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Topic Editor: Mary J. O'Connor, PhD, University of California at Los Angeles, USA
Topic funded by: Margaret & Wallace McCain Family Foundation
The most direct and obvious way to prevent FASDs is to eradicate alcohol consumption in women who are either pregnant, planning a pregnancy or who could become pregnant. However, despite health recommendations, the rates of alcohol consumption of women of childbearing age have remained stable. In addition, inconsistent information given to women and disputes about what is the safe amount of alcohol women should consume during pregnancy contribute to confusion. A clear consensus based on a systematic review of research on PAE is strongly needed, and should guide the recommendations and practice of professionals.
The most successful prevention strategies have been screening for alcohol consumption by health care professionals accompanied by brief interventions or extended brief interventions with pregnant and non-pregnant women of childbearing age. The efficacy of these treatments is also enhanced by implicating the woman’s life partner in the intervention. Health providers must therefore be thoroughly informed and educated about the harmful effects of drinking during pregnancy, and how to conduct brief interventions with women.
For alcohol-exposed children, a classification of syndrome-specific profiles would facilitate diagnosis in the absence of distinct facial characteristics. This would also ensure early identification and intervention, which has been shown to predict positive outcomes in this population. Pediatricians, nurses, educators, and early childhood mental health consultants should all be trained in recognizing the different signs of PAE, and in asking about and keep accounts of maternal alcohol consumption during pregnancy.
Results from animal research also suggest that certain substances could attenuate the negative impact of alcohol on the fetus. For instance, while dietary deficiencies (e.g., low levels of zinc and iron) may worsen the adverse effects of alcohol on fetal development, taking certain supplements (e.g., choline, zinc, vitamin C, E, and B-carotene) may protect against these effects. Exposure to other substances, such as lithium and neuroprotective peptides, has also been successful at reducing the severity of the effects of PAE in animals, but this has yet to be shown in humans.
Treatment
Different interventions on prenatally alcohol exposed rodents have been linked to positive outcomes, including neonatal handling, enriching environment and rehabilitation. In humans, social skills training, socio-cognitive programs focused on mathematics and behavioural regulation have been successful at improving the functioning of children with FASDs. Family interventions can also improve the well-being and daily adaptation of alcohol-exposed children while simultaneously assisting and supporting parents to provide stable and optimal care to their children.
One way to thoroughly trace and organize the types of services offered to children with FASDs is to strengthen cooperation and communication across different child care systems, including health care, child welfare, community centers, and Early Start and Head Start programs. This initiative can also guarantee that FASD does not go undetected.
Existing therapies for children with FASD include behavioural, language, occupational and physiological treatments. The success of those treatments could be improved by taking into consideration the deficits and needs specific of children with FASDs. For instance, although many children with a FASD are prescribed stimulants for ADHD symptoms, the negative side effects of these drugs appear to be particularly salient for children with FASDs, and should therefore be prescribed with caution. Given that the occurrence of FASDs is scattered across economic classes and ethnicities, the assistance provided to these children and their families should be adapted to meet different community and cultural needs.
See also...
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