fasd maine
Maine Health
Department of Psychiatry
Grand Rounds
"The Forest for the Trees: Identification and treatment of children with fetal alcohol spectrum disorders in the psychiatric setting "
September 24, 2024 8AM
Presentation by:
Douglas Waite, MD
Division Chief of Developmental-Behavioral Pediatrics,
Bronx Health System
Asst. Clinical Professor of Pediatrics, Mount Sinai Hospital
Virtual only Register here
Heading Back to School!
Go here for helpful information and resources to share with
teachers and staff
The Red Shoes Gala
by FASD United
September 16, 2024
6:30-9:00PM
National Press Club
Washington, D.C.
FASD deeply impacts the fields of:
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child welfare
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justice
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federal, state, and tribal policy
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health systems
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education
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and so many more.
The Red Shoes Gala offers the rare opportunity to spend time with experts, policy advocates, organization supporters, and people with lived experience.
Register and learn more here!
The American Psychiatric Association Endorses the
FASD United is excited and grateful to announce that the American Psychiatric Association (APA) has authored a letter in support of the FASD Respect Act, S.1800/HR. 3946. The APA is the leading psychiatric organization in the United States, and their endorsement is an invaluable tool in exhibiting the popular support for FASD-informed policies.
We want to give a special thank you to Dr. Danielle Shaw for her hard work and dedication to obtain this endorsement from APA. If you know of any state, local, or national organizations that would be interested in signing onto a letter of support for the FASD Respect Act, click here!
"Families Moving Forward" (FMF)
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The Families Moving Forward (FMF) Program (based on the work of Diane Malbin MSW) was developed by Dr. Heather Carmichael Olson in the early 2000s in response to a call from the CDC to develop, test, and implement interventions for children living with FASD.
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FMF is an evidence-based intervention to help families raising children who are affected by prenatal alcohol exposure, with or without a fetal alcohol spectrum disorder (FASD) diagnosis.
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Read more here
The Strengths and Positive Influences of Children With
Fetal Alcohol Spectrum Disorders
Carson Kautz-Turnbull, Tangeria R. Adams, and Christie L.M. Petrenko
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People with disabilities have not been adequately represented in strengths-based research.
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This study is the first to examine strengths and positive influences of young children with fetal alcohol spectrum disorder (FASD).
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Caregivers reported wide-ranging strengths and positive influences.
Parent of Child with FAS
Founder of "Brain First Parenting"
Maine families have found that Eileen's support has given them a safe place to:
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learn more about their child's invisible brain-based disability
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learn accommodations and intervention that truly support parent/child/family
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find other families who understand their day-to-day reality, where they will find hope, support, inspiration and reprieve
Five Misconceptions
About "Brain First Parenting"
Brain first parenting is an approach supported by more than 50 years of research on the brain, and centers on understanding neurobehavioral conditions as brain-based physical disabilities with behavioral symptoms.
Learn more here.
FASD Collaborative Project
Free recorded webinars here.
Some topics covered:
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9 Core Messages: What Everyone Should Know About Prenatal Alcohol Exposure
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Caregiver Success! Parents of Adults with FASD Share What Works
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A Functional Approach to FASD Diagnosis
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Educational Care for Children Affected by Prenatal Alcohol Exposure
FASD Support Groups online and in person here
FASD Collaborative participating organizations here.
For Educators
FASD Collaborative
Free Recorded Webinars
on Challenging Behaviors"
6 Things Educators and School Staff Should Know About FASD
Nate Sheets 8:00 Video
to Manage Escalation
Nate Sheets 8:00 Video
Racial and ethnic disparities in psychological care for individuals with FASD:
a dis/ability studies and critical race theory perspective toward improving prevention, assessment/diagnosis, and intervention
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FASD can affect people regardless of race, ethnicity, and socioeconomic status (SES).
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FASD is identified at higher rates in Native American, Black, and low-SES communities compared to White and middle/upper class communities.
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This pattern is the opposite in other neurodevelopmental disabilities such as attention-deficit/hyperactivity disorder and autism spectrum disorder , with both diagnoses given to White individuals more frequently than Black, Indigenous, and People of Color (BIPOC).
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Greater attention to these disparities is needed within FASD and is relative to other neurodevelopmental disorders.
Rockhold MN, Gimbel BA, Richardson AA, Kautz-Turnbull C, Speybroeck EL, de Water E, Myers J, Hargrove E, May M, Abdi SS and Petrenko CLM (2024) Racial and ethnic disparities in psychological care for individuals with FASD: a dis/ability studies and critical race theory perspective toward improving prevention, assessment/diagnosis, and intervention. Front. Public Health 12:1355802. doi: 10.3389/fpubh.2024.1355802
Why No Alcohol During Pregnancy is the Safest Choice
Dr. Vincent Smith MD MPH
Division Chief of Newborn Medicine at Boston Medical Center
"Although parents with a substance use disorder* have a higher likelihood of having a child with FASD,
most children with FASDs are born to parents who do not have a substance use disorder."
Prenatal alcohol exposure and potential harm can also occur before a person is aware they are pregnant.
Children with prenatal alcohol exposure come from every social, economic, racial, and ethnic group.
In the United States, nearly 1 in 7 pregnant people report alcohol use in the past 30 days.
The American Academy of Pediatrics (AAP) advises:
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There is no amount of alcohol during pregnancy that is risk-free.
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There is no kind of alcohol during pregnancy that is risk-free.
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There is no time during pregnancy when alcohol consumption is risk-free.
Read complete article here
*Substance use disorder is a treatable chronic disease
in FASD
Dr. Jerrod Brown
This episode of the podcast Living with FASD: Candid Conversations
with Patti Kasper explores the intersection of suggestibility with confabulation and compliance, particularly in high-pressure situations like legal interrogations or in therapy or medical sessions. Dr. Brown guides us through the vulnerabilities that individuals with FASD face.
FAQs
Prenatal Alcohol Exposure
"Pregnant women do not cause FASD. Alcohol causes FASD."
Why is alcohol such a damaging substance?
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Alcohol is a teratogen. All teratogens (like thalidomide or rubella) cause birth defects. Alcohol can cause damage to any system of the body. It is particularly destructive to the brain of the fetus, causing damage to the structures, function, neurochemistry, and the brain's ability to grow and repair. Studies show, there is no safe level of prenatal alcohol exposure.
Read this to better understand how one could not have designed a substance with more capacity to cause damage, given the perfect storm of factors:
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the placenta is not a barrier to alcohol
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recurrent cycle of fetal swallowing and elimination of alcohol
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amniotic fluid acts as a reservoir for alcohol
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Go here for more FAQs
Read recently published research and reports on FASD
75% of children with an FASD have an attention problem and may be diagnosed with ADHD without considering other diagnoses. Attention deficits in children with an FASD without ADHD may derive from deficiencies in:
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executive functioning skills
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short-term memory
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the ability to shift attention
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slower processing speed
Medications for ADHD may worsen symptoms in children with FASD.
11 yo child with parent concerns about attention, hyperactivity, and sleep
In-Utero Alcohol Exposure:
New Tools
for a Difficult Diagnosis
Emma Yasinksi
Researchers are searching for measurements called biomarkers — objective medical signs, such as the presence of a certain molecule in the blood — that will improve diagnosis of prenatal alcohol exposure (PAE) and may provide clues as to which drugs and interventions are most likely to help patients with PAE, the cause of FASD.
Hallmark features of FASD include poor judgement and impulsivity.
This looks to many like ADHD.
But experts say standard ADHD treatments often don’t work as well for children exposed to alcohol in-utero. Lack of awareness, a shortage of specialists, and social stigma have combined to make FASD a condition that is underdiagnosed.
UCLA FASD researcher/psychologist Mary O'Connor and her colleague neuropsychologist Joseph O’Neill, are using imaging techniques along with neurobehavioral measures
to accurately diagnose these children. Read article here.
FASD is often misdiagnosed because many of the characteristics look the same as other mental health disorders, so it is important to get an FASD assessment from a trained professional.
This checklist tool is not intended as a diagnostic assessment, but as a way to see if FASD is something to consider when talking to your/your child’s health care provider.
More on living with an FASD
Thank you to PROOF Alliance for this information.
Go to "For the person with an FASD"
"Developmental alcohol exposure is exhausting: Sleep and the enduring consequences of alcohol exposure during development."
Prenatal alcohol exposure is the leading nongenetic cause of human intellectual impairment.
The long-term impacts of prenatal alcohol exposure are diverse:
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Neuropathology
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Behavioral, cognitive, and emotional impairments
Additionally negative effects also occur on the physiological level:
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Endocrine
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Cardiovascular
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Immune systems
Among these diverse impacts is sleep disruption. In this review we describe:
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How prenatal alcohol exposure affects sleep
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Potential mechanisms of those effects
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Outline the evidence that sleep disruption across the lifespan may be a mediator of some cognitive and behavioral impacts of developmental alcohol exposure, and thus may represent a promising target for treatment.
Wilson, Donald, et al.Neuroscience and Biobehavioral Reviews Volume 158, March 2024
Prenatal exposure to alcohol and its impact on substance use in adulthood.
"Overall, our findings, based on 30 years’ worth of data on a prenatal birth cohort, suggest that even relatively moderate exposure to alcohol during pregnancy, a critical sensitive period for brain development, might alter neural reward processing in the offspring and contribute to the intergenerational transmission of risk for substance use disorders."
Executive Function (EF)
in Individuals with FASD?
Exercise!
Children with prenatal alcohol exposure (PAE) struggle with EF deficits:
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problem solving
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planning
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shifting tasks
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verbal and nonverbal fluency
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impulsivity
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working memory
These abilities are required for successful functioning in society.
For FASD (and ASD):
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Exercise interventions were associated with large improvements in executive function (EF).
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Exercise may be a potentially cost-effective and readily implementable intervention to improve executive function in these populations.
Structured exercise has been shown to:
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directly cause structural and physiological changes in the brain by increasing blood flow
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results in upregulation of brain-derived neurotrophic factor (BDNF)
BDNF plays an integral role in:
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hippocampal functioning*
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neuroplasticity
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learning
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memory
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formation of new neurons and neuroprotection
*The hippocampus is an area of the brain particularly affected by prenatal alcohol exposure.
Dr. Douglas Waite MD
AAP FASD Champion
Dr. Waite is one of ten national FASD Champions/American Academy of Pediatrics, sits on the National Mental Health Advisory Board of the Child Welfare League of America, and is a member of the Society of Developmental-Behavioral Pediatrics. In this episode, Dr. Waite addresses:
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what led him to become involved with the FASD population
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the importance of focusing on the adaptive functioning in FASD diagnoses
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the need for clinical pathways for FASD Diagnoses
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critical information for those parenting a child with an FASD
(recorded 2022)
Dr. Waite has presented on FASD to Maine Health Psychiatry Grand Rounds, Maine AAP Foster Care Committee and Conference, Maine Maternal and Child Health SEI Conference.