“Prince George’s County Maryland – An Opportunity for FASD Awareness”

Last summer, local attorney Evan Wilson had a “light bulb moment” during Dr. Rich’s presentation in Prince George’s County, MD on June 20 about FASD and the law. Dr. Rich and two of the “BSTS change agents” met with him to discuss his perspectives about the role of the judiciary system in identifying and assisting individuals affected by FASD. As a juvenile delinquency attorney, he represents indigent minors in court who cannot afford to pay a lawyer. As Assistant Public Defender in PG County, he sees his job as educating the court about his client as a whole and not solely focused on a “snapshot” of the person’s life. Like the age old question – “Do we look at the crime or the individual?”, public defender Wilson sees the importance of making the court aware of challenges they face in their lives. “If you look at a person they are more than one event, they have a whole life behind them.” He emphasizes the importance of the right treatment protocol for a successful recovery to prevent recidivism (future delinquent acts).  He believes that further education and awareness in the PG County court system to be able to appropriately intervene in the lives of adolescents and adults affected by FASD.

The Guardian – Stop Treating Mentally Ill Children Like Criminals

The Guardian – Stop treating mentally ill children like criminals

This article highlights unthinkable social injustices and human rights discrimination against children and adolescents at their most vulnerable time – during a psychiatric emergency.  Individuals with ND-PAE are often misdiagnosed with or have co-occurring mental illness as a result of their neurodevelopmental disabilities.   When they do have need of inpatient psychiatric services, most are ill-equipped to treat their complex neurodevelopmental issues.  Because they have a hard time understanding consequences and avoiding peer pressure, they are at high risk of delinquent behavior and may end up in detention centers or jail.  There is need for more comprehensive, specialized programs and services for adolescents with ND-PAE and other neuropsychiatric conditions, not just warehousing them away from society.

Early intervention programs to identify exposed infants and toddlers with ND-PAE, as well as raising awareness about how early in pregnancy these problems happen (therefore primary prevention includes preconception health and family planning for alcohol users). Individuals with ND-PAE are at much higher risk of teen pregnancy, poor parenting skills, and subsequent child welfare issues because of low adaptive functioning skills.  Often, the way they were parented leads to their parenting style being harsh and punitive. Their limited coping skills, poor frustration tolerance, and lack of resourcefulness leaves them at much higher risk of neglect and abuse of their own children.  It is important for them to have access to injectable, implantable, and other long term, effective contraception to improve their life skills and community supports prior to pregnancy.

Putting a child in jail to await a psychiatric evaluation is like putting an elderly person with a broken hip in jail while waiting for a bed at a rehabilitation program. When are we going to start valuing the emotional well being of our most precious resource?  The children are our future and we must protect them at all cost!

More information on ND-PAE and criminal justice issues on our blog

Challenges of individuals with FASD. “Lives and crimes: Kids who suffer foetal alcohol spectrum disorder”

American Bar Association Resolution on FASD: A Call to Action for the Criminal Justice System

Prenatal Alcohol Exposure and it’s consequences…

Raising Awareness About FASD

Dr. Susan D. Rich has given Grand Rounds at the University of Minnesota Department of Psychiatry on November 12, 2014 and at Georgetown University Medical Center on Tuesday, January 6th about the topic of Neurodevelopmental Disorder associated with Prenatal Alcohol Exposure (ND-PAE), the diagnostic term in DSM-5 for Fetal Alcohol Spectrum Disorder.

In an article in Psychiatric News in 2005, Dr. Rich said:  “I was furious when I first heard the term ‘funny-looking kid,’ or FLK, almost 12 years ago. A rural pediatrician was describing how doctors overlook the possibility of fetal alcohol syndrome (FAS), the physical and neuropsychiatric effects of prenatal alcohol exposure. He said, ‘They look at the parents and say – `They’re pretty funny looking, too.. .so, I guess it’s genetic.’ My passion for prevention of alcohol-related birth defects has been fueled by such attitudes.”

Dr. Rich has been speaking widely about her clinical work with patients who have ND-PAE and the clinical link between autism and FASD. In November, she also spoke at the Minnesota Organization on Fetal Alcohol Syndrome’s annual conference: “FASD and Human Rights.”  During October, she chaired an all day Etiology, Diagnosis, Treatment, and Prevention in an Era of DSM-5 at the American Academy of Child and Adolescent Psychiatry annual conference in San Diego, California.

DSM-5 includes the diagnosis of “Neurodevelopmental Disorder Associated with Prenatal Alcohol Exposure” (ND-PAE) under “Specified Other Neurodevelopmental Disorders” (315.8). The Centers for Disease Control and Prevention estimates that as many as 1 in 20 (or 2-5%) of school aged children in middle class communities have some degree of this preventable disorder. Up to 85% of individuals with ND-PAE have a lifetime prevalence of moderate to severe mental illness.

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Alcohol Research Roundtable at the Physicians Committee for Responsible Medicine

Dr. Susan Rich, President and Founder of 7th Generation Foundation, Inc. – BSTS’s parent organization, was one of three guest speakers on friday december 5th at a roundtable discussion at the Physicians Committee for Responsible Medicine (http://www.pcrm.org/about/about/about-pcrm) in Washington, DC. 
To view the roundtable agenda see PCRM Agenda
PCRM is dedicated to “dramatically changing the way doctors treat chronic diseases such as diabetes, heart disease, obesity, and cancer. By putting prevention over pills, doctors are empowering their patients to take control of their own health.”  The nonprofit has recently redirected its efforts toward research funding and policy related to Fetal Alcohol Spectrum Disorders. PCRM has partnered with Dr. Rich to help highlight solutions to prevent the epidemic caused by our social drug of choice: alcohol.
 
More than 40 years of animal and human research since Fetal Alcohol Syndrome was characterized in 1973 by Drs. Ken Jones and David Smith has shown that alcohol is a neurotoxin and teratogen (cause of birth defects).  In 1981, Dr. Kathleen Sulik of the University of North Carolina showed that these problems occur as early as the late 3rd to early 4th week after conception – long before most women know they are pregnant.  It is not enough to focus prevention of FASD/ND-PAE on pregnant women and put a tiny label on alcohol.  Over 50% of U.S. pregnancies are unplanned and few Americans understand that this condition happens as early as the first few weeks.
Each year, the National Institutes on Alcohol Abuse and Alcoholism funds $30 million toward FASD research – $17 million devoted to animal research, rather than evaluating effective ways to prevent and treat FASD/ND-PAE in people.  Montgomery County, MD where NIAAA is located earns $30 million in profit from the sales of alcohol – equivalent to the entire national budget of NIAAA FASD research. Yet not one warning sign is posted by the local liquor control board or anywhere else in Maryland to raise awareness about the dangers of alcohol during pregnancy or prior to pregnancy recognition (41 other states have adopted such point of purchase signage).
Dr. Rich shared her insights and highlighted the Better Safe than Sorry Project at the roundtable to promote more effective FASD/ND-PAE prevention research.

Dispelling Myths About Alcohol Related Birth Defects – A Documentary

If you are pregnant or planning a pregnancy, avoid alcohol. If you are using alcohol, avoid pregnancy. Alcohol and unprotected sex don’t mix!

This is a 40 minute documentary produced by the University of North Carolina Bowles Center for Alcohol Studies in 2001 with funding from the Centers for Disease Control and Prevention.

Interviews with leading scientists and researchers in the field of Fetal Alcohol Spectrum Disorder provide compelling evidence to clarify the controversies about alcohol use among childbearing age women.

http://www.youtube.com/watch?v=3TnYC7KtM34