Kids with fetal alcohol syndrome need stable homes

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Children born with fetal alcohol syndrome are less likely to get in trouble with the law or to have behavioral problems in later years if they are diagnosed early and are raised in a stable home, according to new study findings.

These findings show “there really is hope for children with fetal alcohol syndrome,” lead study author Dr. Ann P. Streissguth, of the University of Washington in Seattle, told AMN Health.

"There are things families and communities can do to really improve outcome,” she added.

Fetal alcohol syndrome affects children born to mothers who abused alcohol during pregnancy. Each year an estimated 12,000 children in the US are born with the syndrome, and many more are born with fetal alcohol effects, a less severe form of the condition.

Children with fetal alcohol syndrome tend to have brain damage that, for example, causes infants to be slow to nurse and feed, growth deficiencies that leaves them shorter or slighter than their peers, and typical facial features including smaller eyes and a thin upper lip, Streissguth noted.

These children are also known to have lowered IQ, attention deficits and other problems with intellectual functioning as well as behavioral and emotional problems.

Streissguth and her colleagues collected information about 415 children, adolescents and adults, aged 6 to 51 years, who were enrolled in the University of Washington’s Fetal Alcohol Follow-up Study. Only 20 percent of the group were raised by their biological mothers, and 67 percent had been physically or sexually abused.

Those who were raised in a stable, nurturing home environment and who received an early diagnosis, however, were two to four times more likely to escape later involvement in various negative life experiences, the researchers report in the Journal of Developmental and Behavioral Pediatrics.

Overall, 39 percent of the 6 to 11-year-old children exhibited inappropriate sexual behaviors at some point in their life, as did 48 percent of the 12 to 20-year-old adolescents and 52 percent of adults.

Children were more likely to engage in exposing and inappropriate sexual touching, while adolescents and adults tended to more frequently engage in promiscuity and inappropriate sexual advances. Such inappropriate behaviors began as early as 9 years of age.

Fourteen percent of school children and 61 percent of adolescents and adults experienced a disruption in their schooling, including suspensions and expulsions at some point in their lives. Similar percentages of children and older subjects had also experienced some trouble with the law, such as being involved in theft, assault or burglary.

In particular, 35 percent of study participants aged 12 years and older had problems with drugs and alcohol.

Eight percent of children and 50 percent of adolescents and adults had experienced confinement—either psychiatric hospitalization, or incarceration for a crime, or in-patient drug or alcohol treatment.

Being raised or spending time in a healthy home environment, however, seemed to protect the study participants from becoming involved in antisocial or unlawful activities. Those who spent the least amount of time in stable, nurturing environments had the greatest risk of getting into trouble, the report indicates.

Half of the study participants were diagnosed with fetal alcohol syndrome or fetal alcohol effects at 10 years of age or younger, while the other half were diagnosed at later ages. Again, the earlier the age at diagnosis, the lower the risk of involvement in negative experiences, study findings show.

“If you don’t know early on what’s wrong with a child...the problem doesn’t get treated,” Streissguth said. She added that the average child is not diagnosed until 6 years of age.

Because 87 percent of the study participants had IQ scores above the level associated with mental retardation, they didn’t qualify for the school services and specialized training for jobs and life skills that they need. Many instead “end up getting treatment in mental health institutions,” Streissguth said.

In light of the findings, continuing efforts are needed in every community to educate women about the consequences of drinking while pregnant or during the childbearing years, Streissguth said. A concerted effort is needed to address this “community problem,” she added, citing the need for resources for alcohol abusing women and for their children, to “help them achieve the best they can in life.”

SOURCE: Journal of Developmental and Behavioral Pediatrics, August 2004.

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