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FASD. Indiana FASD Prevention Taskforce. Working to Prevent Fetal Alcohol Spectrum Disorders Through High School and Middle School Curricula This presentation was designed for use in Middle School and High School Introductory Biology, Health, Family and Consumer Science Classes. FASD.

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Indiana FASD



Working to Prevent Fetal Alcohol Spectrum DisordersThrough High School and Middle School CurriculaThis presentation was designed for use in Middle School and High School Introductory Biology, Health, Family and Consumer Science Classes

Fetal alcohol spectrum disorders why a person should not drink alcohol if she could get pregnant


Indiana FASD



Fetal Alcohol Spectrum DisordersWhy a person should NOT drink alcohol if she COULD get pregnant!

Fetal alcohol spectrum disorders fasd


Fetal Alcohol Spectrum Disorders (FASD)

Possible Diagnoses

  • Fetal alcohol syndrome (FAS)

  • Partial FAS (pFAS)

  • Alcohol-related neurodevelopmental disorder (ARND)

  • Alcohol-related birth defects (ARBD)



FAE (fetal alcohol effects) is an older term used to describe the last three listed above.

On any given day in the united states


On any given day in the United States…

  • Approximately 11,000 babies are born

  • 1 of these babies is HIV positive

  • 3 of these babies are born with muscular dystrophy

  • 4 of these babies are born with spina bifida

  • 10 of these babies are born with Down syndrome

  • 20 of these babies are born with FAS

  • 100 of these babies are born with a FASD

From the Executive Summary of the IOM Report. FAS Community Resource Center. http://www.come-over.to/FASCRC

The prevalence of fas and fasd


The Prevalence of FAS and FASD

  • The prevalence of FAS is estimated to be about 1 in 500 to 1 in 1000 births

  • The prevalence of FASD is estimated to be nearly 1 in 100 births

Eustace LW 2003; Substance Abuse and Mental Health Services Administration;

and the Centers for Disease Control and Prevention

How much is too much


How much is too much?

  • The more alcohol consumed during pregnancy, the higher the risk for adverse effects

    • Binge drinking is particularly harmful!

  • No amount of alcohol has

    been proven ‘safe’ to

    consume during pregnancy

  • Every FASD is 100% preventable!

What is a drink


What is a Drink?

A Binge is four or more drinks on one occasion for a woman; five or more for a man

A Drink is 12 ounces of beer, five ounces of wine, or 1.5 ounces of hard liquor

= =

The effect of alcohol on a baby s development


The Effect of Alcohol on a Baby’s Development

  • Alcohol freely crosses the placenta from the mother to the baby

  • Blood alcohol levels of the baby are equal to that of the mother, within minutes of consumption

  • The critical period is the entire pregnancy



Brain and nervous system



Lips and palate



The Effect of Alcohol on a Baby’s Development

Development of the brain is occurring throughout the pregnancy, which means that alcohol exposure at any point may cause brain damage.

Figure from http://www.fda.gov/cber/gdlns/rvrpreg_fig1.gif

The diagnosis of fas


The Diagnosis of FAS

Defined by four criteria:

  • Exposure to alcohol while in the womb

  • Characteristic facial features

  • Growth problems

  • Involvement of the central nervous system (the brain)

Fasd facial features smooth philtrum and thin upper lip


FASD Facial Features: Smooth Philtrum and Thin Upper Lip

Smooth philtrum

(little to no groove

above upper lip)

Thin upper lip

NOTE: Although these features are associated with fetal alcohol syndrome,

they may also be seen in people who do not have a FASD.



FAS Facial Features: Short Palpebral Fissures (Eye Openings)

Eyes are measured from the outer corner to the inner corner

The effect of alcohol on growth


The Effect of Alcohol on Growth

  • Alcohol consumption increases the risk for having a baby with growth problems

  • After birth, exposed children may continue to have a decreased growth rate and subsequent short stature

Day and Richardson, 2004, AJMG 127C:28-34.

Alcohol affects overall brain size


Alcohol Affects Overall Brain Size

Brain of a

healthy baby

Brain of a baby

exposed to alcohol

Photo by Sterling Clarren, MD


Alcohol affects brain function


Alcohol Affects Brain Function

  • Developmental delays

  • Learning difficulties

  • Mental retardation

  • Speech/language disorders

  • Problems with memory, perception, and the senses


  • Differences in brain function may appear as:

    • Taking longer to process information

    • Problems remembering things

    • Difficulties with generalizing, forming associations, and understanding abstract concepts

    • Problems understanding consequences or cause-and-effect



Malbin D. 2002

A teenager with a fasd who is 18 years old may function at the level of a child or adolescent

A teenager with a FASD, who is 18 years old, may function at the level of a child or adolescent

Emotional maturity


Social skills

Concepts of money and time

Living skills

Reading ability

Physical maturity

6 years

6 years

7 years

8 years

11 years

16 years

18 years

Skill Developmental Age Equivalent

Adapted from: www.efsmanitoba.com/html/Final%20Paper%20Defining%20Needs%20of%20women%20with%20FAS_E2.htm

Primary vs secondary disabilities


Primary vs. Secondary Disabilities

  • Primary disabilities result from brain damage due to the alcohol exposure

  • Secondary disabilities develop over time due to lack of intervention and unmet needs

    • They are believed to be preventable

Secondary disabilities in fasd

Mental health issues

Disrupted school experiences

Inappropriate sexual behavior

Trouble with the law

Confinement in jail or treatment facilities

Alcohol and drug problems

Dependent living

Employment problems


Secondary Disabilities in FASD


Secondary disabilities

Secondary Disabilities

www.fasdcenter.samhsa.gov; Streissguth AP, et al. 2004

The long term consequences of fas


The Long Term Consequences of FAS

  • Only 3% of children lived with biological mother

  • Poor behavior was common

  • Average academic function was between 2nd and 4th grade

  • Independent living was uncommon among adults with FAS

Streissguth et al. 1991

For more information


For More Information

  • Fetal Alcohol Spectrum Disorders: Trying Differently Rather Than Harder, by Diane Malbin, MSW. Available at www.FASCETS.org.

  • Fetal Alcohol Syndrome: A Parents Guide to Caring for a Child Diagnosed with FAS, by Leslie Evans, MS, et al. Available for download at http://otispregnancy.org/pdf/FAS_booklet.pdf

  • Fetal Alcohol Syndrome, Fetal Alcohol Effects: Strategies for Professionals, by Diane Malbin, MSW. Hazelden Foundation, Center City, MN.

  • Fetal Alcohol Syndrome: Practical Suggestions and Support for Families and Caregivers, by Kathleen Tavenner Mitchell, MHS, LCADC, and the National Organization on Fetal Alcohol Syndrome. Available at http://www.nofas.org/estore




  • Alan Guttmacher Institute. Facts on American teens’ sexual and reproductive health. www.guttmacher.org/pubs/fb_ATSRH.htm

  • The Centers for Disease Control and Prevention. Fetal alcohol spectrum disorders. www.cdc.gov/ncbddd/fas/fasprev.htm

  • Day NL and Richardson GA. 2004. An analysis of the effects of prenatal alcohol exposure on growth: A teratologic model. American Journal of Medical Genetics Part C. 127C:28-34.

  • Eustace LW, et al. 2003. Fetal alcohol syndrome: A growing concern for healthcare professionals. Journal of Obstetric, Gynecologic, and Neonatal Nursing. 32:215-221.

  • The Institute of Medicine. 1996 Report on FAS. http://www.come-over-.to/FAS/ IOMsummary.htm

  • Lupton C, et al. 2004. Cost of fetal alcohol spectrum disorders. American Journal of Medical Genetics Part C. 127C:242-50.

  • Mattson SN, et al. Teratogenic effects of alcohol on brain and behavior. National Institute on Alcohol Abuse and Alcoholism. http://pubs.niaaa.nih.gov/publications/ arh25-3/185-191.htm

  • Streissguth AP, et al. 1991. Fetal alcohol syndrome in adolescents and adults. Journal of the American Medical Association. 265(15):1961-7.

  • Streissguth AP, et al. 2004. Risk factors for adverse life outcomes in fetal alcohol sydnrome and fetal alcohol effects. Developmental and Behavioral Pediatrics 25(4):228-238.

  • Substance Abuse and Mental Health Services Administration Fact Sheets. http://www.fasdcenter.samhsa.gov/grabGo/factSheets.cfm

Helpful websites


Helpful Websites

  • National Organization on Fetal Alcohol Syndrome- www.nofas.org

  • Fetal Alcohol Syndrome, Education and Training Services, Inc.- www.fascets.org

  • The FASD Center for Excellence, Substance Abuse and Mental Health Services Administration- www.fascenter.samhsa.gov

  • FASlink- http://www.acbr.com/fas/

  • The Arc- http://www.thearc.org/fetalalcohol.html

  • The Centers for Disease Control and Prevention- http://www.cdc.gov/ncbddd/fas/default.htm

Indiana resources


Indiana Resources

  • The Fetal Alcohol Syndrome Center of Indiana - Indiana University Medial Center975 West Walnut Street, IB 130Indianapolis, IN 46202Phone: 317-274-2450  Fax: 317-274-2387  Provides diagnosis, education and patient advocacy for those affected with prenatal alcohol exposure.

  • CNS - Center for Neurobehavioral Sciences3010 E. StateFt. Wayne, IN 46805Phone: 260-471-2300  Toll Free: 1-800-901-8416Provides therapy, education and patient advocacy for those affected with prenatal alcohol exposure. Organizes a support group for parents and caregivers (and other interested parties) of those with a FASD.

Indiana resources1


Indiana Resources

  • Indiana Department of Health - IN Perinatal Network (IPN), Prenatal Substance Use Prevention Program (PSUPP)2 N Meridian Street; Indianapolis, IN 46204Phone: 317-233-1269

    Fax: 317-233-1300

    Referrals and early intervention for substance-using pregnant

    women. Training for professionals.

  • Indiana Protection and Advocacy Services4701 N Keystone Avenue, Suite 222, Indianapolis, IN 46205

    Phone: 800-622-4845 or 317-722-5555      Fax: 317-722-5564Statewide agency for persons with developmental disabilities.www.in.gov/ipas




Slides developed by:Lisa J. Spock, Ph.D., C.G.C.

Gordon Mendenhall, Ed.D.

Assisted by:David D. Weaver, M.D.

Becky Kennedy, M.Ed.

James M. Ignaut, M.A., M.P.H., C.H.E.S.

Supported by: Indiana University School of Medicine

Indiana State Department of Health

Indiana Department of Education

University of Indianapolis

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