Towards Healthy Outcomes for Individuals with FASD — To help support intervention approaches across the lifespan, the Healthy Outcomes model has been developed to help support intervention approaches across the lifespan. This model embodies this perspective, and provides us with a roadmap that can help to think carefully and proactively about healthy pathways. The model is founded on core beliefs that reflect integration of the research with wisdom from communities and caregivers, as well as the lived experiences of those with FASD.

The National Fetal Alcohol Spectrum Disorder (FASD) Strategic Action Plan 2018-2028 — This plan has been developed to provide a clear pathway of priorities and opportunities to improve the prevention, diagnosis, support and management of FASD in Australia. It builds on the signi cant foundational work and investment over recent years made by governments, non-government organisations, family advocates, researchers and clinicians, individual champions and communities who have raised awareness and supported individuals and their families living with FASD.

The Marulu Strategy 2008–2012: overcoming Fetal Alcohol Spectrum Disorder (FASD) in the Fitzroy Valley — Aboriginal leaders concerned about high rates of FASD in the Fitzroy Valley, remote north-western Australia, introduced restrictions on access to take-away full-strength alcohol. Following this, Aboriginal leaders engaged strategic partners in a broader strategy to address FASD in the region. The aim of this study was to develop and implement a community-led, researcher-supported, FASD strategy.

Putting Fetal Alcohol Spectrum Disorder (FASD) on the Map in New Zealand: A Review of Health, Social, Political, Justice and Cultural Developments — In this article, the developments within New Zealand’s health, justice, social and cultural sectors are traced and the work of many individual trailblazers who have put FASD on the map is acknowledged.

Best Practices for Serving Individuals with Complex Needs – Guide and Evaluation Toolkit — This document is intended to provide guidance for individuals and agencies working with clients with a Fetal Alcohol Spectrum Disorder (FASD) and their families. Together as a single source, a best practice guide and evaluation tool kit are provided for use by agencies and their staff. There are two anticipated uses for this resource: 1) to assess current service delivery by providing indicators and outcomes that can be measured to inform practice improvements; and 2) to inform future service offerings by supplying a framework on which to develop policy and practices.

Intervention Across the Lifespan: Where are we at and where do we need to go? — This paper identifies the existing gaps in research and provides an overview of the key needs at different developmental stages within the lifespan of an individual with FASD.

Accessible Canada—Creating new national accessibility legislation—In 2016, Minister Carla Qualtrough launched the website Accessible Canada, where Canadians were asked to think about what accessibility means to them and what it could mean for their communities. Between June 2016 and February 2017, over 6,000 Canadians and over 90 organizations shared their ideas about an accessible Canada, culminating in this report.

Issue Papers

CanFASD Issue Paper: Strengths Among Individuals with FASD — The vast majority of FASD research is focused on the challenges and impairments associated with the disability, as well as the burden of FASD on families and the broader community. This type of research can help to validate the experiences of individuals with FASD and their families, and to inform where services and supports might be needed the most. However, the simultaneous lack of strengths-based studies can perpetuate a sense of shame, suffering, and victimization, and contribute to the stigma already associated with FASD. By neglecting to explore the successes of individuals with FASD, we fail to recognize their immense potential and celebrate the unique contributions that each individual has to offer. The goal of the current issue paper was to review the existing strengths-based FASD literature and highlight the need for more studies to fill this critical gap.

Computer Game Interventions for Individuals with FASD — Fetal Alcohol Spectrum Disorder (FASD) is an umbrella term used to describe the range of disabilities and diagnoses that can result from prenatal exposure to alcohol. Intervention and treatment options for individuals with FASD are both costly and resource-intensive because they are tailored to the client. Computer game interventions present a novel approach to interventions that may help mitigate the effects of brain injury associated with FASD.

The Impact of Jordan’s Principle on Children with FASD — Jordan’s Principle is a child-first principle meant to prevent First Nations children from being deprived of essential public services or experiencing delays in receiving them.

Nutritional Supplementation and FASD — Fetal Alcohol Spectrum Disorder (FASD) is an umbrella term used to describe the range of disabilities and diagnoses that can result from prenatal exposure to alcohol. Maternal nutrition can often be compromised when alcohol is consumed, especially in situations of chronic alcoholism. Poor overall nutrition may contribute to and/or compound the effects of prenatal alcohol exposure. Recent evidence from preclinical studies suggests that pre- or postnatal nutritional supplementation may improve neurocognitive function (e.g., learning, memory) and behaviour. Thus nutritional supplementation may be an accessible method for improving maternal and fetal pre- and postnatal health.

Marijuana Use During Pregnancy and Breastfeeding: Implications for Neonatal and Childhood Outcomes — Marijuana is one of the most widely used substances during pregnancy in the United States. Emerging data on the ability of cannabinoids to cross the placenta and affect the development of the fetus raise concerns about both pregnancy outcomes and long-term consequences for the infant or child. Social media is used to tout the use of marijuana for severe nausea associated with pregnancy. Concerns have also been raised about marijuana use by breastfeeding mothers. With this clinical report, we provide data on the current rates of marijuana use among pregnant and lactating women, discuss what is known about the effects of marijuana on fetal development and later neurodevelopmental and behavioral outcomes, and address implications for education and policy.

Issue papers

Cannabis Use During Pregnancy — In 2018, the Canadian government plans to introduce legislation that would allow adults to legally possess and use cannabis. This paper explores what is known about the effects of cannabis use during pregnancy.

Fetal Alcohol Spectrum Disorder and Sexually Inappropriate Behaviors: A Call on Sex Offender Treatment Clinicians to Become Informed. Fetal Alcohol Spectrum Disorder resulting from prenatal alcohol exposure is a permanent condition that can include a range of adaptive, cognitive, social, and physical impairments. Not only can symptoms have a deleterious impact on global functioning, but can increase the likelihood of entanglement in the criminal justice system. This can sometimes involve behaviors associated with sexual misconduct. This article provides a brief overview of Fetal Alcohol Spectrum Disorder, the relationship between the disorder and inappropriate sexual behavior, treatment of this population, and areas for future research.

Unprepared: An Appeal for Sex Education Training for Support Workers of Adults with Developmental Disabilities — The sexuality of adults with developmental disabilities (DDs) is a topic seldom addressed, even by those who are charged with their care. The importance of acknowl- edging that these individuals have the right to express sexual desires and be given com- prehensive sex education is paramount for both their physical and mental health. This qualitative study involved presenting a series of open-ended questions to individuals currently or previously employed as support workers. These questions concerned the training and knowledge of these support workers regarding the sexuality of adults with DDs, and the policies relating to such issues in the institutions in which they work. Results reflect the lack of experience that support workers have as well as their lack of confidence in dealing with their clients when issues concerning sexuality arise.

Persons with FASD: Disability and Sexuality — Sexuality is an essential component of human beings that may be difficult for some people with disabilities to express in satisfying ways. A disability that is often overlooked, partly due to the fact that The Diagnostic and Statistical Manual of Mental Disorders (DSM-V) does not list it as a clinical disorder, is Fetal Alcohol Spectrum Disorder (FASD). Although Lemoine, Harousseau, Borteyrun, and Menuet first identified Fetal Alcohol Syndrome (FAS) in 1968, it is now recognized to be part of a greater Fetal Alcohol Spectrum Disorder (FASD), which refers to a range of effects that can occur in an individual whose mother consumed alcohol during pregnancy (Ryan, 2006, p. 1). These effects can be physical, mental, behavioural, and cognitive (Pelech, Badry, & Daoust, 2013, p. 121). The most common traits that are present in all children with FASD are cognitive confusion, learning and memory impairment, as well as the inability to understand the consequences of their actions (Blackburn, Carpenter, & Egerton, 2009, p. 141). For the purpose of this study adults with FASD and their partners or parents were interviewed to learn of the impacts of the condition of FASD. Their responses to the interview questions identified key areas of concern and needs that are largely not being met. An unexpected finding was the difficulties they have with relationships and sexuality. This article discusses that portion of the results that dealt with disability and sexuality.

Lesbian, Gay, Bisexual, and Transgender Youth with Disabilities: A Meta-Synthesis — This meta-synthesis of empirical and nonempirical literature an- alyzed 24 journal articles and book chapters that addressed the intersection of disability, [homo]sexuality, and gender identity/ expression in P–12 schools, colleges and universities, supported living programs, and other educational and social contexts in Australia, Belgium, Canada, New Zealand, Sweden, the United Kingdom, and the United States. The articles and chapters empha- sized the diversity of lesbian, gay, bisexual, and transgender youth with disabilities—culturally, linguistically, sexually, and in terms of abilities, disabilities, and related service needs—while noting that all (or certainly most) lesbian, gay, bisexual, and transgen- der youth with disabilities possess multiple stigmatized identities as sexual/gender minorities and young people with disabilities.

Experiences of Healthcare Providers of Lesbian, Gay, Bisexual, and Transgender Foster Youth — As a disproportionately overrepresented group in public child welfare, Lesbian, Gay, Bisexual, and Transgender (LGBTQ) foster youth have unique health disparities and needs related to their marginalized identities. This thesis discusses current research related to healthcare providers and their experiences serving LGBTQ foster youth in Washington State. The purpose of this study is to better understand the experiences of healthcare providers working with LGBTQ foster youth to improve their health outcomes. This research is performed through eight semi-structured key informant interviews, which provide a qualitative assessment of the experiences of healthcare providers of the LGBTQ foster youth population of Washington State, as well as these providers’ insight into the intersectional issues of LGBTQ foster youth, including race, transgender and gender nonconforming identities, and homelessness.

Gender Considerations in Addiction: Implications for Treatment — Individuals with substance use disorders (SUD) are heterogeneous, making comprehensive assessment an essential part of treatment planning. Since a variety of pharmacological and psychosocial treatments are available, patient needs and characteristics, as well as substance-specific treatment options must be taken into account. In particular, clinicians should consider patient gender, as well as hormonal and other biological factors, when making treatment recommendations. Women are at greater risk for a variety of medical and psychosocial consequences, and may benefit from pharmacological and/or behavioral therapies that differ from those most beneficial for men. Pregnancy and gender identity also warrant special consideration. It is imperative that clinicians keep informed about new research findings that can guide tailoring of evidence-based treatments for men and women with SUD. Looking ahead, the field of pharmacogenomics offers additional promise for identifying the most effective pharmacotherapies for specific patients with SUD.

Our Relatives Said: A Wise Practices Guide | Voices of Aboriginal Trans People — This manual is about identifying needs faced by Aboriginal Trans-people, honouring their stories and experiences and what they say they need in order to find a more welcoming and supportive place in society.

Issue Papers

FASD and Inappropriate Sexual Behaviour — The occurrence of inappropriate sexual behaviours (ISB) is an adverse life outcome that may be experienced by individuals with FASD. The purpose of this paper is to highlight an overview of the current existing research conducted in this area and offer implications for individuals, families, caregivers, and policy makers.

Addiction and Mental Health Care: Resources to Support Collaboration — The Canadian Centre on Substance Abuse (CCSA), the Mental Health Commission of Canada and the Canadian Executive Council on Addictions have collected a list of examples and resources to support collaboration between addictions and mental health systems and service delivery in Canada.

The Implementation of the 2012 Mental Health Strategy for Canada Through the Lens of FASD — Abstract: It is the current authors’ perspective that the successful implementation of Changing Directions, Changing Lives, which seeks to improve mental health and well-being in Canada, cannot be realized effectively without considering FASD. Given that 94% of individuals with FASD also have mental disorders, practitioners in the mental health system are encountering these individuals every day. Most mental health professionals have not been trained to identify or diagnose FASD, and therefore it goes largely “unseen,” and individual treatment plans lack efficacy. Implementation of FASD-informed recommendations, such as those of the Truth and Reconciliation Commission of Canada (2015), can provide a more effective approach to mental health services and improve mental health outcomes.

Fetal alcohol spectrum disorder (FASD): A beginner’s guide for mental health professionals — FASD can feature a diverse range of impairments in cognitive, social, and adaptive functioning. These impairments are often accompanied by co-occurring mental illness, behavioral disorders, substance use, traumatic brain injuries, and developmental disabilities. The presence of these co-occurring conditions creates significant challenges for mental health professionals in terms of screening, assessment, differential diagnosis, and treatment. The key to maximizing the effectiveness of care for clients requires treating each individual’s unique risks and needs in an integrated service delivery framework. Unfortunately, there is typically a lack of expertise in FASD among mental health professionals, which can only be resolved by the increased availability of advanced education and training programs on FASD. To increase awareness of these needs and FASD in general, this article provides general information on the definition and symptoms of FASD, the screening and assessment of FASD, adaptive functioning and memory-related considerations of FASD, and the treatment of FASD.

Toward Quality Mental Health Services in Canada: A Comparison of Performance Indicators Across 5 Provinces — In 2015, the Graham Boeckh Foundation (GBF), in collaboration with the Canadian Alliance on Mental Illness and Mental Health (CAMIMH), initiated a project to test the feasibility of creating and reporting on a small number of mental health and addictions services performance indicators that could be compared across provinces. A team of mental health and addictions scientists from ve provinces (British Columbia, Alberta, Manitoba, Ontario and Québec) developed and generated the measures, where possible for ages 10 years and up, using data already available from the healthcare systems. This is the Summary Report. A full Technical Report is available at https://www.sfu.ca/carmha/publications/prov_indic_2017.html

Caregiver Needs and Stress in Caring for Individuals with Fetal Alcohol Spectrum Disorder: Lay Summary — Individuals with Fetal Alcohol Spectrum Disorder (FASD) often present with a large range of strengths of difficulties making it difficult to identify capabilities and set goals with them. In addition, the areas of difficulty described in this population are often related to adverse outcomes such as delinquency and school conflict. This can have a significant impact on caregivers, contributing to high levels of stress in the caregiver role. However, there is little research on the needs of caregivers supporting individuals with FASD and associations with caregiver stress. Thus, in the current study we examined: 1) the needs of those caring for individuals with FASD, 2) whether their needs are met, and 3) whether caregiver stress is associated with these needs and other caregiver/child characteristics.

Addiction and Mental Health Care: Resources to Support Collaboration — The Canadian Centre on Substance Abuse (CCSA), the Mental Health Commission of Canada and the Canadian Executive Council on Addictions have collected a list of examples and resources to support collaboration between addictions and mental health systems and service delivery in Canada.

Issue Papers

FASD, Stress and Mental Health — Fetal Alcohol Spectrum Disorder (FASD) is a neurodevelopmental disorder resulting from prenatal alcohol exposure (PAE). Individuals with FASD can experience complex behavioural and intellectual problems that persist throughout the lifespan, and can become increasingly complicated, even when supported. Over the last few decades, further research has begun to reveal a close relationship among PAE, stress pathways and mental health.

Infographics

FASD and Mental Health & Addictions - Pathways to Care. Recommendations Developed from a Qualitative Investigation & Clinician Survey
thumbnail for A Systematic Review of Mental Health & Addictions Interventions for Individuals with Fetal Alcohol Spectrum Disorder/Prenatal Alcohol Exposure infographic
A Systematic Review of Mental Health & Addictions Interventions for Individuals with Fetal Alcohol Spectrum Disorder/Prenatal Alcohol Exposure
FASD and Mental Health & Addictions - Pathways to Care. Summary of Findings from a Qualitative Investigation
thumbnail for Psychotropic Medication Algorithm for FASD/Prenatal Alcohol Exposure infographic
Psychotropic Medication Algorithm for FASD/Prenatal Alcohol Exposure
thumbnail for FASD in Psychiatry infographic
Role of Psychiatry in Treating Patients with FASD Across the Lifespan

Education Essentials For Students With FASD: Setting Them Up For Success — Fetal Alcohol Spectrum Disorder (FASD) is an umbrella term that describes the range of effects that can occur in an individual who was prenatally exposed to alcohol with the most common and serious result being life-long damage to the brain. Understanding that the permanent brain damage from alcohol use in pregnancy causes the behaviours commonly found in students with FASD reduces confusion and frustration for educators and is the basis for developing effective support and intervention strategies for students who have or are suspected of having FASD. One way to effectively support students with FASD is the neurobehavioural approach developed by Diane Malbin. From Ontario’s FASD ONE. For more of their educational resources see http://www.fasdontario.ca/cms/service-areas/education/

Understanding Adverse Experiences and Providing School-Based Supports for Youth who are High Risk with and without FASD — Youth who are high risk (YHR) face numerous adversities, and those with Fetal Alcohol Spectrum Disorder (FASD) may experience even more complex challenges due to the compounding impact of brain dysfunction. However, very little research has been conducted to understand or characterize this vulnerable group, or explore potential strategies for supporting their specific needs. In the current study, we sought to characterize some of the adverse experiences of YHR with and without FASD (N = 90) who were attending an innovative school that supports students who have struggled in other educational settings. We also examined services offered at this school and explored whether service access and several social and educational factors differ between youth with and without FASD. Findings indicate that YHR with FASD have more complex needs and a different pattern of service use than YHR without FASD. These findings are discussed in the context of how we might better support YHR and foster successful outcomes.

FASD Treatment Improvement Protocol (TIP) — The Canada FASD Research Network (CanFASD) Research Network received support from the Government of Alberta through the FASD-Cross Ministry Committee to develop a Treatment Improvement Protocol (TIP) for FASD based on Canadian research and practice and to pilot the TIP in Alberta. The goal of the TIP was to identify those at risk for having FASD, or having a child with FASD, from substance abuse and mental health centres, with the ultimate goal of improving outcomes through education, screening and better matched interventions. The online training program for TIP is available at https://estore.canfasd.ca/towards-improved-practice

Assessment for Intervention of Children with Fetal Alcohol Spectrum Disorders: Perspectives of Classroom Teachers, Administrators, Caregivers, and Allied Professionals — This study increases the links between research and practice as we move toward a model of assessment for intervention. Such a model has a strong potential for optimizing assessment practices to better meet the needs of children with FASDs as it promotes a shift that focuses on successful child outcomes regardless of diagnosis.

Neuropsychological Aspects of Prevention and Intervention for FASD in Canada – Pei, J., Tremblay, M., McNeil, A., Poole, N., McFarlane, A. (2016). Journal of Pediatric Neuropsychology. doi:10.1007/s40817-016-0020-1

Issue Papers

Current Strategies and Educational Supports for Students with FASD — Evidence shows the need for revised strategies and improved educational supports for students with FASD through all levels of diagnosis, assessment, and intervention planning if positive learning outcomes are desired.

Infographics


Math Interactive Learning Experience (MILE)

Sex Work and Motherhood: Social and Structural Barriers to Health and Social Services for Pregnant and Parenting Street and Off-Street Sex Workers

Stigma, Discrimination and FASD — The stigma associated with problematic alcohol use, particularly among pregnant women, presents a significant barrier to accessing medical treatment, services and supports. Individuals affected by Fetal Alcohol Spectrum Disorder (FASD), as well as their families and caregivers, can also experience stigma.

Common Messaging Guide—The purpose of this document is to assist those writing and talking about people with FASD or the issues related to the disability to use the same statistics, framing of topics, and language.

Language Guide—This guide is intended to provide alternative words or phrases for those commonly found in news media and other public communications. We propose these be used in an effort to promote the dignity of those living with FASD and their families.

Issue Papers

Individuals with Fetal Alcohol Spectrum Disorder and Experiences of Stigma — The purpose of this issue paper is to explore the ways in which individuals with FASD experience stigma, identify the implications of stigma on individuals and their families, and provide recommendations to reduce stigma.

Policy Action Paper: Toward a Standard Definition of Fetal Alcohol Spectrum Disorder in Canada — This policy action paper describes the approach taken to create a standard definition of FASD, as well as our proposed definition for use in FASD policy and practice.

Strengths Among Individuals with FASD — The vast majority of FASD research is focused on the challenges and impairments associated with the disability, as well as the burden of FASD on families and the broader community. This type of research can help to validate the experiences of individuals with FASD and their families, and to inform where services and supports might be needed the most. However, the simultaneous lack of strengths-based studies can perpetuate a sense of shame, suffering, and victimization, and contribute to the stigma already associated with FASD. By neglecting to explore the successes of individuals with FASD, we fail to recognize their immense potential and celebrate the unique contributions that each individual has to offer. The goal of the current issue paper was to review the existing strengths-based FASD literature and highlight the need for more studies to fill this critical gap.

Guide for Employment Professionals: Supporting Employment in Adults with Fetal Alcohol Spectrum Disorder — This document is intended to provide guidance for individuals and agencies working with clients with Fetal Alcohol Spectrum Disorder (FASD). It is for use by employment professionals to guide their work as they assist clients in preparing for, obtaining, and maintaining employment. This document is based on current literature, interviews, as well as survey data from people with FASD and their caregivers and support workers.

Supporting Employment in Individuals with FASD: A Guide for Employment Professionals and Final Report — This report presents findings from a project focused on successful employment for individuals with Fetal Alcohol Spectrum Disorder (FASD)

FASD & Employment Report, April 2016 — This report was prepared by CanFASD to identify current employment programs and model frameworks that are currently used to support adults with FASD.

Issue Papers

Employment and FASD: Strategies for Success — Fetal Alcohol Spectrum Disorder (FASD) is the most common type of developmental disability in North America. Although a large majority of individuals with FASD do not have any visible signs of their disability, they all have some kind of permanent brain injury that impacts their daily life; in particular, the ability to find meaningful employment.

Creating Intersections: A systematic and person-centred harmonizing framework for housing individuals with FASD — This project marks the first step of many in the implementation and maintenance of meaningful housing service delivery and supports to better understand how to meet the needs of individuals with FASD. Our hope for the framework described in this document is twofold. First, that it empowers service providers in their efforts to support individuals in meaningful ways, and second, that it reflects the voices of individuals struggling to be housed. We hope that through the use of this framework we can begin to recognize current practices, celebrate successes, and adapt programming to better meet the needs of individuals with FASD.

Feasibility Study in Housing for People with FASD — Since 2002, over 25 organizations have been networking in Regina to improve services to people with Fetal Alcohol Spectrum Disorder (FASD) and their caregivers. Recognizing the need to explore housing, three of those organizations (The Saskatchewan FAS Network, The Regina FASD Community Network and the Regina Community Clinic) partnered to apply for funding from the National Homelessness Initiative (NHI). This feasibility study was the outcome of that funding.

Housing Literature Review—Literature review and best practices for the housing and supports framework; housing and supports initiative; and creating connections: Alberta’s addiction and mental health strategy.

The Addiction and Mental Health Tertiary Care Framework: Models of Evidence Based/Informed Rehabilitation (Models of Care) — Mental health redesign has taken place in many jurisdictions, notably Italy, UK, US, Australia and Canada. The Canadian experience is described in this report.

Addiction and Mental Health Housing and Supports Framework—Creating Connections: Alberta’s Addiction and Mental Health Strategy

Understanding mothers experiencing homelessness: A gendered approach to finding solutions for family homelessness — This report examines social experiences for mothers and children who are experiencing homelessness in two shelters and one housing program in Calgary, Alberta. Currently, much of the research on homelessness and what works for supporting individuals into sustainable housing comes from research on the single, adult, male population. This study provides evidence to better understand how families become homeless, and the experiences of mothers and children as they move within various public systems while dealing with a history of violence, trauma, and poverty.

Bill C-325 Policy Alert—Bill C325 and Implications for Individuals with FASD