Fetal Alcohol Syndrome & Prenatal Drug Exposure

Charisa Kelly & Sarah Jane Calub

Occupations of Children and Adolescents I

What is

Fetal Alcohol Syndrome?

Fetal alcohol syndrome is growth, mental, and physical problems that may occur in a baby when a mother drinks alcohol during pregnancy.

Causes and Risk Factors

• Alcohol easily passes across the placenta to the fetus

• Alcohol can harm the baby’s development

• No “safe” level of alcohol use during pregnancy established

• Most harmful during the first 3 months of pregnancy

Signs and TestsA physical exam of the baby may show a heart murmur or other heart problems. As the baby grows, there may be signs of delayed mental development and problems with the face and bones.Tests include: • Blood alcohol level in pregnant women who show signs of being drunk

(intoxicated) • Brain imaging studies (CT or MRI) after the child is born • Pregnancy ultrasound

Symptoms

• Poor growth while the baby is in the womb and after birth • Decreased muscle tone and poor coordination • Delayed development and problems in three or more major areas:

thinking, speech, movement, or social skills • Heart defects such as ventricular septal defect (VSD) or atrial septal

defect (ASD) • Facial features: ◦ Narrow, small eyes with large epicanthal folds ◦ Small head ◦ Small upper jaw ◦ Smooth groove in upper lip ◦ Smooth and thin upper lip

A baby with fetal alcohol syndrome may have the following symptoms:

When, What, and WHO?

Prenatal Drug Exposure

• Pre-natal drug exposure falls under the area of exposure to teratogens, which is any substance such as drugs, radiation and chemicals

(Case-Smith, 2010).

• Many factors are considered when discussing how teratogens will affect the fetus, such as how much is ingested, how itʼs ingested, the gestational period and the sensitivity of the fetusʼs organs at the time of exposure.

• Pre-natal drug exposure can affect the fetus in development, the infant and the growing child into adulthood.

Cocaine and Opiates

• A psycho. stimulant that increases dopamine, serotonin and norepinephrine levels.

• It can cause: • Decreased cognition, attention and motor skills• Problems with social interaction• Lack of emotion regulation, hypersensitivity and irritability• ADHD, SIDS• Addicted infants with drug withdrawal symptoms can

occur as well.

Nicotine

• Addictive property in cigarettes introduced through maternal smoking or exposure to second hand smoke.

• It enters through the fetal nervous system and affects on the fetus is dependent upon exposure amount.

• It can cause:• Decreased birth weight• Intrauterine growth retardation• Preterm birth and SIDS• ADD/ADHD• Anti-social behaviors• Learning deficits• Timing of puberty may also be affected

Intrauterine growth retardation

Anti-depressants

• AN SSRI medication (Selective Serotonin Reuptake Inhibitor)

• Serotonin and its receptors are formed early in prenatal development, due to this fact exposure to anti- depressant medications can cause:• Cardiac abnormalities

• Increased anxiety behaviors and learning difficulties

• Can also be associated with the development of the brain and peripheral organs

Neonatal Abstinence Syndrome

Impact on Occupations

• Outcome for infants with FAS varies = spectrum (“FASD”)• Abnormal brain development, impacting cognitive and motor milestones• Disrupted education

• Memory• Learning new information• Initiation and termination of tasks• Copying information from the board• Short attention span and poor concentration• Learning to write

• Difficulty in maintaining employment and living independently

Role of Occupational Therapy

• Children do best if diagnosed early and referred to therapists who can work on educational and behavioral strategies that fit child’s needs

• Identify external factors impacting performance and discrepancies between child’s ability and activity demands

• Develop interventions in partnership with child, family, and teachers

• Sensory integration• Behavioral management• Patient education: FAS is 100% preventable

Support Group: National Council on Alcoholism and Drug Dependency -- www.ncadd.org

References

Assink, E., Rouweler, B., Minis, M., & Hess-April, L. (2009). How teachers can manage attention span and activity level difficulties due to Foetal Alcohol Syndrome in the classroom: an occupational therapy approach. South African Journal Of Occupational Therapy, 39(3), 10-16.

Borchers, D. (2003, Prenatal drug exposure: What parents need to know).

Case-Smith, J., Allen, A.S. & Pratt, P.N. (2010). Occupational therapy for children (6th ed.). St. Louis, MO: Mosby

Fetal alcohol syndrome. (2012). In A.D.A.M. Medical Encyclopedia. Retrieved from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001909/

Thompson, B. L., Levitt, P., & Stanwood, G. D. (2009). Prenatal exposure to drugs: effects on brain development and implications for policy and education. Nature Reviews Neuroscience, 10(4), 303-312. doi:10.1038/nrn2598