Raising awareness of a preventable disability in our
Associate Professor David Dossetor,Child
Psychiatrist with a special interest in Intellectual Disability and
Autism, Area Director for Mental Health,The
Children's Hospital at Westmead.
Reference: Dossetor, D. (2012). Fetal Alcohol Spectrum Disorders
(FASD): Raising awareness of a preventable disability in our midst.
CHW School-Link Newsletter. Vol 3, Iss 2, Pp. 2-5.
The following in an excerpt of an article about Fetal
Alcohol Spectrum Disorder written by Associate professor David
Dossetor. You can find the full version online at www.schoollink.chw.edu.au
. Click on CHW School-Link Newsletter on the left hand
menu and select Volume 3, Issue 2.
Tristan is a 13 year old boy from Fitzroy Crossing a community
of 2500 in the Kimberly 400km east of Broome. Tristan is a likeable
and generally happy boy who uses repetitive sensory activities to
help him concentrate and keep calm and has major problems of memory
and connecting thoughts. This makes it difficult for him to engage
with peer friendships. He has major learning difficulties needing
individual support in school. He has high energy levels, with
problems of distraction and benefits from plenty of outdoor
activity, but his coordination problems limits his love of sports
to being linesman for the local AFL team. Amongst his physical
abnormalities is a congenital heart defect corrected by surgery.
Marmije (his aunt) and her husband Geoff are both teachers and
highly skilled in providing the supportive environment for him and
his 2 younger foster brothers also affected by Fetal Alcohol
Spectrum Disorder. Poignantly, Tristan wishes he was normal.
The rising culture of teenage binge drinking means that
teratogenic harm to a developing baby can be done before a girl is
even aware of being pregnant. Surveys show 25% of 14 to 19 year
olds have had a drink in the last week. 11% of females 18-24
indulged in high risk drinking. 7 or more standard drinks a week in
pregnancy has been associated with attention deficits in the child.
Some studies suggest that alcohol in pregnancy is now the leading
cause for intellectual disability with incidences of 2-4%
suggested! However, lack of professional knowledge, enquiry and
recognition limits identification.
The first challenge is for clinicians to think of the
possibility of the diagnosis. Treatment needs to be
multidisciplinary, multimodal and multiagency, tailored to the
individual child and family. O'Malley lists: detailed diagnostic
assessment followed by individual treatment, dyadic therapy, family
therapy, group therapy, residential/housing,
vocational/rehabilitation, dental care and advocacy. The individual
therapy may include: sensory/motor training, non-verbal play
therapy, cognitive behaviour therapy, reality-based therapy and
trauma-based therapy. Speech and language therapy may be important,
but recognition of special need and appropriate support from the
education system is a pivotal influence to subsequent trajectory.
The criminal justice system also needs to be proactive in
identifying and seeking treatment for such young people (Paley
& Auerbach, 2011).
Tristan and his community have shown us courage and leadership,
bringing "hope to the Valley" and an example to all Australians
(Elliott et al, 2012). The raising of awareness will be
important for us all, as we come to appreciate the scale of this
new silent epidemic of damaged and troubled youngsters and adults
in our midst. As June Oscar (an aboriginal elder) says "the
attitude of society to FASD has to change, since the children with
the condition can't".
Elliott, E.J., Latimer, J., Fitzpatrick, J., Oscar, J., Carter,
M. (2012). There is hope in the valley: Viewpoint. Journal of
Paediatrics and Child Health. Vol 48, Ppl 190-192.
O'Malley, K.D. (Ed.) (2007). ADHD and Fetal Alcohol Spectrum
Disorders. 2nd Printing, Nova Science Publishers,
Paley, B., Auerbach, B. (2011). Children with fetal alcohol
spectrum disorders in the dependency court system: challenges and
recommendations. Journal of Psychiatry and Law. Vol 38,
Blackburn, C., Carpenter, B. and Edgerton, J. (2012). Fetal
Alcohol Spectrum Disorders: Interdisciplinary Perspectives.
Blackburn, C., Carpenter, B. and Edgerton, J. (2012).
Educating Children and Young People with Fetal Alcohol Spectrum
Disorders: Constructing Personalised Pathways to Learning.
NOFASARD is the peak national non-government organisation
representing the interests of parents, carers and others interested
in or affected by FASD.
This is a UK based organization. Although there is a lot of UK
based information for support, you can also subscribe to their
newsletter. They have also produced a booklet 'FASD- A Teachers
Guide' that you can purchase.
If you would like more information about Mental Health and
Intellectual and Developmental Disabilities in children and
adolescents, please subscribe to the CHW School-Link newsletter
. For enquiries you can contact Jodie Caruana or Hebah Saleh at
the Children's Hospital at Westmead by email on email@example.com
or 02 9891 7208.