YOLANDA ROSS, LBSW LEAH DAVIES, LMSW CENTRAL TEXAS AFRICAN AMERICAN FAMILY SUPPORT CONFERENCE MARCH 27, 2015 Prenatal Alcohol Exposure: Lifelong Impacts.

YOLANDA ROSS, LBSWLEAH DAVIES, LMSW

CENTRAL TEXAS AFRICAN AMERICAN FAMILY SUPPORT CONFERENCE

MARCH 27 , 2015

Prenatal Alcohol Exposure:Lifelong Impacts

Welcome and Thank you for coming!

FASD

Pregnancy

Choice?

Addiction

Mental Health Disabilit

y

HealthAlcohol Development

Support

Knowledge

Yolanda’s Story

ALCOHOL USE AMONG PREGNANT WOMEN

Understanding FASD

Women and Alcohol

Studies show that women with alcoholism are up to twice as likely as men to die from alcohol-related causes such as suicide, accidents, and illnesses.

Alcohol becomes more highly concentrated in a woman’s body.

Women who drink heavily are more prone to liver disease, heart damage, and brain damage than men.

The code of silence around women and substance abuse and women is harming women and their babies.

The Numbers

1 in 13 pregnant women drink (CDC, 2012)

47% of Texas pregnancies are unintended (PRAMS, 2009) Approximately 68% for women aged 19 and younger

44.3 % of Texas women report drinking any alcohol before pregnancy (PRAMS, 2009)

5.7 % reported drinking any alcohol during the 3rd trimester

34% of pregnant adolescents (age 12-14) report using one or substance in past 30 days (Salas-Wright, 2015)

Most commonly used: Alcohol (16%)

Most likely to report alcohol use during pregnancy in 2012 CDC MMWR report:

White Between the ages of 35 and 44 College graduates Employed

Drinking while pregnant?

Women may be unaware that they are pregnant

Women may know other women who drank during pregnancy and who have children who appear outwardly to be healthy

Women may use alcohol to cope with difficult life situations such as: poverty, violence, isolation, despair or depression

Women may be struggling with addiction.

STIGMA

FASD is not about the face, it’s about the brain!

Wattendorf, D. MAJ, MC, USAF, and Muenke, M, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland. Am Fam Physician. 2005 Jul 15;72(2):279-285.

Prevalence Experts estimate that an FASD may occur in approximately 2-

5% of all live births. (May. P et al., 2014).

The chart below reflects national prevalence estimates for new cases of each of the listed health issues

Spina Down Childhood Diabetes FASD Bifida Syndrome Cancers (Type 1)

Thus, of the 380,000 or so infants born in Texas in 2011(DSHS), approximately 7,600-19,000 may have been born with a disorder within the FASD spectrum*.

0

5,000

10,000

15,000

20,000

25,000

30,000

35,000

40,000

Characteristics of FASD Due to Brain Damage

Impaired executive function

Developmental delay

Mental Health Issues Attention deficits Increased stress

responseIncreased activity Sleep disturbances

Decreased visual focus

Decreased/increased response to noise or stimulation

Delayed speech development

Possible intellectual disability

Learning difficulties

FASD and well-being . . .

Oppositional Defiant Disorder (ODD)ADHD, ADDBipolar disorderIntermittent Explosive DisorderAutism Spectrum (including Asperger’s

Syndrome)Reactive Attachment DisorderTraumatic Brain InjuryAntisocial Personality DisorderConduct DisorderBorderline Personality DisorderDepression

Logic Model

Because FASD is a brain-based disability, seen mostly in behaviors . . .

Then providing accommodations for people with an FASD or other neurocognitive impairment is as

appropriate, effective and important as providing accommodations for people with other physical

disabilities

• PREVENTION

• INTERVENTION

So what should we do?

Prevention is key!

Screening

Brief Intervention(if positive)

Referral to Treatment(if necessary)

Shift in Thinking

From believing the individual with an FASD…

To understanding the individual possibly…

Won’t Can’t

Annoying Frustrated, challenged

Lies Fills in the blanks

Irritable Overstimulated

Trying to get attention Needs contact, support

Inappropriate Displays behaviors of a child, is developmentally younger

IS the problem HAS a problem

Adapted from Malbin, 2002

Developing Accommodations

Identify what was going on

just before

behavior = the need

Adapt teaching and/or

environment,carefully monitor progress

Ask: What can I do to help meet this child in his/her need?

So what works?Hannah’s experience

MHMRA of Harris CountyEarly Childhood Intervention (ECI)Pasadena Independent School District (PISD)NOFASUniversity of Washington The Council on Alcohol and Drugs Houston

(Cradles Project)K.I.N.D.E.R. Clinic through Memorial

Hermann Hospital (No longer in existence)No Place Like Here

Strategies for Success

Stable routineLimit (but provide,) choices and instructionCelebrate successes (even small ones)Teach social skills and emotionsProvide supports in school (to individual,

teachers, and classmates.)Repetition!ConsistencyUse concrete language and explanationsTeach self-advocacy

What doesn’t work

Rewards or punishments that will happen “in the future.”

Independence as a goal.

Viewing inability to follow through as a lack of motivation.

Zero Tolerance policies.

Approaches that rely heavily on verbal processing – like MI.

“We must move from viewing the individual as failing if s/he does not do well in a program to viewing the program as not providing what the individual needs in order to succeed.”

—Dubovsky, 2000

For more information

The Texas Office for Prevention of Developmental Disabilities http://www.topdd.state.tx.us Leah Davies: [email protected]

The CDC http://www.cdc.gov/ncbddd/fasd/index.html

The FASD Center for Excellence (SAMHSA) http://www.fasdcenter.samhsa.gov/

Questions/Thoughts

There is also no safe time during pregnancy to drink and no safe

kind of alcohol. We urge pregnant women not to drink alcohol at

any time during pregnancy.”

– Centers for Disease Control and Prevention, 2011

“There is no known safe amount of alcohol to drink while

pregnant.

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Thank you!