Neuropsychological Aspects of Prevention and Intervention for FASD in Canada

Pei, Jacqueline; Tremblay, Mélissa; McNeil, Allison; Poole, Nancy; McFarlane, Audrey

doi:10.1007/s40817-016-0020-1

Cited by 11 publications

(6 citation statements)

References 48 publications

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“…Given that the limited research focusing on adolescents and adults with FASD has primarily emerged from the United States and Europe, it is important to situate the current findings in the Canadian context (e.g., Day et al, 2013;Lynch et al, 2015;Rangmar et al, 2015;Spohr et al, 2007;Streissguth et al, 1991). Canada maintains relatively strong publicly funded health, education, and social service systems and is often considered a leader in FASD-specific policy, research, programming, and prevention initiatives at both regional and national levels (e.g., Cook et al, 2016;Pei et al, 2017;Poole et al, 2016). These factors likely impact the social determinants of health linked with the incidence of PAE and FASD and may differentiate the current difficulty profile relative to other countries.…”

Section: Discussionmentioning

confidence: 99%

Difficulties in Daily Living Experienced by Adolescents, Transition‐Aged Youth, and Adults With Fetal Alcohol Spectrum Disorder

McLachlan

Flannigan²,

Temple

et al. 2020

Alcoholism Clin & Exp Res

106

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Background: Individuals with fetal alcohol spectrum disorder (FASD) experience a range of problems in their cognitive, affective, and physical functioning following prenatal alcohol exposure (PAE), in addition to multiple complex difficulties in daily living that impact well-being. Using the Canadian National FASD Database, we sought to profile a range of difficulties in daily living, along with risk factors, in a large cross-sectional cohort of adolescents, transition-aged youth, and adults with PAE, of which a subset was ultimately diagnosed with FASD. Methods:We summarized data for 9 current difficulties in daily living reported at the time of diagnostic assessment for 726 individuals with PAE assessed at 26 FASD diagnostic clinics across Canada, including 443 adolescents (12 to 17 years), 135 transition-aged youth (18 to 24 years) and 148 adults (25 to 60 years). Difficulties included problems related to school disruption, employment, independent living needs, supportive or sheltered housing, legal problems with victimization, legal problems with offending, incarceration, alcohol misuse, and other substance misuse. Risk factors included age, gender, living placement, postnatal trauma, and neurodevelopmental impairment.Results: Across the full PAE sample, adolescents, transition-aged youth, and adults presented with high rates of difficulties in daily living, including independent living support needs (63%), alcohol misuse (38%), other substance misuse (46%), employment problems (37%), legal problems with offending (30%), assisted or sheltered housing (21%), school disruption (18%), legal problems with victimization (4%), and incarceration (3%). Difficulty rates were similar for those with FASD irrespective of diagnosis (e.g., with or without sentinel facial features), but rates greater for adults, and those with low overall intellectual functioning (IQ < 70). Controlling for age and IQ, cumulative difficulty was independently associated with gender, living placement, and neurodevelopmental impairment.Conclusions: Adolescents, transition-aged youth, and adults with FASD experienced a range of substantial and complex difficulties at the time of their diagnostic assessment, signaling a high level of service needs. These findings underscore the importance of developmentally informed assessment continued through childhood, as well as ongoing functional and needsbased service provision as youth with FASD transition to adulthood and beyond.

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Section: Discussionmentioning

confidence: 99%

Difficulties in Daily Living Experienced by Adolescents, Transition‐Aged Youth, and Adults With Fetal Alcohol Spectrum Disorder

McLachlan

Flannigan²,

Temple

et al. 2020

Alcoholism Clin & Exp Res

106

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“…The relationship between mother’s use of alcohol and the lasting impact on the child is a focus in the articles identified from a public health perspective (Corrigan, Shah, Lara, Mitchell, Combs-Way, Simmes and Jones, 2018; Corrigan, Shah, Lara, Mitchell, Simmes and Jones, 2018; Corrigan et al , 2017; Zizzo and Racine, 2017). Other disciplines identified in the literature include neuropsychology (Davis et al , 2017; Pei et al , 2017; Glass and Mattson, 2017; Fitzpatrick, Latimer, Olson, Carter, Oscar, Lucas, Doney, Salter, Try, Hawkes, Fitzpatrick, Hand, Watkins, Tsang, Bower, Ferriera, Boulton and Elliot, 2017; Fitzpatrick, Oscar, Carter, Elliott, Latimer, Wright and Boulton, 2017); criminal justice perspective (Brown et al , 2017; Tait et al , 2017; Flannigan et al , 2018); child health, social work and child welfare (Mukherjee et al , 2017; Kapasi and Brown, 2017; Hafekost et al , 2017; Bakhireva et al , 2017; Petrenko and Alto, 2017; Gibbs and Sherwood, 2017; Myra et al , 2018); the substance use field (Washio et al , 2017); nursing (Marcellus, 2017; Howlett et al , 2017), women’s health (Cook, Green, de la Ronde, Dell, Graves, Ordean, Rutler, Steeves and Wong, 2017; Cook, Green, de la Ronde, Dell, Graves, Morgan, Ordean, Steeves and Wong, 2017; Hui et al , 2017; Hemsing et al , 2017; Osterman et al , 2017); health care ethics (Elias et al , 2018; Helgesson et al , 2018); and education (Millar et al , 2017). It is interesting to note that the literature emerging from the search terms FASD and stigma yielded results from multiple sources indicating that this topic is of interest to a variety of disciplines in the health and social sciences fields.…”

Section: Introductionmentioning

confidence: 99%

Stigma as a dominant discourse in fetal alcohol spectrum disorder

Choate

Badry

2019

ADD

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Purpose The purpose of this paper is to conduct a scoping review of the literature to explore the many ways stigma affects people with FASD and to highlight the disciplines and places where discourse on FASD and stigma is taking place. Design/methodology/approach Searches were conducted in PubMed, ERIC, Family & Society Studies Worldwide, Families Studies Abstracts and Google Scholar between 2008 and 2018. Search terms focused on stigma, shame and the connection to FASD with a view to looking across social and medical science literature. Findings Searches identified 39 full text manuscripts, 13 of which were included in the scoping review. Stigma toward people with FASD exists in multiple professional forums across disciplines. The relationship between mother’s use of alcohol and the lasting impact on the child is a focus in the articles identified from a public health perspective. The review showed there was limited cross-disciplinary discussion evident. In total 13 articles were selected for inclusion in this review. Research limitations/implications Negative discourses predominate with little attention being paid to possible areas of success as well as cases of lower FASD impacts. There is a significant void in work focusing on positive outcomes for people with FASD. Such discourse would support a better understanding of pathways to more positive outcomes. Originality/value This paper highlights the issue of FASD and stigma through identification of relevant literature and expands the conversation to offer insights into the challenging terrain that individuals with FASD must navigate. The issue of stigma is not linked only to individuals with FASD but also their support systems. It is critical to recognize the multiple attributions of stigma to FASD in order to effectively take up conversations across and between disciplines to promote new discourses focused on de-stigmatization.

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“…Their patterns of ability will vary from domain to domain rather than being uniform. If the fire service professional is not qualified or equipped for determining developmental age, a qualified specialist may be consulted. Pedruzzi et al., 2021 Pei et al., 2017 Temple et al., 2021 Take into account how deficits affect persons with FASD such memory problems and difficulties linking cause and effect and how this might contribute to firesetting being repeated on multiple occasions. Also be aware of memory related deficits that may reduce ability to comply and learn fire safety precautions.…”

Section: Introductionmentioning

confidence: 99%

Fetal alcohol spectrum disorders (FASD) and youth firesetting: A call on criminal justice, emergency responder, and fire prevention specialists to become informed

Brown

Spiller²,

Carter

et al. 2021

Behavioral Sci & The Law

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Central nervous system damage resulting from prenatal exposure to alcohol, often referred to as fetal alcohol spectrum disorders (FASD), commonly manifests as lacking cognitive functioning, problem solving, impulsivity, memory, executive functioning, and social skill deficits. For individuals with FASD, these brain‐based deficits translate into impulsive behaviors and poorly thought‐out decision‐making, coupled with an inability to anticipate and recognize the sometimes very severe consequences of their behaviors. Not unexpectedly, individuals with FASD frequently find themselves disproportionately involved in the criminal justice system and mental health services. For some individuals with FASD, these behaviors can also include firesetting. First responders, like other health and legal professionals, are often unable to recognize the behavioral indicators of FASD, primarily due to a lack of training. As a result, firesetting behaviors are often attributed to deliberate, willful acts of delinquency, a desire to damage property, thrill seeking, or as attempts for personal gain, rather than being viewed as maladaptive attempts to solve problems by individuals who lack the tools to do this in more appropriate ways. These same skill deficits also present when individuals with FASD are interviewed about their involvement in such behaviors, sometimes resulting in confabulation, suggestibility, and false confessions. Further education and training in FASD are vital for first responders if they are to better support individuals with FASD and minimize their chances of becoming involved in firesetting behaviors. Furthermore, this training and education will help ensure that first responders can intervene in more appropriately when crisis situations do occur. This article will outline key behavioral symptoms of FASD as well as provide first responders with suggestions as to how to best support individuals when FASD is suspected. The brief quote that follows highlights some of the key challenges facing individuals with FASD and how poor decision‐making and impulsiveness can result in severe consequences for the individual and those around them.

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Neuropsychological Aspects of Prevention and Intervention for FASD in Canada

Cited by 11 publications

References 48 publications

Difficulties in Daily Living Experienced by Adolescents, Transition‐Aged Youth, and Adults With Fetal Alcohol Spectrum Disorder

Difficulties in Daily Living Experienced by Adolescents, Transition‐Aged Youth, and Adults With Fetal Alcohol Spectrum Disorder

Stigma as a dominant discourse in fetal alcohol spectrum disorder

Fetal alcohol spectrum disorders (FASD) and youth firesetting: A call on criminal justice, emergency responder, and fire prevention specialists to become informed

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