FASD and Adverse Childhood Experiences

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Researchers from CanFASD and other partner organizations have recently published a new paper on FASD and early life adversity called Characterizing Adverse Childhood Experiences among Children and Adolescents with Prenatal Alcohol Exposure and Fetal Alcohol Spectrum Disorder. You can access the paper for free until February 19th.

FASD and Adversity

Individuals with prenatal alcohol exposure (PAE) and FASD experience brain-based and environmental challenges throughout their lives. Prenatal alcohol exposure can disrupt the development of our brain’s stress-response systems, meaning that people with FASD may be more sensitive to stress.

Compounding this brain-based vulnerability, people with FASD also experience abuse, neglect, and other stressful and traumatic experiences at disproportionately high rates. This combination of stressors can have impacts that last for many years.

Equally importantly, there are also protective factors that can help to foster positive outcomes for people with FASD. Individuals who live in stable and nurturing home environments and who are diagnosed early are less likely to experience negative outcomes.

Understanding Adverse Childhood Experiences (ACEs)

Adverse Childhood Experiences (ACEs) are traumatic experiences that happen during childhood and impact an individual’s health and well-being throughout their life. These experiences include things like trauma, abuse, neglect, and exposure to stressful home environments. Children who experience high ACEs are more likely to have poor physical, psychological, and behavioural outcomes as adults.

The Research Study

Several CanFASD researchers and their colleagues wanted to know more about adverse experiences in early childhood for individuals assessed for FASD. Their research questions were:

1. Do people with PAE and FASD have higher rates of ACEs than those in the general public or other disability groups?
2. Are certain factors – like age, sex, living situation, IQ, co-occurring mental health challenges – linked to higher rates of early life adversity for individuals with PAE/FASD?

To answer these questions, the researchers reviewed clinical records from 333 children and adolescents who were assessed for FASD at one diagnostic clinic in Canada.

People with PAE and FASD have high rates of adverse experiences in childhood

The researchers found that rates of ACEs were exceptionally high in children and adolescents with PAE and FASD in their study. This group experienced an average of 3.4 ACEs, with almost half (46%) of participants having experienced four or more, and 13% having six or more. These numbers are notably higher compared with individuals with other disabilities or in the general population.

The most common adverse experiences for children and adolescents in the study involved the home environment. Almost all participants experienced disruptions in their caregiving situation, and many had been exposed to substance use and mental health issues in the home.

Practice and policy efforts are a key piece of the puzzle

Experiences of early adversity and trauma can have life-long impacts on an individual’s development, health, and well-being. Service providers who are supporting individuals with PAE and FASD need to be aware of the high rates of adversity in this population. Support services for people with PAE/FASD should be informed by a holistic understanding of the individual’s needs, and service providers may need to adopt a trauma-informed lens.

What’s more, there is a need to promote safe, stable, and nurturing home environments for children and adolescents with PAE/FASD. This may be done through FASD-specific training for professionals working in the child protection and justice systems; early identification and diagnosis of children with PAE and FASD; resources and supports for families caring for kids with PAE/FASD; and ensuring a “good fit” between the child and their care providers. Safeguards are needed to reduce the risk of placement breakdowns and prevent further harm for individuals with PAE/FASD.

This research helps us to better understand the complex nature of FASD and work to improve supports for these individuals and their families. The paper is free to access from now until February 19, 2021.

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