FetalAlcohol Spectrum Disorders (FASDs)
FetalAlcohol Spectrum Disorders (FASDs)
FASDconsists of several conditions that arise as a result of alcoholconsumption during the pregnancy period. The common issues related tothis disease include physical abnormalities, short height, lowweight, reduced head, poor hearing, inadequate body coordination, andpoor eyesight. In some cases, the affected individuals may portrayhigh-risk behaviors in alcohol problems and use of other drugs. Inthis type of disorder, the primary condition is referred to as fetalalcohol syndrome. In most cases, the risk problems are dependent uponthe amount and frequency of alcohol consumption. The main reason asto why this event occurs is because alcohol can traverse theblood-brain barrier thus affecting the baby. The best means ofprevention is by avoiding alcohol entirely.
Apparently,FASD begins when a pregnant woman consumes alcohol in quantities thatsurpass the standard four drinks in a day. In some instances, twodrinks per day have been shown to have detrimental effects althoughmilder. In additions, small amounts of alcohol consumed can causeunseen physical appearance, but behavioral issues may be present. Nosingle precise or straightforward mechanism leads to FASD. However,clinical research studies have determined several pathways thatfacilitate the adverse effects of alcohol from the mother to thefetus. A closer outlook on the genetic examinations reveals thepresence of long-lasting molecular effects of alcohol use.Researchers have established that the placenta is capable of allowingthe passage of ethanol and other toxic materials into the fetalcompartment. When this event happens, the developing fetus develops aparticular sensitivity to the increasing toxicity. Ultimately, theaccumulation leads proliferation, neural migration, and outgrowth ofthe synaptic network among several other changes. Since the fetusdoes not have a liver for detoxification, it is exposed to theethanol toxicity for extended periods leading to these problems. Theoutcome is thus characterized by low weight, specific facialcharacteristics, and malformations of organs such as bones, kidneyand vision system as well as nervous system damage (Ospina &Dennet, 2013).
Variousmeans of diagnosing FASD conditions exist. Concerning growth, theassociated deficiency includes height and weight that is belowaverage. In some cases, reduction of weight that is not associatedwith malnutrition can also be used as a diagnostic criterion. Thefacial features, on the other hand, range from brain damage and othercraniofacial abnormalities. Specifically, the groove located betweenthe nose and upper lip flattens as a result of alcohol exposure.Another feature is the thinning of the upper lip as well as decreasedeye width. Damage to the central nervous system can lead to staticencephalopathy.
Likewise,bodily harm to the brain can be observed including microcephaly,abnormalities of the brain structure and function. Further diagnosescan indicate disorders such as epilepsy, seizures, impaired motorskills, loss of hearing, lack of coordination, poor eye coordination,and clumsiness. Furthermore, academic and learning disabilities maybe present coupled with cognitive deficits, social skills, andcommunication. In summary, FASD diagnosis features must involve thegrowth deficiency criteria, the facial features, damage to thecentral nervous system and confirmed exposure to prenatal alcoholconsumption [ CITATION Ros15 l 1033 ].
DifferentialDiagnosis and Comorbidity
Severalsyndromes have features which overlap those of fetal alcohol spectrumdisorders. However, the disorders do not contain all the facialcharacteristics. Also, none of them occur as a result of exposure toalcohol in the prenatal stage. These syndromes include the Aarskogsyndrome, Williams syndrome, Noonan syndrome, Brachman-DeLangeSyndrome, Toluene syndrome, Fetal hydantoin syndrome, Fetal valproatesyndrome, and Maternal PKU fetal effects.
Regardingcomorbidity, five pre-existing conditions have been known to have thehighest prevalence of approximately 50-91%. They include problems ofthe peripheral nervous system, conduct disorders, abnormal results offunction studies of peripheral nervous system, receptive languagedisorder, special senses, chronic serous otitis media, and expressivelanguage disorder. Although not considered as diagnostic features,other conditions that co-occur with FASD due to prenatal alcoholconsumption include heart murmurs, joint anomalies, kidney-relatedproblems, light sensitivity, diminished visual acuity, cleft lip,short neck, spina bifida and in some cases hydrocephalus (Popova etal., 2016).
Quiterecently a research study was conducted with the main aim ofidentifying the relevant interventions that could be put in place soas to reduce the use of alcohol among adolescents with FASD. Thestudy enrolled 54 participants who were subjected to a 6-week groupintervention process. The regimen involved education concerningalcohol and the promotion of how to respond to social pressure thatlures one towards alcohol consumption. Similarly, caregivers had aseparate session with emphasis on ways of handling parentingchallenges about alcohol use.
Atthe end of the days, a significant percentage of these participantsreduced the alcohol-related unwanted behaviors. Likewise, athree-month follow-up exercise revealed a lack of increase in alcohol–related outcomes. The results obtained at the end of this researchprovided a foundation for better and efficient treatment ofadolescents these methods can either prevent or reduce theconsumption of alcohol and thus its adverse effects in this most atrisk population (O`Connor et al., 2016).
Thebest and most recommended method of preventing FASD is to ensure theavoidance of alcohol and any related substances during pregnancy.However, there is still contention regarding moderate drinking andthe potential harm to the fetus. There is no definite cure for thisdisorder, but treatment can be carried out. It is important to notethat no single method of therapy works for every person. Psychoactivedrugs can be employed mainly in the FASD symptoms that are related topsychological disorders. In some instances, behavioral interventionscan be applied depending on the learning theory. It may involveparenting styles, special education services, modification of thegeneral behavior as well as outcome-based education. Treatmentmethods can also be tailored in such a way that the affectedindividuals can be able to attain the developmental tasks and needs.Delayed adaptive behavior can be targeted and supported more so forspecific development stages delays. Advocacy can also be employedwhere a family member, friend or caregiver stimulates change andassists the affected person to attain their goals.
FASDis a disorder that needs special attention especially with theincreasing rates of alcoholism. Sound public health policies can beinfluential in the treatment and control of this condition. Treatmentof FASD at a public health level fosters prevention through resourceallocation. This methodology does not focus on the treatment of anindividual. On the contrary, it is based on the promotion of healthat a system level, for instance, a community or society. As such, thecommunity is developed using education and level specific preventionstrategies. One of these approaches can involve the strict screeningfor cases of maternal alcohol consumption during medical care visitsfor all pregnant women. There can also be a nationwide awareness andeducation program which has been taken up by several governmental andnon-governmental institutions.
O`Connor, M. j.,, Quattlebaum, J., Castañeda, M., Dipple, K. M. (2016). Alcohol Intervention for Adolescents with Fetal Alcohol Spectrum Disorders: Project Step Up, a Treatment Development Study. Alcoholism Clinical and experimental Research, 1744-1751.
Ospina, M.& Dennet, L. (2013). Systematic Review on the Prevalence of Fetal Alcohol Spectrum Disorders. Edmonton: Institute of Health Economics.
Popova, S. Shannon, L., Kevin, S., Alanna, M., Albert, C., Raja, M., Dennis, B., Jurgen,R. (2016). Comorbidity of fetal alcohol spectrum disorder: a systematic review and meta-analysis. The Lancet, 978-987.
Roszel, E. L. (2015). Central nervous system deficits in fetal alcohol spectrum disorder. The Nurse Practitioner, 24-33.
Stephen, M., & Feng, C. Z. (2015). Genetics and epigenetics of fetal alcohol spectrum disorders. Frontiers Media: San Antonio.