Fetal Alcohol Syndrome

Fetal Alcohol Syndrome

This paper will discuss different characteristics that accompany fetal alcohol syndrome or FAS in the different stages of a child's life.

"At birth, infants with intrauterine exposure to alcohol frequently have low birth rate; pre-term delivery; a small head circumference; and the characteristic facial features of the eyes, nose, and mouth" (Phelps, 1995). Some of the facial abnormalities that are common of children with FAS are: small head size, small eye openings, broad nasal bridge, flattened mid-faces, thin upper lip, skin folds at the corners of the eyes, indistinct groove on the upper lip, low nasal ridge, and an abnormal smallness of the lower jaw (Wekselman, Spiering, Hetteberg, Kenner, & Flandermeyer, 1995). These infants also display developmental delays, psychomotor retardation, and cognitive deficits. In the central nervous system there is mental retardation, alcohol withdrawal at birth, poor sucking response, sleep disturbances, short attention span, and learning disabilities. Plus the child will have muscle problems, bone and joint problems, genital defects, heart defects, and kidney defects.

As a child with FAS progresses into preschool, physical, cognitive and behavioral abnormalities are more noticeable. These children are not the average weight and height compared to the children at the same age level. Cognitive manifestations are another problem with children who have FAS. "Studies have found that preschoolers with FAS generally score in the mentally handicapped to dull normal range of intelligence" (Phelps, 1995). Children with FAS usually have language delay problems during their preschool years. Research has also

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shown that these children exhibit poorly articulated language, delayed use of sentences or more complex grammatical units, and inadequate comprehension (Phelps, 1995). There are many

behavioral characteristics that is common among children with FAS. The most common characteristic is hyperactivity (Phelps, 1995). "Hyperactivity is found in 85% of FAS-affected children regardless of IQ"(Wekeselman 1995). School failure, behavior management difficulties, and safety issues are some of the problems associated with hyperactivity and attention deficit disorder. Another behavioral abnormality of with children with FAS, is social problems. "Specific difficulties included inability to respect personal boundaries, inappropriately affectionate, demanding of attention, bragging, stubborn, poor peer relations, and overly tactile in social interactions" (Phelps, 1995). Children are sometimes not diagnosed with FAS until they reach kindergarten and are in a real school setting. School-aged children with FAS still have most of the same physical and mental problems that were diagnosed when they were younger. The craniofacial malformations are one of the only physical characteristic that diminishes during late childhood (Phelps, 1995).

"Several studies have evaluated specific areas of cognitive dysfunction in school-age children exposed parentally to alcohol. Researchers have substantiated: (a) short term memory deficits in verbal and visual material; (b) inadequate processing of information, reflected sparse integration of information and poor quality of responses; (c) inflexible approaches to problem solving; and (d) difficulties in mathematical computations" (Phelps, 1995).

The behavioral manifestations of a child with FAS during the early years of life are still apparent in children who are in grade school. Hyperactivity is still the most common characteristic portrayed by these children. Some of the descriptions used to explain these school-

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aged children's behaviors include: distractible, impulsive, inattentive, uncooperative, poorly organized, and little persistence toward task completion (Phelps, 1995).

As a child reaches puberty and develops into an adult, some of the physical, mental and behavioral characteristics change. These adolescents begin to gain weight, but still remain short and microphalic (Phelps, 1995).

Cognitive abilities of children with FAS continue to be low through adolescence and adulthood. Low Academic performance scores of adolescents and adults are persistent throughout their lives. Many cognitive tests have been done on adolescent/adults with FAS, and each of them have found deficiencies in mathematics and reading comprehension (Shelton & Cook, 1993).

The behavioral manifestations of adolescents and adults with FAS continue to concentrate around the problem of hyperactivity. Inattentiveness, distractibility, restlessness, and agitation are the main behaviors that stem from hyperactivity. "Vineland Adaptive Behavior Scales results suggest that communication and socialization skills average around the seven year old range"(Phelps, 1995).

The prevalence of children with FAS is on the rise. More than ever, children are being diagnosed with FAS. Better techniques and knowledge by physicians are accountable for the increase. Physicians are diagnosing more babies today with FAS, because they have more knowledge and resources to evaluate the children at risk. FAS has no racial barriers and has been reported by variable ages from neonatal to young adult (Becker, Warr-Leeper, & Leeper, 1990). Estimates in the United States of people with FAS vary from 2 live births per 1,000 to 1 per 750 (Shelton & Cook, 1993). "In a medical review of 5602 women, six instances of FAS

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were identified among 38 children of alcohol abusing women. Although 22 of the 38 were traced at follow-up, the outcome for the 6 FAS cases per se was not specified.

Nevertheless, 18 of 22 children of the alcohol-abusing women were found to be in state hospitals" (Emhart, Greene, Sokol, Martier, Boyd, & Ager, 1995). For a doctor to identify a child as having FAS, he/she must have the proper education. A test to see if a child has a central nervous system dysfunction or growth deficiency is not enough for a reliable diagnosis. An accurate diagnosis would also involve a facial phenotype study (Astley & Clarren, 1995). The Southwestern Native Americans have the highest incidence of FAS in the United States (Shelton & Cook, 1993). "Native Americans are three times as likely as Caucasians to produce FAS children" (Shelton & Cook, 1993). Tribes that have a loose social organization reflect a higher rate of FAS compared to a structured organization because the structured organization views an alcoholic female in the tribe as socially unacceptable (Shelton & Cook, 1993). More cases