Effects+of+Fetal+Alcohol+Syndrome

IN CHILDREN
Problems associated with FAS tend to intensify as children move into adulthood. These can include mental health problems, troubles with the law, and the inability to live independently.

Kids with FAE are frequently undiagnosed. This also applies to those with alcohol-related neurodevelopmental disorder (ARND), a recently recognized category of prenatal damage that refers to children who exhibit only the behavioral and emotional problems of FAS/FAE without any signs of developmental delay or physical growth deficiencies.

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Often, in kids with FAE or ARND, the behavior can appear as mere belligerence or stubbornness. They may score well on intelligence tests, but their behavioral deficits often interfere with their ability to succeed. Extensive education and training for the parents, health care professionals, and teachers who care for these kids are essential

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 * __CAUSES & SYMPTOMS __**

FAS is not a genetic or inherited disorder. It is a pattern of birth defects, learning, and behavioral problems that are the result of maternal alcohol use during the pregnancy. The alcohol freely crosses the placenta and causes damage to the developing embryo or fetus. Alcohol use by the father cannot cause FAS. If a woman who has FAS drinks alcohol during pregnancy, then she may also have a child with FAS. Not all individuals from alcohol exposed pregnancies have obvious signs or symptoms of FAS; individuals of different genetic backgrounds may be more or less susceptible to the damage that alcohol can cause. The dose of alcohol, the time during pregnancy that alcohol is used, and the pattern of alcohol use all contribute to the different signs and symptoms that are found.


 * __CLASSIC FACIAL FEATURES OF FETAL ALCOHOL SYNDROME __**



﻿Classic features of FAS include short stature, low birthweight and poor weight gain, microcephaly and a characteristic pattern of facial features.

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These facial features include smaller eye openings (measured from inner corner to outer corner), epicanthal folds (folds of tissue at the inner corner of the eye), small or short nose, low or flat nasal bridge, smooth or poorly developed philtrum (the area of the upper lip above the colored part of the lip and below the nose), thin upper lip, and small chin.

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Some of these features are nonspecific, meaning they can occur in other conditions, or be appropriate for age, racial, or family background. Other major and minor birth defects that have been reported include cleft palate, congenital heart defects, strabismus, hearing loss, defects of the spine and joints, alteration of the hand creases, small fingernails, and toenails. Since FAS was first described in infants and children, the diagnosis is sometimes more difficult to recognize in older adolescents and adults. Short stature and microcephaly remain common features, but weight may normalize, and the individual may actually become overweight for his/her height. The chin and nose grow proportionately more than the middle part of the face and dental crowding may become a problem. The small eye openings and the appearance of the upper lip and philtrum may continue to be characteristic. Pubertal changes typically occur at the normal time.

Newborns with FAS may have difficulties with feeding due to a poor suck, have irregular sleep-wake cycles, decreased or increased muscle tone, seizures or tremors. Delays in achieving developmental milestones such as rolling over, crawling, walking and talking may become apparent in infancy. Behavior and learning difficulties typical in the preschool or early school years include poor attention span, hyperactivity, poor motor skills, and slow language development. Attention deficit-hyperactivity disorder is a common associated diagnosis. Learning disabilities or mental retardation may be diagnosed during this time. Arithmetic is often the most difficult subject for a child with FAS. During middle school and high school years the behavioral difficulties and learning difficulties can be significant. Memory problems, poor judgment, difficulties with daily living skills, difficulties with abstract reasoning skills, and poor social skills are often apparent by this time. It is important to note that animal and human studies have shown that neurologic and behavioral abnormalities can be present without characteristic facial features. These individuals may not be identified as having FAS, but may fulfill criteria for alcohol-related diagnoses, as set forth by the Institute of Medicine.

﻿In 1991, Streissguth and others reported some of the first long-term follow-up studies of adolescents and adults with FAS. In the approximate 60 individuals they studied, the average IQ was 68, with 70 being the lower limit of the normal range. However, the range of IQ was quite large, as low as 20 (severely retarded) to as high as 105 (normal). The average achievement levels for reading, spelling, and arithmetic were fourth grade, third grade and second grade, respectively. The Vineland Adaptive Behavior Scale was used to measure adaptive functioning in these individuals. The composite score for this group showed functioning at the level of a seven-year-old. Daily living skills were at a level of nine years, and social skills were at the level of a six-year-old.

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