial dysmorphology Growth retardation CNS dysfunction
pFAS Partial FAS
Confirmed exposure to maternal alcohol Facial dysmorphology and either Growth retardation or CNS dysfunction
ARND Alcohol-related Neuro-developmental Disorder
Confirmed exposure to maternal alcohol CNS dysfunction
ARBD Alcohol-Related Birth Defects
Presence of congenital anomalies eg cardiac, skeletal, renal ocular, auditory – known to be associated with prenatal alcohol exposure
Alcohol freely crosses the placenta and produces equivalent BAC (blood alcohol concentrations) in fetal circulation to that of the mother
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Placenta
Umbilical Cord
Stratton, K.; Howe, C.; and Battaglia, F. 1996. Fetal Alcohol Syndrome: Diagnosis, Epidemiology, Prevention, and Treatment.
Washington, DC: Institute of Medicine, National Academy Press.
http://books.nap.edu/html/fetal
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The blood alcohol content (BAC) of the fetus becomes equal to or greater than the blood alcohol level of the mother. Because the fetus cannot break down alcohol the way an adult can, its remains high for a longer period of time
Gillen, P. No date. Fetal Alcohol Syndrome Prevention presentation. Denver: Colorado Area Health Education Center.
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PHASE 1 EMPLOYMENT -
FUNCTIONAL (happy, productive, confident, active) PHASE 2
EMPLOYMENT – DYSFUNCTIONAL (work avoidance, gradual decline in
activity, dismissal or resignation)
PHASE 3 UNEMPLOYMENT -DYSFUNCTIONAL
(no active job search, emotionally drained,
angry)
PHASE 4 UNEMPLOYMENT -
FUNCTIONAL (happy to begin looking for work,
productive, confident, active)
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DYSFUNCTIONAL
FUNCTIONAL OPEN EMPLOYMENT
UNEMPLOYMENT
2-6 months 6-12 months
FASD Training
T C A Training Connections Australia
* Training outside the box
Eighty-six per cent of the individuals with FASD have an IQ in the "normal" range and do not qualify for services for developmental disabilities. They nevertheless have impaired mental functioning caused by brain damage that is permanent and incurable
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Based on the Final Report from Research on Secondary Disabilities by Ann Streissguth, presented to the FAS
Conference in Seattle in September of 1996
© RFFADA 2011 – this document cannot be altered without permission from the developer
It will be difficult for the client with FASD to participate with any depth in the discussion of these steps.
Because of difficulty in comprehension and their desire to please, they will agree with your suggestions. It will be difficult for any case worker to really understand or know where their real interests lie because they will change from day to day.
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Barber J. Beyond casework. London: MacMillan 1991
Dual diagnosis is an expectation, not an exception. There is a high prevalence of co-morbidity in both mentally ill populations and substance disordered populations.
Even though it should be an expectation it is often not identified.
How much less often is FASD identified as part of the triad of issues?
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Dan Dubovsky – FASD Specialist Building FASD State Systems Meeting May 5-6, 2004
Possible primary characteristics of teenagers with FASD
o Low self esteem o Trouble keeping up or fitting in at school o Social emotional age much younger than chronological o Reading comprehension is poorer than word recognition o Mathematics tends to be the most difficult task o May be able to ‘talk the talk’ while unable to ‘walk the talk’ o Often misjudged as being lazy, stubborn, and unwilling to learn
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http://www.helpstartshere.org/kids-and-families/early-childhood-development/early-childhood-development-tip-sheet-fetal-alcohol-spectrum-disorders-what-everyone-should-know.html
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o Poor impulse control o Problems managing time and money o Difficulty identifying and labelling feelings o Difficulty showing remorse or taking responsibility for actions o Increased problems with abstract thinking and the ability to link
cause and effect o High risk for problems with law and involvement with criminal
justice system
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http://www.helpstartshere.org/kids-and-families/early-childhood-development/early-childhood-development-tip-sheet-fetal-alcohol-spectrum-disorders-what-everyone-should-know.html
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Possible primary characteristics of teenagers with FASD
o Low motivation o Low self-esteem o Clinical depression may be evident o High risk for exploitation and peer manipulation o Sexual boundary issues with the possibility of sexual activity
beginning at an earlier age
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http://www.helpstartshere.org/kids-and-families/early-childhood-development/early-childhood-development-tip-sheet-fetal-alcohol-spectrum-disorders-what-everyone-should-know.html
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Possible characteristics of adults with FASD
o Remembering things o Getting along with others o Generalising, learning o Perseveration o Maths and concepts of time o Thinking things through, reasoning o Learning from their past experience o Understanding the consequences of their actions
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http://www.helpstartshere.org/kids-and-families/early-childhood-development/early-childhood-development-tip-sheet-fetal-alcohol-spectrum-disorders-what-everyone-should-know.html
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It is unlikely that the person with FASD will self refer to drug and alcohol or mental health services unless in crisis.
The majority of referrals will be via:
o Court ordered diversion (Courts: drug/mental health/district)
o Family/friend referral or intervention o The individual (only when in crisis)
Workers should not assume that treatment will be ineffective
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Beha
viour
al He
alth R
ecov
ery M
anag
emen
t Ser
vice P
lannin
g Gu
idelin
es C
o-oc
curri
ng P
sych
iatric
and S
ubsta
nce D
isord
ers
Kenn
eth M
inkoff
MD
There are six steps that the worker should adopt when the client has come via one of these referral pathways. The steps are:
o Clear the air with the client o Identify legitimate client interests o Identify non-negotiable aspects of intervention o Identify negotiable aspects of intervention o Negotiation the case plan o Agree on criteria for progress
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Barber J. Beyond casework. London: MacMillan 1991
An assessment should include: oMedical history oFamily history oMental health oDevelopmental disabilities oNeuropsychological testing oAdaptive functioning testing
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Dan Dubovsky – FASD Specialist Building FASD State Systems Meeting May 5-6, 2004
There are several primary hurdles to the successful treatment of FASD clients:
o recognition and diagnosis do not occur with sufficient frequency
o unhelpful philosophical approaches do not support individuals with FASD
o precipitate discharge and inadequate post treatment supports
o belief that the client is able to follow through after discharge
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FASD Grows up - Mary Berube, MSW, RSW
Most case management models encourage workers to empower clients to take responsibility for decisions and choices they need to make for themselves and empathically confront clients with the negative consequences of poor decisions. People with FASD are typically unable to take responsibility
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Dan Dubovsky – FASD Specialist Building FASD State Systems Meeting May 5-6, 2004
© RFFADA 2011 – this document cannot be altered without permission from the developer
