Fetal Alcohol Syndrome: An Epidemic (Part II)

Fetal alcohol syndrome has been a widely known danger associated with maternal drinking for more than forty years. It is the most common cause of mental retardation, surpassing Down syndrome and spina bifida, and might be the most common preventable cause of learning disabilities. The purpose of this two-part essay is to examine the silent epidemic that is better known as fetal alcohol syndrome. Nurses Announcements Archive Article

Fetal Alcohol Syndrome: An Epidemic (Part II)

Fetal alcohol syndrome (FAS) is an irreversible pattern of multiple birth defects caused by maternal ingestion of alcohol during pregnancy. The noticeable facial features, small head, stunted growth, and behavioral issues are the result of alcohol that has traveled across the placenta during prenatal development. Children who do not have the facial features associated with full-blown FAS might receive a diagnosis of fetal alcohol effects (FAE).

Each baby born with Fetal Alcohol Syndrome (FAS) costs society $4 million or more during its lifetime, and it's estimated that FAS costs the United States $6 billion annually (Crime Times, n.d.). The first part of this two-part essay discussed the signs and symptoms of FAS and FAE.

Learning does not come easily to children afflicted with FAS/FAE as a result of brain damage. Due to organic brain damage, memory retrieval is impaired, making any learning difficult -- academic and social (MACMH, n.d.). Although many of these children may exhibit verbal skills that are average or above average, they tend to struggle with aspects of social communication, such as interpreting social cues.

Furthermore, they typically do not comprehend social skills such as waiting one's turn, sharing, and getting along with others. Some children with FAS/FAE have been known to lack stranger anxiety and be overly friendly with adults who are unfamiliar to them.

Children with FAS/FAE tend to be concrete thinkers and learners who struggle with abstract ideas. Because children with FAS/FAE don't internalize morals, ethics or values (these are abstract concepts), they don't understand how to do or say the appropriate thing (MACMH, n.d.). Also, they are unable to link past experiences to present actions, so they make mistakes over and over.

Because of their impulsivity and impaired judgment, individuals with FAS also are at high risk for alcohol or drug abuse (Crime Times, n.d.). Research shows that people with FAS face daunting odds of dropping out of school, getting fired from jobs, becoming teenage parents, dabbling in drugs, tangling with the police and drifting in and out of homelessness (Philp, 2003).

When dealing with children who have FAS/FAE, consistency is the key. Educators recommend that the adults in their lives utilize plenty of repetition, brevity, and simple words. Since punishment seems to be ineffective with these children, emphasis should be placed on positive reinforcement. Don't ask "why" questions as they are abstract (MACMH, n.d.). Realize that small tasks require a great deal of mental effort from children who are afflicted with FAS/FAE. Most importantly, early diagnosis is crucial, preferably before the age of six.

References

Fetal Alcohol Syndrome/Fetal Alcohol Effects (FAS/FAE)

Middle-Class FAS: A Silent Epidemic?

TheCommuter

About TheCommuter, BSN, RN

TheCommuter, BSN, RN, CRRN is a longtime physical rehabilitation nurse who has varied experiences upon which to draw for her articles. She was an LPN/LVN for more than four years prior to becoming a Registered Nurse.

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in the long-ago, iv etoh (ethyl alcohol) was the tocolytic treatment of choice for threatened premature labor. i had a coworker who had lost three pregnancies so they put her to bed on an alcohol drip. she carried the baby to term...but it was a fas baby. we didn't know what that was at the time, only that she had had this really strange kid, and after all that prior loss and sacrifice. heartbreaking.

Specializes in LTC Rehab Med/Surg.

These babies are the adults who will be responsible for taking care of us oldies.

Scary.

It has been my experience with pts, that when questioned about alcohol,

they are not entirely truthful. Since early intervention is the key for a

FAS baby, most may be out of luck with a mother who may not admit

she drank while pregnant.

This is kind of a hi-jack, but it always surprises me when pts will honestly

tell you they smoke 2-3 packs a day, but will lie about drinking that fifth

of whiskey every w/e.

Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
It has been my experience with pts, that when questioned about alcohol,they are not entirely truthful. Since early intervention is the key for a FAS baby, most may be out of luck with a mother who may not admit she drank while pregnant.
I've previously mentioned that I suspect there are a lot of adults in society who have undiagnosed FAS/FAE because the telltale facial traits disappear as one grows up.

I also get the hunch that many children and teenagers have undiagnosed FAE (fetal alcohol effects). This is harder to diagnose because the infant or child does not have the facial characteristics of full-blown FAS, and their IQs are usually normal or near normal. I suspect many children with FAE are misdiagnosed as having ADD/ADHD, conduct disorder, oppositional defiant disorder, and attachment problems. Behavioral and learning problems related to prenatal alcohol exposure are probably more prevalent than anyone realizes.