We’re highlighting a brand new article published by two of CanFASD’s research leads (Dr. Jacqueline Pei and Dr. Nancy Poole), CanFASD Executive Director (Audrey McFarlane), and two University of Alberta PhD students (Melissa Tremblay and Allison McNeil).

Neuropsychological Aspects of Prevention and Intervention for FASD in Canada is part of a special issue in the Journal of Pediatric Neuropsychology covering international perspectives on FASD prevention and intervention. Other contributions to the special issue cover research in USA, Australia, China, Great Britain, South Africa, and Poland.

The authors overview the current landscape of FASD research and programming in Canada. Their article highlights notable efforts in many areas:

Diagnosis:

• Development of the new Canadian guidelines: Fetal Alcohol Spectrum Disorder – Guidelines for Diagnosis of FASD Across the Lifespan.

Health Care:

• The FASD National Strategic Project Fund was added to the federal budget in 1999.
• CanFASD, Canada’s first comprehensive national FASD research network, has been in operation since 2005 and has status as a national Canadian charitable organization.
• The Canada Northwest FASD Partnership (alliance of 4 western provinces and 3 northern territories) has been working together since 1998.

Justice:

• Provincial Mental Health Courts in Ontario and Quebec divert individuals with FASD (and other mental illnesses) from the regular system to one that offers a more holistic approach.
• Community Wellness Court in Yukon Territory works with individuals with addictions, mental health problems, and/or FASD.

Intervention Research:

• Daily supports are often provided based on general wisdom and eclectic models that are not based in solid research evidence.
• Research-based interventions include the Alert Program for Self-Regulation (see previous post for recruitment posters for adolescents with FASD), the Math Interactive Learning Experience, Cognitive Carnival, and other memory and attention programs.

*Keep an eye out for our upcoming CanFASD Connect series on the latest FASD intervention research, and what you can take from them to apply in practice. Our goal is to make research evidence more accessible to the public.*

Intervention Programs:

• Breaking the Cycle in Toronto is an early identification and prevention program designed to reduce risk and enhance development in substance-exposed children (prenatal to 6 years old). The program provides support for maternal addictions and mother-child relationships through a community-based cross-systems model.
• Catholic Social Services in Edmonton offers numerous FASD programs. Two that have been formally evaluated and show encouraging results are Step by Step for parents with FASD, and Coaching Families for families raising children with FASD.

Prevention Framework:

• The 4-level prevention framework was adopted by the Public Health Agency of Canada.
  1. Building awareness
  2. Discussing pregnancy, alcohol use, and related risks with women of childbearing age
  3. Providing specialized, holistic supports for pregnant women who have addictions and other health problems
  4. Supporting new mothers to maintain healthy changes made during their pregnancies and women who are not able to stop drinking and need ongoing support

Prevention Research:

• 27% of pregnancies are unintended in Canada (Oulman et al. 2015; Singh et al. 2010) and alcohol use during pregnancy ranges from 10.8% (Walker et al. 2011) to 60% (Muckle et al. 2011).
• There have been 262 prevention campaigns in northwestern Canada (e.g., the posters you see at the doctor’s office), but research suggests that these campaigns alone are not enough to change drinking behaviour during pregnancy. Other levels of prevention are needed to reinforce changes in behaviour.

Prevention Programs:

• Project Choices is a Winnipeg program about alcohol, sex, and birth control for girls and women who are not currently pregnant, but are sexually active and drinking alcohol.
• The Prevention Conversation trains healthcare and social service providers on how to support women of childbearing age in a non-judgemental and conversational way. They have a blog too!
• The Parent Child Assistance Program is a cost-effective mentorship program for women with alcohol use and other social/health problems.
• There are over 800 community-based pregnancy outreach programs across our country. Tell us about yours!

More work needed:

• FASD prevalence rates in Canada are not well defined, and estimates range from 0.26% to 26.9% in various communities and settings. We need to improve our documentation and data collection processes and use more consistent diagnostic methods.
• Health care systems would better serve women if there was increased interagency cooperation and coordination across various systems of care.
• Best practices for interventions are not yet clear.
• We do not know how prevention efforts are leading to changes in preventing FASD in Canada.
• We need to ensure that appropriate supports and interventions are offered to students with FASD in provinces with inclusive special education approaches.