Fetal alcohol spectrum disorder requires new approach

Often all people see in a child with fetal alcohol spectrum disorder is their bad behaviour.

“The behaviours make it difficult to deal with the kid in many cases,” said Allan Mountford, who teaches in a special program that helps troubled teenagers transition to high school.

“The kid is not inherently bad,” Mountford stressed. “The student has a disability.”

Mountford will be speaking at an all-day forum on fetal alcohol spectrum disorder hosted by KidsAbility on Monday at Bingemans.

Intended for parents, educators, medical professionals and researchers, the forum’s other topics include interventions and supports at school and accessing services. Registration is $99 and available online at kidsability.ca.

Mountford urges people to look beyond the bad behaviours common with fetal alcohol spectrum disorder, which covers a range of permanent birth defects are caused by prenatal exposure to alcohol. When alcohol crosses the placenta, it interferes with normal cell development in the brain, nervous system and other organs.

At least one out of 100 children born in Canada will have fetal alcohol spectrum disorder. Many more are undiagnosed.

Epidemiology of FASD

The prevalence of FAS in the United States has been reported as 1–3 per 1000 live births and the rate of FASD as 9.1 per 1000 live births. However, diagnosis may often be delayed or missed entirely.

There are no national statistics on the rates of FASD in Canada, although studies have estimated its prevalence in small populations. In an isolated Aboriginal community in British Columbia, FASD prevalence was 190 per 1000 live births. In northeastern Manitoba, an incidence of about 7.2 per 1000 live births was found. In another Manitoba study in a First Nations community, the prevalence of FAS and partial FAS was estimated to be 55–101 per 1000. In their survey, Asante and Nelms-Matzke estimated the rate of FAS and related effects at 46 per 1000 native Canadian children in the Yukon and 25 per 1000 in northern British Columbia. Based on referrals to a diagnostic clinic in Saskatchewan, the rate of FAS was estimated at 0.589 per 1000 live births in 1988–1992 and 0.515 per 1000 in 1973–1977. However, none of these data should be generalized to other communities, other populations or the Canadian population in general.

Risk factors

A common misconception is that FASD is associated with ethnocultural background. However, the data suggest that risk factors for prenatal alcohol exposure include higher maternal age and lower education level, prenatal exposure to cocaine and smoking, custody changes, lower socioeconomic status and paternal drinking and drug use at the time of pregnancy; and reduced access to prenatal and postnatal care and services, inadequate nutrition and a poor developmental environment (e.g., stress, abuse, neglect).