Here’s a brief summary of some of the latest research published on Fetal Alcohol Spectrum Disorder (FASD).
Prevention
How health care providers communicate with women about alcohol use during pregnancy is very important for FASD prevention. The authors of this study evaluated 61 midwives in a southwestern U.S. state to understand how their personal alcohol use compared to their professional recommendations about alcohol consumption during pregnancy. They found that:
- All midwives reported that they typically screen a patient for alcohol use during their initial visit
- Some midwives reported providing advice that does not align with the current accepted guidelines around alcohol consumption during pregnancy (i.e., that the safest option for women is not to consume alcohol).
- 8.2% of midwives advised that patients could drink “once in a while”
- 6.6% of midwives instructed patients to have no more than one drink per day
- There was no difference between the responses of certified nurse midwives and certified professional midwives
Key takeaway: Advocating for the health of health care practitioners is very important, as is ensuring appropriate communication to discuss the risks of alcohol use during pregnancy in ways that align with current best-practices, emphasizing that there is no safe amount of alcohol consumption during pregnancy.
Olusanya, O.A., Barry, A. E. (2020). Dissemination of Prenatal Drinking Guidelines: A Preliminary Study Examining Personal Alcohol Use Among Midwives in a Southwestern US State. Journal of Midwifery & Women’s Health. https://doi.org/10.1111/jmwh.13
More Prevention Research
Guideline No. 405: Screening and Counselling for Alcohol Consumption During Pregnancy
Screening for Mental Health and Substance Use Disorders in Obstetric Settings
Diagnosis
A Survey of Measures Used to Assess Brain Function at FASD Clinics in Canada
Researchers conducted an online survey to better understand the measures that are being used by clinicians in Canada to evaluate brain function in individuals assessed for FASD. They found that:
- Clinicians reported using 182 unique measures as part of FASD assessments across the country
- Almost all of the most frequently reported measures align with the 2015 Canadian Diagnostic Guideline
- Several commonly reported measures are not in the guideline but may be useful to include in future iterations of the guideline as assessment and diagnosis continue to evolve
Key takeaway: The findings from this study underscore the importance of establishing and maintaining consistency within and across FASD assessment. Ongoing training for FASD clinicians, and continued evaluation of the current body of research evidence, will help to guide FASD best practice.
Flannigan, K. R., Coons-Harding, K. D., Turner, O., Symes, B. A., Morrison, K., & Burns, C. (2020). A survey of measures used to assess brain function at FASD clinics in Canada. Canadian Psychology/Psychologie canadienne. Advance online publication. https://doi.org/10.1037/cap000024
More Diagnosis Research
Identifying Fetal Alcohol Spectrum Disorder Among South African Children at Aged 1 and 5 years (Open Access)
Intervention
Exploring Self-Regulation Strategy Use in Adolescents with FASD
For individuals with FASD, self-regulation is often a challenge. Targeted interventions can help individuals with FASD learn strategies to self-regulate. Two kinds of strategies that may be helpful for people with FASD are sensory-based strategies (i.e., taste, move, touch, look, listen), aimed at improving emotional state, and non-sensory strategies (i.e., thinking), aimed at self-monitoring arousal levels. Researchers studied the experiences of 23 adolescents with FASD who participated in an intervention program designed to give them the skills and knowledge to improve self-regulation. The researchers found that:
- Participants increasingly used the skills they learned in this program in their everyday lives; the majority reported using these skills at school
- Overall, the participants were satisfied with the intervention program
- 96% of participants enjoyed the program
- 91% of participants reported that the things they learned in the program helped them in their daily lives
- Participants reported having increased capacity for their own self-regulation
- Overall, the participants gravitated towards sensory strategies first to improve self-regulation
- However, 28% chose non-sensory strategies or a combination between the two
- When participants are engaged in the process of identifying strategies, they may think beyond program boundaries to find solutions that work for them
Key Takeaway: Adolescents with FASD can learn and apply strategies to help improve their self-regulation. Co-creating strategies, fostering relationships, and individualizing strategies for each individual are key factors in engaging the individual and encouraging the use of these strategies at home and at school.
Aamena Kapasi , Jacqueline Pei , Kathryn Kryska , Vannesa Joly , Kamaldeep Gill , Sandra Thompson-Hodgetts , Kaitlyn McLachlan , Gail Andrew & Carmen Rasmussen (2020): Exploring Self-Regulation Strategy Use in Adolescents with FASD, Journal of Occupational Therapy, Schools, & Early Intervention, DOI: 10.1080/19411243.2020.1822260
More Intervention Research
Family Collaboration
Although there are a number of programs in the U.K. to reduce the stress of caregivers in general, there are no programs specifically designed for caregivers of people with FASD. The aim of this study was to understand the stress faced by caregivers of individuals with FASD and to suggest ways that programs can mitigate this stress. The researchers found that:
- Caregivers reported clinically significant levels of stress, warranting further professional consultation
- High levels of caregiver stress were related to specific challenges in their child’s adaptive functioning, executive functioning, and behaviours
- Caregivers need evidence-based interventions focused on helping them to develop skills to manage their child’s functional difficulties in order to reduce stress
Key Takeaway: There is a need to create evidence-based interventions to support caregivers to help reduce the clinically high levels of stress they experience.
Mohamed, A., Carlisle, A.C.S., Livesey, A. C., and Mukherjee, R.A.S. (2020). Carer stress in Fetal Alcohol Spectrum Disorders: the implications of data from the UK national specialist FASD clinic for training carers. Adoption & Fostering. 44(3):242-254. https://doi.org/10.1177/0308575920945112.
This blog is intended to provide a summary of some of the recent literature on FASD. For a more complete and nuanced understanding of these findings, read the full research papers. Please note this is not a comprehensive list of all research published on FASD in September 2020.