Blogging with Dr. Susan

 

Blogging with Dr. Susan

Fetal Alcohol Syndrome

Fetal Alcohol Syndrome, a child’s right to be born without a disability! Fetal Alcohol syndrome doesn’t have to happen.

Alcohol use is gross abuse in the womb, increasingly prevalent, as a growing trend to drink during pregnancy develops among young parents-to-be.  It is a growing problem among men who do not link drinking effects to the fetus they and their female partner conceived. Fetal alcohol syndrome (or FAS) is not a genetic accident, or a case of genetic inheritance or any other condition associated with the gene pool…it is a group of defects among genes caused by alcohol consumption.  Blame can be directly leveled at a parent’s conscious decision to drink in the early months of pregnancy when gestation is in the early stages and the fetus is at the mercy of genetic development. Hardly a disease exists that is the result of such selfish and unmanaged use of drugs and alcohol.  The choice to continue drinking is often a thoughtless social habit that will haunt drinking parents without end… fathers-to-be can care!

When pregnant women and their partners choose to drink alcohol, their choice impacts the early and middle fetal stages of growth and development. It is as simple as that!  A mother who drinks every day and the father, who joins her, run the risk of having a child whose care can top a hundred thousand dollars. Beer and wine and hard alcoholic drinks are time bombs, going off regularly in biological time terms, destroying fetal cells, their shapes, their productivity and soft tissue resulting in abnormal fingers and toes, ears and other anomalies, widely varied, but dependent on a healthy central nervous system, negatively affecting the brain’s flexibility and brilliant ability to throw off infection and disfigurement.

Now, a description of a family whose children who showed symptoms of FAS after several months and who had to give up their dreams at early ages.

Brenda is a divorced mother of three sons and a daughter.  It is the girl that she and Mike conceived a year prior to their marriage who has been diagnosed with fetal alcohol syndrome.  She was pregnant (a boy) again the next year when they did marry, using drugs in addition to alcohol throughout this time.  Now, with 2 boys in diapers and pregnant, Brenda came to the decision, to throw Mike out of the house, file for divorce and move in with a new man who was older and had “resources.”          Brenda’s daughter was diagnosed in the nearby school, as mentally handicapped and unable to be in a regular prekindergarten classroom.

The daughter‘s slow development in visual-motor activities and lack of coordination were ignored, and she stayed home with her brothers.  Brenda cut back somewhat on her daytime drinking and noticed that her daughter was not eating or growing.  The girl’s name was Marcy, and she appeared (at this point Brenda was taking more notice) to lack the ability to hear or follow directions even at the level of her younger brothers. Marcy’s frequent eye- blinking episodes and seizure-like twitches, lack of bowel and bladder control at home now caused Brenda to think more clearly and concerned, for the first time, and she took her five year- old to a walk-in clinic, where an assessment was done.  The clinic insisted on a drinking and drug abuse oral history of Mike and Brenda at that first meeting.

Answering questions concerning Mike’s drug abuse and her neglect of the children, Brenda says she “came clean” and asked for help for her family.  The diagnosis, a week later, was fetal alcohol syndrome with mental retardation and pervasive developmental disorder.  She and Mike talk more often and are able to take turns, since neither is working, to use public transportation to take Marcy every day to an early intervention program five miles from Brenda’s home which she shares with her boyfriend.  Now Brenda points to her daughter and says, ”Marcy is going to recover and get smarter!”  she is determined to make a life that is as normal as possible for her boys and Marcy and she doesn’t think the boys have the same problems.

In fact, the clinic identified that the three little boys have forms of hearing loss, poor bone mass, low muscle and joint problems in their fingers, toes.  They, too, will start early intervention therapy at a school-based clinic closer to their house, where Brenda hopes they will later go to school there, and learn normally.  “I know my drinking and Mike’s caused this so now I have to help the kids, she says.

Fetal alcohol syndrome (FAS) is a condition that results from prenatal alcohol exposure. If you drink during pregnancy, you place your baby at risk of fetal alcohol syndrome. The defects that are part of fetal alcohol syndrome are irreversible and can include serious physical, mental and behavioral problems, though they vary from one child to another. As many as 40,000 babies are born with some type of alcohol-related damage each year in the United States. If you suspect that your child has fetal alcohol syndrome, talk to your doctor as soon as possible. Early diagnosis may reduce the risk of problems associated with fetal alcohol syndrome, including troubles at school, with substance abuse and with the law.

Fetal alcohol syndrome (FAS) is a disorder that may occur to the embryo when a pregnant woman ingests any amount of alcohol during pregnancy. An ingestion of alcohol does not always result in FAS, but no amount of alcohol whatsoever is proven safe for consumption during pregnancy. The current recommendation of both the US Surgeon General and the UK Department of Health is not to drink alcohol at all during pregnancy.[1][2]

Alcohol crosses the placental barrier and can stunt fetal growth or weight, create distinctive facial stigmata, damage neurons and brain structures, and cause other physical, mental, or behavioral problems.[3][4][5] Surveys found that in the United States, 10–15% of pregnant women report having recently used alcohol, and up to 30% use alcohol at some point during pregnancy.[6][7][8] The main effect of FAS is permanent central nervous system damage, especially to the brain. Developing brain cells and structures are underdeveloped or malformed by prenatal alcohol exposure, often creating an array of primary cognitive and functional disabilities (including poor memory, attention deficits, impulsive behavior, and poor cause-effect reasoning) as well as secondary disabilities (for example, mental health problems, and drug addiction).[5][9] The risk of brain damage exists during each trimester, since the fetal brain develops throughout the entire pregnancy.[10]
Fetal alcohol exposure is the leading known cause of mental retardation in the Western world.[11][dubiousdiscuss] In the United States the FAS prevalence rate is estimated to be between 0.2 and 2.0 cases per 1,000 live births, comparable to or higher than other developmental disabilities such as Down syndrome or spina bifida.[12][dubiousdiscuss] The lifetime medical and social costs of each child with FAS are estimated to be as high as US$800,000.[13] http://en.wikipedia.org/wiki/Fetal_alcohol_syndrome

Signs and Symptoms

If you adopted a child or consumed alcohol during pregnancy and are concerned that your child may have FAS, watch for characteristics of the syndrome, which include: low birth weight, small head circumference, failure to thrive, developmental delay, organ dysfunction, facial abnormalities, including smaller eye openings, flattened cheekbones, and indistinct philtrum (an underdeveloped groove between the nose and the upper lip), epilepsy, poor coordination/fine motor skills, poor socialization skills, such as difficulty building and maintaining friendships and relating to groups, lack of imagination or curiosity, learning difficulties, including poor memory, inability to understand concepts such as time and money, poor language comprehension, poor problem-solving skills, behavioral problems, including hyperactivity, inability to concentrate, social withdrawal, stubbornness, impulsiveness, and anxiety http://kidshealth.org/parent/medical/brain/fas.html

FASD Widespread Among Inmates, Yet Overlooked Study Says

According to a new report, individuals with FASD are at high risk for coming into contact with the criminal justice system, and as a result FASD is pervasive among both male and female inmate populations across the U.S. The report emphasizes an earlier finding that sixty percent of individuals ages 12 and older with FASD have been in trouble with authorities, charged or convicted, at some point in their lifetime. http://www.nofas.org/



Future DSM V Diagnostic Manual

 

What do the pros think a year later about recently-released Diagnostic DSM V manual  of diagnostics affecting future diagnosis and treatment of many disorders common in the development of children and youth?    

Here  is what a  colleague of mine at the Yale Child Study Center, Yale University School of Medicine, says about the debate that I referred to as,” a war of conflict and consternation” affecting the care and treatment of  young children, middle school agers, adolescents, teens and tweens, ….  

Dr. Brian Reichow:  I don’t think the diagnostic issue has become a war, yet, but there are worries, which Fred (Volkmar, MD., PhD, author and renowned expert on Autism) alluded to in his interview for NPR a little while back. I think to really look at the issue, one must go past the giving and getting of a diagnosis and look at what purpose the diagnosis is serving. For parents who have a child with problems, which sometimes they cannot explain, getting a diagnosis can be helpful, and lumping PDD-NOS and Asperger’s into an ASD category might help them secure better services for their child. However, for treating the child, a diagnosis is just a start, and one should not treat a diagnosis as much as the behaviors or conditions that need changing. Thus, the diagnosis should become less of an issue."

Thanks Brian



Personal Stories on Developmental Disabilities

 

As users of my www.turben.com child development site you have had several years to learn from me about Developmental Ability and Disability as I work with and report on parents and kids’ physical and mental problems from birth!  Thanks for spreading the word.  I hear from some of you and delight in the family stories so here comes more!

Be sure to tell others about this newest part of the site, and refer parents whose children have personality and discipline issues, attitudes, as well as behavior difficulties and school problems. 

This new section explores special personal stories of children from Northern Russia experiencing different types of disabilities from autism, cerebral palsy, cortical vision impairment, poverty, unemployment, environments and serious to profound disabilities . 

I introduce you to each child, give my assessment and then recommend ways parents and teachers can help each child become a functioning member of society.  Want to know what works with different personalities? 

Want to raise and parent kids, starting with communication, family meetings and no need to do any yelling?  I teach families to set family rules, learn to listen and let everyone have a voice!  Some children need extra help in expressing themselves, they need to learn how to socially engage other children and develop their imaginations and learn how to think and respond in new ways.

At each visit to Russia, I see improvements as children are able to be placed in preschool, kindergartens, playing with others, exercising and getting to know sports, intellectual and fun games and activities. 

Susan helps families get on the right track! 

If you are a parent of a child with a disability, you will especially appreciate techniques I have found to be promising and helpful.

I know you will find this section of my website, inspiring, thought-provoking and educational.  Click here to begin your journey.  http://turben.com/category/259/Personal-Stories-of-Children-With-Developmental-Delays



Learning Differences in Autistic Children

 

Hints for parents and children, kids and their friends: how to understand learning differences including autistic-like patterns of thinking, talking, writing and reading, behaving and having fun…

  1. Increase vocabulary by building his own library and vocabulary word bank of high interest words.
  2. Increase oral reading skills (to self privately) using books that are self selected (of his interest) his likes/dislikes are important Zach Bell/ Pokémon/One Piece/Battleship
  3. Improve selection of reading materials to include comics, sign language or any other print of his choice using adult assistance
  4. Identify and Understand idioms, common expressions, slang, and corrected slang
  5. Use a grammar disk to listen to proper word usage
  6. Write more clearly examples of how nouns and adjectives agree
  7. Use possessives, questions and statements to answer questions
  8. Write common sentences that form a paragraph about basic ideas that he originates in his mind
  9. Help receive adult tutoring and classroom assistance to help him release his ideas aloud prior to writing use drawing in addition to writing

 



Helping Developmentally Disabled Children Become Functioning Adults

 

As you know, I am a Child Development Specialist and I work with a lot of children with Developmental Delays.  Please check out my new section that explores personal stories of children from Russia experiencing different types of disabilities from autism, cerebral palsy, cortical vision impairment to environmentally caused defects.

I introduce you to each child, give my assessment and then recommend ways parents and teachers can help each child become a functioning member of society.  Some children need extra help in expressing themselves, they need to learn how to socially engage other children and develop their imaginations and learn how to think and respond in new ways. At each visit to Russia, I could see improvements in children and many were placed in regular kindergarten when it was time for them to go to school. Early intervention is the key to getting these kids on the right track.

If you are a parent of a child with a disability, you will appreciate some of the techniques I have found to be promising and helpful.

I know you will find this section of my website, inspiring, thought-provoking and educational.  Click here to begin your journey.  http://turben.com/category/259/Personal-Stories-of-Children-With-Developmental-Delays



Global Developmental Delay

Question: This is about an infant one year old with global developmental delay due to epilepsy from the age of three months. Complete control from 11 months. Sitting with support. Hearing sound well. Not responding by turning head toward the direction of sound. According to Docs seeing dim light and following light. Unable to recognize mother. 


 

Thank you so much for bringing this difficult situation to my attention and I will do my best to give you some tricks of the trade!  Take this information as if it were a long but worthwhile way of looking at your child’s temperament and think about experimental ways of finding  “your child” and your personality and the family they’re growing up in…..   You were a child once ….. Remember?  So take seriously and with compassion all aspects of how your child will need to learn and survive and be part of “family” regardless of the disability and confusion about what your child needs and the serious nature of what you are facing.   Professional helpers are also important through schools and Head Start and other day care and home care settings. Modify your concerns. Make YOU HAPPIER and more responsive to the infant in your life, and that infant who needed help with their arms and legs, poor head control can changes direction.  This is essential.  Do not wait.

Eye gazing, continuous touch, body holding and wrapping, shielding and speech-talk also help!  All these are important for your situation and I hope you will find the right person beside yourself to help with your concerns and your future enjoyment!  Watch and enjoy feeding for many reasons ...including eye gazing, head lifting, warmth and fun!  

Start out thinking, “all children have assets” and these assets must have internal controls that process in one way or another with the help of professionals and parents…unique characteristics…so infants have working temperaments with unique personalities and brain development over time.  Child development and accommodations for that development allow infants to start to learning and to think.

Physical love and attachment are critical to infant learning at all stages and ages… here are some examples:

SING! Yes, sing and talk.  Move your arms and legs on or near your child’s body, because this is one-way infants are attracted to looking around and making sounds and noises.  Even crying and cuddling are tactile surprises for infants with hearing.  You should ignore problems and focus on touch such as moving arms and legs, cuddling, talking and making eye contact!  There’s more too!  Body contact that feels motion relaxes their body and improves the urge to move around.  Make contact activities to encourage growth and increase images and sounds that stimulate the brain.  These things will help the child react to you, loving, comforting, but with difficulty ….it will become clear what  “existing behaviors” will mean for the future.  You might spend time writing down how your child reacts to all the ups and downs. Use quiet humming to keep calm and smile.   For severe disabilities, changing directions and movement along with changing positions is essential along with list of ways for family members to repeat sounds, hum, turn to the infant and gaze, turn child over and the same sounds each day, all times of the day and night, some humming, some self voices that are clear. Use the touch that everyone in fact needs, more or less constantly.  Wrapped, or unwrapped, touch coupled with cuddling or your own type of touch that is happy and gentle.  All of these things help facilitate an understanding between child and parent or caregiver.

 Keep moving your child’s body… a lot to deal with but it will be worth the happy thoughts and the attention received by your child or children!

 Finally the child will begin to listen, respond or even ignore.  Yes! Even ignore!  This is a good thing, so you keep on, making sounds, smiling and sitting back, and redirecting the activity the child so dearly needs!   Or move away and they will grunt or laugh and more.  It is important to start as soon as each child or children is diagnosed.  There are so many factors that you think you should do such as play and therapy engagement one day at a time, but that is not the case, instead there many parts, some coming and some going, and some to move and communicate!    

Many factors have to do with personality and movement, especially temperament, so the chances are great that you can enjoy your child and find good ways to encourage your child from a variety of movements and enhance movement and personality, behaviors, and much more.  Direct movement and other activities help enhance the chances that each child and parent, while learning, can find their way but it may take a long time so be patient. Families, like yours, are longing for help with their children so they can thrive and develop!

Good luck and I look forward to talking to you via email soon!  

Dr. Susan Turben
Turben Developmental Services