BSTS Talk Show – FASD Awareness Day

What’s the best way to promote awareness about ND-PAE?

Join us as the BSTS interns discuss last years FASD Awareness Day, where they kicked of the condom campaign by passing out condom bookmarks at the Barking Dog Bar in Bethesda, MD. This was to promote awareness of the dangers of prenatal aochol exposure even prior to pregnancy recognition.

If you are planning a pregnancy, avoid alcohol, and if you are drinking alcohol, avoid pregnancy!!

Growing Recognition of Prevalence of Disorders Brought on by Prenatal Alcohol Exposure

Psychiatric News – American Psychiatric Association News
Just how prevalent is this epidemic?

In a study on the prevalence of the ND-PAE epidemic, Carl Bell, M.D., found that nearly 40% of patients seeking mental health care in Chicago had profiles consistent with ND-PAE, or Neurodevelopmental Disorder associated with Prenatal Alcohol Exposure. This was found in a study with 611 adult and child psychiatric patients at the Family Medicine Clinic at Jackson Park Hospital, located in Chicago’s South Side.

Carl Bell attended our symposium that was given at the 2015 APA Conference in Toronto, Canada on May 18th 2015. At this symposium, Dr. Susan D. Rich, MD, MPH, was joined by Scott Parnell, MD, and Sydnie Butin, a fellow BSTS intern, as they presented on the various levels of the ND-PAE epidemic. Their presentations were followed by a panel in which Bonnie Buxton, author of Damaged Angels, and her husband Brian Philcox spoke about raising their adopted daughter with ND-PAE, and Lauren Grenier, a fellow BSTS intern, spoke about her time at a three-month stint in a Residential Treatment Center and her new perspective on ND-PAE.

To find out more about Carl Bell’s findings and the APA conference: read the article here.

“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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FASD Matters. Impressions from the 2014 MOFAS conference “FASD and Human Rights”

 MOFASSusan
I’m delighted to be a visiting scholar for the University of Minnesota’s Department of Child Psychiatry this week.  I had the opportunity to meet with many people from the Department who are doing amazing work to prevent and treat Fetal Alcohol Spectrum Disorder.  I presented at the MOFAS  “FASD and Human Rights” conference today:  “From Deinstitutionalization to Incarceration –  The Human Rights Tragedy of FASD”. Perhaps more than any other agency in the country, MOFAS has taken the lead to address the leading preventable cause of neurodevelopmental disorders and intellectual disability in the world.  Up to 50% of the 60,000 children adopted from Russia and the former Soviet countries have some degree of this problem and 1 in 20 (5%) of school age American children in middle class families are affected.  These statistics are not surprising given that 50% of pregnancies are unplanned and there are epidemic rates of childbearing age women binge drinking.
 

The efforts of the Minnesota Organization on Fetal Alcohol Syndrome have led to pregnancy test kits being put in some of the bars in this state to help women stop and think about whether they might be pregnant before they buy a drink.  It’s a great idea, and a novel prevention approach.  It will hopefully help non-pregnant alcohol consumers “stop and think” about preventing pregnancy before they drink.  Though it’s only in 4 bars in the state, if this effort prevents only 4 children from having FAS, the state would save $850,000 per child, accounting for years of productive life lost and healthcare/mental health/delinquency costs.  That would be nearly $1.5M the state could put toward educating its future citizens, creating opportunities for resources for families and prevention of this condition.
While pregnancy test kits are at least further upstream than the tiny warning label on alcohol, I’m our Better Safe than Sorry campaign goes to the small tributaries where the salmon are spawning.  By alcohol consumers preventing pregnancy (through contraception) and avoiding alcohol if pregnant or planning a pregnancy, we will be able to stem the tide on this preventable epidemic.  That’s why we say – It’s Better Safe than Sorry – Alcohol and Unprotected Sex Don’t Mix! 
Simply put – If you use alcohol, contracept! 
For more information:
MOM. LOVE. HOPE. JOY. Three inspiring words and emotions most women experience during pregnancy: Check out MOFAS new campaign 049 ZERO ALCOHOL FOR NINE MONTHS  
http://www.mofas.org/drinking-pregnancy/049-2/

MOFAS