#TYTD2017 - Too young to drink - #FASD

Que ce soit une soirée exceptionnellement (très) arrosée ou une consommation légère régulière, tout alcool est contre-indiqué pendant une grossesse, rappelle une campagne de l'INPES.

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Abstract
Over the past 40 years, a significant body of animal and human research has documented the teratogenic effects of prenatal alcohol exposure (PAE). Neurobehavioral Disorder associated with PAE is proposed as a new clarifying term, intended to encompass the neurodevelopmental and mental health symptoms associated with PAE. Defining this disorder is a necessary step to adequately characterize these symptoms and allow clinical assessment not possible using existing physically-based diagnostic schemes. Without appropriate diagnostic guidelines, affected individuals are frequently misdiagnosed and treated inappropriately (often to their considerable detriment) by mental health, educational, and criminal justice systems. Three core areas of deficits identified from the available research, including neurocognitive, self-regulation, and adaptive functioning impairments, are discussed and information regarding associated features and disorders, prevalence, course, familial patterns, differential diagnosis, and treatment of the proposed disorder are also provided.
Keywords

ND-PAE Fetal alcohol spectrum disorders Prenatal alcohol exposure Psychiatric diagnosis
The Diagnostic and Statistical Manual, 5th edition, from the American Psychiatric Association now includes in its nomenclature “Neurobehavioral Disorder associated with Prenatal Alcohol Exposure (ND-PAE)” [1]. ND-PAE was listed in the Conditions for Further Study and also given as an example under “Other Specified Neurodevelopmental Disorder (315.8).” This paper presents research supporting ND-PAE diagnostic criteria. In addition, interactive effects of adverse psychosocial influences, relation to other DSM-5 diagnoses, culture influences, prevalence, developmental course, family patterns and treatment considerations are briefly described.
A large body of evidence from experimental animal research, longitudinal prospective human studies, and clinical research documents the teratogenic effects of prenatal alcohol exposure (PAE) on fetal growth and development, central nervous system (CNS) function, and behavior throughout the lifespan [2]. Extensive research on the effects of PAE supports the existence of a spectrum of diagnostic conditions as described by the Institute of Medicine in 1996 (IOM) [3]. Accordingly, these conditions are collectively referred to as Fetal Alcohol Spectrum Disorders (FASD), a non-diagnostic umbrella term accepted in 2004 by consensus of governmental, research and advocacy organizations [4].
The diagnostic coding schema put forth by the IOM has been useful in delineating variation in physical characteristics associated with PAE. However, this schema does not adequately describe the significant neurodevelopmental and mental health symptoms often associated with PAE. Without a diagnostic schema that fully captures these symptom patterns, service needs of many individuals affected by PAE are often not identified or appropriately treated by mental health professionals. The diagnostic term “ND-PAE” was proposed to encompass the range of neurodevelopmental disabilities that can be associated with PAE and can be diagnosed either in the presence or absence of physical effects of PAE. For example, individuals with an ND-PAE diagnosis may also be diagnosed with Fetal Alcohol Syndrome (FAS) or partial FAS.

The SAMHSA FASD Center for Excellence will host a free Webinar on September 9, 2015 for the 16th annual International FASD Awareness Day. The Webinar will consist of a facilitated panel discussion with a diverse group of service providers. Topics will include effective prenatal and post-natal care, FASD prevention for pregnant women and women of childbearing age, and assisting individuals in treatment who may have an FASD. The Webinar will include a Q&A session open to participants.

L’alcol contenuto in qualsiasi bevanda alcolica durante la gravidanza attraversa la placenta facilmente e danneggia le cellule del futuro bambino, in particolare quelle del cervello. Astieniti dal bere bevande alcoliche quando cominci a pensare seriamente di avere un figlio e durante la gravidanza. Non esiste una quantità di alcol minima che durante la gravidanza possa essere considerata sicura.

According to the study, most of the ads analyzed (87 percent) incorporated a responsibility message, but none actually defined responsible drinking or promoted abstinence at particular times or in certain situations. When responsibility messages were accompanied by a product tagline or slogan, the messages were displayed in smaller font than the company's tagline or slogan 95 percent of the time.

The study found that recall of the current, voluntary warning labels on Australian alcohol products was non-existent, overall awareness was low, and few people reported visiting the DrinkWise website.

"These findings demonstrate that the current approach of industry self-regulation is a straightforward case of regulatory failure," said one of the report authors Peter Miller, Associate Professor of Psychology at Deakin.

Alcol in gravidanza: cosa sai, cosa ne pensi, cosa inseriresti nel retro del segnalibro per sensibilizzare le future mamme?
Si è cercato di dare una risposta a queste domande attraverso una piccola sperimentazione sul campo realizzata in collaborazione con:
- il Consultorio Familiare di Carpi
- il Dipartimento provinciale di Ostetricia e Ginecologia
- l'Associazione Gruppo di Mamme per l'Allattamento Materno (GAAM)
- l'Educazione alla Salute dell'AUSL di Modena
- e alcune donne in gravidanza del Percorso Nascita.
Sono stati effettuati degli incontri durante i quali ci si è:
- informati/confrontati sul tema alcol e gravidanza e livello di consapevolezza delle donne in gravidanza, famigliari e anche operatori sanitari
- scelto quali informazioni e linguaggio utilizzare per il retro del segnalibro
- validata l'efficacia del messaggio attraverso il coinvolgimento di donne in gravidanza frequentanti un corso di preparazione al parto.
Il segnalibro è nato dal connubio fra progetto grafico di Fabrica e gruppo di lavoro multi-componente che ha scelto i contenuti.

Salivary DNA methylation diagnostics are informative for fetal alcohol spectrum Disorder (FASD) at a level much more sensitive than current diagnostics.

~The Fetal Alcohol Spectrum Disorders (FASD) Toolkit was developed to raise awareness, promote surveillance and screening, and ensure that all affected children receive appropriate and timely interventions.

All children, including those with chronic conditions and FASDs, should have their health care delivered in a medical home.

Abstract
The adverse effects of prenatal alcohol consumption have long been known; however, a formal description and clinical diagnosis of these effects was not introduced until 1973. Since then, the distinction of the wide range of effects that can be induced by prenatal alcohol exposure, and, consequently, the terminology to describe these effects has continued to evolve. Although much progress has been made in understanding the consequences of prenatal alcohol exposure, challenges still remain in properly identifying all affected individuals as well as their individual patterns of alcohol-induced deficits. Also, as the large numbers of women who continue to drink during pregnancy indicate, prevention efforts still require further refinement to enhance their effectiveness. In addition, the mechanisms underlying alcohol-induced damage have not yet been fully elucidated; as knowledge of the mechanisms underlying alcohol-induced deficits continues to grow, the possibility of minimizing potential harm by intervening during prenatal alcohol exposure is enhanced. Finally, researchers are exploring additional ways to improve or fully restore behavioral and cognitive functions disrupted by prenatal alcohol exposure by treating the individuals with fetal alcohol spectrum disorders, thereby reducing the heavy burden for affected individuals and their families.

Fetal Alcohol Spectrum Disorder - or FASD - covers a wide range of brain and physical development impairments that start with prenatal exposure to alcohol. It can result in significant behaviour and learning problems, that are not easily addressed. Families and FASD experts want it to be classed as a disability so that services to diagnose and treat it, are better aligned and funded. Lynn Freeman speaks with a couple who foster two children with FASD and FASD expert consultant Kerryn Bagley, who is based in Brisbane.

A South Island couple who foster two daughters with possible foetal alcohol syndrome disorder (FASD) fear one of them could end up in court because they do not get adequate support.

FASD covers a wide range of brain and physical development impairments caused by prenatal exposure to alcohol.

Families and experts want the disorder classed as a disability so that services for its diagnosis and treatment can be better aligned and funded.

Listen to more on Nine to Noon ( 23 min 27 sec )

The couple, who did not wish to be named, told Nine to Noon their daughters did not have access to specialists in the South Island.

They said the family could go to the North Island for help, but that would cost thousands of dollars.

"What we're hoping for is that nationally there will be a lot more effort put into providing the services that families in our position need.

"So that's not actually a postcode lottery in terms of what you get based on where you live."

The couple said one of the daughters had behavioural problems - she was volatile, attention seeking and had been caught stealing at school.

They noticed something was wrong when she was about two years old, and said the family got little support from Child, Youth and Family.

Even though they sought counselling for the girl, the couple said FASD was not brought up until after a community constable visited.

"[The constable] was the one that put us in contact with the counselling service here in the city," they said.

"It was through that counselling service that we started to get someone who heard our concerns and realised that we were dealing with a child that possibly had attachment issues, but probably more than that."

Kerryn Bagley, a Brisbane-based consultant on the disorder who worked in New Zealand for seven years, said services for FASD were scattered around the country, and many people went undiagnosed.

"In many areas, including most of the South Island, there's no access to best practice FASD assessment or diagnostic services at all."

She said there was also an overwhelming lack of understanding on how to treat it.

The Ministry of Health is currently working on an action plan for FASD.

The draft plan has goals to raise awareness in the community of the dangers of drinking alcohol while pregnant.

It also aims to provide better care and support for people with FASD and their families.

The plan is expected to be finalised next year.