I. Alcohol metabolism in a mother's body and her fetus
Alcohol consumption in any amount by pregnant women cannot be considered safe for the fetus. Although a causal linkage between the quantity and duration of alcohol consumption, phase of pregnancy, and fetotoxic effect has not yet been established, there is no room for doubt that the concept of low risk and responsible drinking does not apply to pregnant women. The fetus is safest when the mother abstains from drink. However, it is estimated that more than 10 percent of women choose to continue drinking during pregnancy.
When alcohol is consumed, it is absorbed into the bloodstream through the digestive tract, and acetaldehyde is formed mainly by the oxidation of alcohol dehydrogenase (ADH) in the liver. Then acetaldehyde dehydrogenase (ALDH) converts this acetaldehyde to acetic acid. Acetic acid undergoes several and complex routes, and is finally broken down into H2O and CO2 which are discharged to the outside of the body.
The alcohol metabolism of a pregnant woman is much depressed compared with that of a non-pregnant woman, as estrogens largely inhibit the activity of ADH and ALDH, especially estradiol, one of three principle forms of estrogens, which has the strongest effect. Moreover, the total amount of estrogens in the serum of a pregnant woman in the early stages of pregnancy will increase by 10 - 100 times compared to that of a non-pregnant woman, and in mid to late pregnancy, increase by 100 - 1000 times. This affects the alcohol metabolism of a pregnant woman, and each of the three main estrogens exhibit relatively more volatility.
In terms of the alcohol metabolism in the body, there is no feedback mechanism and the metabolic rate is stable, 7g per hour. Generally, each of one medium size of bottle of beer (500ml), one goh of Japanese sake (180ml), two glasses of wine (240ml), two fifth goh of shochu (distilled spirit, 70ml), or one double whisky or brandy (60ml) contains 20g of alcohol. Therefore, the time required for the completion of alcohol metabolism when several kinds of alcohol are consumed can be estimated by dividing the total amount of alcohol consumption (g) by 7g. For a pregnant woman, this estimated time should be multiplied by 1.5. For example, when a person drinks one medium bottle of beer and two goh of Japanese sake, total amount of alcohol consumed will be 20g + (two goh × 20g) = 60g. Thus the required time for alcohol metabolism for this person will be 60g / 7g = 8.6 hours, and in case of pregnant woman, 8.6 × 1.5 = 13 hours.
A pregnant woman is physiologically in a state of dynamic equilibrium along with the development of fetus, therefore, her condition places her at a disadvantage for the efficient metabolism of alcohol. ADH can be found in a fetal liver from the middle of the third month of pregnancy, and its activity will slightly linear increase; nonetheless, a fetus has almost no capacity to break down alcohol. In addition, a low molecular weight alcohol passes swiftly through the placenta and harms a developing fetus. Fifty percent of the alcohol crossing the placenta enters the bloodstream of the fetus, and the remaining 50% enters the circulatory system via the fetal liver. While alcohol remains in the bloodstream, the fetus, so to speak, continues being forced to consume alcohol by the mother.
II. A congenital anomaly (Fetal Alcohol Syndrome: FAS)
Forty percent of pregnant women addicted to alcohol give birth to a baby with Fetal Alcohol Syndrome (FAS). In Japan, Dr. Takashima and others presented the first case in 1978. Both FAS as well as FAE (Fetal Alcohol Effects, incomplete features of FAS) are considered to be caused mainly by the direct action of alcohol (ethanol). There are also cases of suspected FAS (potential group) without any apparent symptoms. Three main diagnostic terms are used to describe babies associated with FAS caused by prenatal exposure to alcohol: facial abnormalities, dysfunction of the central nervous system, and retardation of growth.
Dr. Rosett standardized the diagnostic criteria(1) for FAS as shown below;
- Prenatal and/or postnatal growth deficiency, if any one or more of weight, length, or head circumference are below the 10th percentile.
- Central nervous system (CNS) disorders, including at least one of the following: neurological abnormality, developmental delay, and intellectual impairment.
- A distinctive pattern of facial anomalies, including at least any two of microcephalia; microphthalmia and /or short palpebral fissures (eye slits); an indistinct philtrum; a thin upper lip; and an elongated, flattened midface (the zone between the nose and the mouth).
If symptoms are found in all of 1, 2, 3 categories above, the baby is suspected to have FAS, and if symptoms are found in any of 1, 2, 3 categories, then suspected to have FAE. Meanwhile, Dr. Streissguth (2000) proposed the concept of Fetal Alcohol Spectrum Disorder (FASD), a continuum of permanent birth defects caused by maternal consumption of alcohol during pregnancy.
In Japan, the estimated rate of FAS at birth was 1 per 1,000 births 30 years ago, and the current rate must be lower than 10% of that. However, this rate may vary considerably depending on the living standard of local communities.
A fetus by the 8th week of pregnancy is still called an embryo. This embryonic period is the critical time when the fetal organs are most susceptible to the development of major abnormalities caused by the fetotoxic effect of alcohol. Susceptibility to alcohol regarding whole organs or a part shows individual variability. Thalidomide, a notorious sleep-inducing drug, causes birth defects if a pregnant woman takes the drug at a certain stage of the embryonic period (34th - 50th day after the first day of the last menstrual period). In contrast, alcohol exposure can cause damage to fetus at all stages of in utero development. The effects of fetal toxicity on development of the fetal organs occur mainly at the early stage of pregnancy including the embryonic period, and on the entire growth of the fetus at the period of mid to late pregnancy. Thus, it can be said that FAS (FAE) is embryopathy and at the same time, fetopathy. FAS is not an accidental disease; this is just the tip of the iceberg, below the surface there are enormous hidden problems.
More specifically, the embryo or fetus in a pregnant woman who continues drinking will sustain fatal damage and miscarry as a process of natural selection. However, if this damage is limited and not fatal to the embryo or fetus, it will remain in the womb due to the anti-miscarriage effect of alcohol and continue to develop. Nevertheless, the development of the entire fetus will be inhibited if the mother continues drinking. As a result, some babies are born with clinically evident congenital abnormalities (FAS) and some with several suspected abnormalities but no apparent symptoms.
III. Prenatal treatment
In the light of recent advances in testing techniques and instrumentation such as an ultrasonotomography, it seems that prenatal treatment(2) has some potential for a fetus exposed to alcohol, but is still unrealizable today. For a baby born with a congenital anomaly, this means receiving appropriate child-care. A Fetal Alcohol Syndrome Screening test (FAST)(3) (Table 1) can be used for embryo screening. However, this test should be practiced to help determine risk for abnormalities of a fetus or newborn baby, but never in order to recommend an induced abortion. It is useful to refer to FAST to prepare the specific instruments for parturition in advance, because a pregnant woman who drinks alcohol quite often needs an obstetric operation during the intrapartum period.(4) FAST data can be applied as reference after childbirth as well. There is also the problem drinking screening chart for pregnant women as shown below(5) (Figure 1), a combination of the FAST method and the Kurihama Alcoholism Screening Test (KAST)(6) (Table 2) to be used at the time of pregnancy or labor.
While the problem drinking screening chart for pregnant women(5) will identify the alcoholic pregnant woman, the DSM-IV, an alcohol dependence diagnosis, defines alcohol abuse as follows (quote Higuchi's chart(7) in part).
Alcohol use with clinically significant impairment is indicated by at least three of the following seven items within any one-year period: 1. tolerance; 2. withdrawal; 3. loss of the ability to have control over drinking; 4. unsuccessful attempts or desire to reduce or control drinking; 5. great deal of time spent drinking or recovering from drinking; 6. decrease in social, occupational, or recreational activities that are not centered on drinking; 7. resistance to negative reinforcement.
The typical process of becoming an alcoholic is considered as follows: first-time drinking --> occasional drinking --> habitual drinking --> wider repertoire of drinks (succumb to any kind of alcohol) --> search for alcohol (find out and drink even hidden alcohol) --> become a strong drinker --> repeat withdrawals --> drink alcohol to avoid withdrawals --> intense desire to drink --> abnormal drinking (continuous drinking).
|1)||Rosett, H.L.(1980): A clinical perspective of the fetal alcohol syndrome. Alcoholism., 4: 119|
|2)||Yoichi Niimi (1990): Prenatal treatment for fetal alcohol syndrome - Present condition of approach to prenatal treatment, Research on medical care for alcoholic, 7:45|
|3)||Yoichi Niimi, Taro Matsumura, et al. (1989): FAS screening test for fetus and new-born baby (FAST) by diagnostic process with an interview with the patient, Research on medical care for alcoholic, 6:207|
|4)||Yoichi Niimi (1975): Statistical considerations in women with alcohol preference in child birth, Obstetrics and gynecology, 42:9|
|5)||Yoichi Niimi (1994): Pregnant women and drinking alcohol, Gynecology medical treatment, 68:773|
|6)||Saito, S., Ikegami, N. (1978): KAST (Kurihama Alcoholism Screening Test) and its applications, Japan J. Stud. Alcohol., 13:229|
|7)||Susumu Higuchi (2003): An introduction to alcohol addiction, Separate volume, Psychiatric syndrome III, Nippon Rinsho, 405|
Example of a Compare and Contrast essay on Health about:
Fetal Alcohol Syndrome / fetus / disabilities / retardation / pregnancy
The estimation of the reasons that provoke such a disease known as the Fetal Alcohol Syndrome and the consequences of this syndrome for the newborn.
What are the possible outcomes of the Fetal Alcohol Syndrome? How does the fetus utero development occur? What type of changes happen in the fetus’ physiological and mental spheres? Are there any possible ways to treat the Fetal Alcohol Syndrome?
The contemporary medical world is very much concerned with the female alcohol abuse phenomenon and the appearance of a group of inclinations known as the Fetal Alcohol Syndrome is nowadays one of the major worries prenatal medicine is facing.
Fetal Alcohol Syndrome (FAS) essay
Table of contents:
2. FAS and possible outcomes
3. In utero fetus development
4. Changes for newborns with FAS
1. Physical changes
2. Changes in mental development
5. Fetal Alcohol Syndrome “barriers”.
1. FAS children and social adaptation
2. Predictable academic achievements
3. Suggestions how to deal with FAS-children
6. FAS genetic factor
7. FAS possible treatment
Introduction: Humanity has always yielded to the pressure of different chemical substances that eventually caused it irreparable damage. Finding the “cure” from the damage obtained was the next step. And it seems that only now, when the number of the diseases caused by different substances has reached its peak, people have finally understood that the best “cure” is the prevention of any forms of substance abuse. Alcohol is not the last one in the list of these destructive substances. It is the “companion” of any significant event occurring in the life of modern people or even an everyday way to relax and get away from all the difficulties. People relax and forget that they are supposed to think not only about their health but also about the health of their future offspring. This especially concerns women, as they are the ones to deliver the next generation into the world. A woman’s organism is a lot more influenced by any external chemical influences and alcohol becoming woman’s frequent “companion” becomes a real threat for the health of the nation. The contemporary medical world is very much concerned with the female alcohol abuse phenomenon and the appearance of a group of inclinations known as the Fetal Alcohol Syndrome is nowadays one of the major worries prenatal medicine is facing. This syndrome is the giant problem, which needs to be fixed desperately. It is very important to understand its nature, forms of development and irreparable consequences in order to analyze the range of the problem.
2. FAS and possible outcomes. Fetal Alcohol Syndrome (FAS) is a terms used to define a number of various physical and mental defects of a baby that can appear when a woman drinks alcohol during the period of her pregnancy. This syndrome unites different degrees inclinations in the psychophysical development of a newborn. The word “fetal” indicates an accent on the prenatal nature of the syndrome generation. A woman’s refusal to abstain from alcohol during her pregnancy may result in severe pathologies of her fetus. AS alcohol is the substance that causes these pathologies it is necessary to define what fit in this category. The term alcohol is applicable for: beer, wine, whiskey, vodka or other drinks containing this denominination. In other words alcohol with its most dangerous for the fetus product ethanol, which is so quickly adopted by the female organism, causes a wide range of destructive consequences. Fetal Alcohol Syndrome affects three major spheres of the fetus development:
1. Growth retardation, which includes such manifestations as the reduction of normal weight and length of a newborn infant. This pathology starts during the prenatal period and continues in the postnatal development of the child, creating new problems.
2. Damage of the Central Nervous System (CNS). This brain damage is the primary, irreversible danger of the syndrome, which directly leads to a group of different disorders that depend on what brain areas, are especially damaged. In some cases the brain is change make the brain severely deformed and unrecognizable. These possible disorders include learning disabilities and inclinations in the behavior of children with FAS.
3. The third sphere, which is influenced by alcohol, is the appearance of the infant. Facial and head changes that occur under the influence of alcohol a can be corrected by a surgeon although sometimes remain “invariant”. These abnormalities include the size of eyes and head and many other features [Goodstadt, 1984].
This “disabilities” caused by alcohol last a lifetime and therefore completely change the life of the child and those people who will take care of him. Therefore, people who have been exposed to alcohol during their fetal development suffer throughout their whole lives sometimes not even having a small hope to find their places in life and not being even “comparatively” independent. They cannot concentrate, talk too much and are not capable of making proper decisions. Such children are completely helpless and unprotected. The diagnosis of Fetal Alcohol Syndrome is a real “tragedy” because it is the synonymy of a person who will have so many restrictions and disabilities caused by parent irresponsibility that no doctor would ever be able to help him. The outcomes of the FAS are severe and the only reason for its existance is maternal alcohol abuse, which affects the development of vital stages of the fetus formation. Children with FAS are not able to adapt in the contemporary world, which requires independence and a large luggage of knowledge and skills in order to succeed.
3. In utero fetus development. In utero child is "a member of the species homo sapiens, at any stage of development, who is carried in the womb". Thi is written in the legistaltion which was approved on the 20th of March 2004 by the US Senate.As the Fetal Alcohol Syndrome may be gained during the period of pregnancy it is very important to understand how alcohol affects the fetus. It is common knowledge that fetus is very vulnerable, especially during the first three trimesters. The main reason for this vulnerability is that throughout this periods its basic formations. The unborn baby is influenced by everything his mother is exposed to. The same thing works for alcohol. Female exposure to alcohol during the period of pregnancy is result in the inclination in the development of the fetus and therefore further “chain reaction” of incorrect development. Females metabolize alcohol very quickly and this is the primary cause of their necessity to abstain from alcohol. The fetus is already in high danger of obtaining FAS if the pregnant female consumes around 3 ounces of pure alcohol per day 1[Caleekal, 1989].
Alcohol does not need to make much efforts to cross the placenta and therefore to enter the fetus’s organism. Alcohol may cause spasm of placenta vessels and the umbilical cord. This leads to the oxygen “starvation” of the fetus. As the amount of zinc in the cells is rapidly reduced their growth and development is damaged. Through these effects alcohol causes changes called “mutations” in the DNA of the fetus cells. In its turn, the mutation of DNA in the fetus cells leads to pathologies of the development of different organs and tissues [Cole, 1990]. Alcohol is also the cause of the vitamin shortage in the fetus body. Metabolism and hormonal process are corrupted, too2. Basically saying fetus organs and systems suffers the most and CNS being one of the most important ones becomes the most severe damaged one.Some women during the first three or four weeks of their pregnancy do not know that they are pregnant. Alcohol abuse during this period affects the formation of cartilage during the whole embryonic stage. The fetal stage begins around days 46-48, so therefore it starts on the eighth week of pregnancy and continues to the very moment of the baby’s birth. This period becomes vital for the future infant, as it is the period of its formation. The effect of alcohol throughout this period is immense and even the lesser amount of alcohol may cause some changes. These destructive processes, which occur inside the fetus organism, cause irreparable damage that it made on the genetic level. Even “social drinking” causes changes in intellectual and behavior activity of children [Burgess, 1990]. Heavy abuse, causing Fetal Alcohol Syndrome with severe disorders has nowadays become unbelievably widespread. All this changes throughout the period the development of the fetus cause mental disabilities and the sphere of behavior of the future child. The period of pregnancy is a period of increased sensitivity towards any biological influences and improper develop met cause by alcohol abuse is critically prohibited.
4. Changes for newborns with FAS. As it has been already mentioned Fetal Alcohol Syndrome causes certain mental and physical birth defects, which make the living of the newborn harsh and sometimes even impossible to resist. It is obvious that all the processes occurring in FAS child the organism are usually delayed or transformed. Children start walk and talk later than they should have started. Infants have a very hard time trying to focus their attention on one object or follow it trajectory. They cannot fix their attention on bright objects and have difficulties with hearing concentration. The hypertension of the muscles stays much longer and the first attempts to pronounce some slabs are in the best cases tardy [Haase, 1990]. As so many women drink alcohol nowadays some of these changes have become quiet common. Nevertheless, FAS remains a combination of all these features, making the life of the newborn very hard.Newborns with Fetal Alcohol Syndrome face a lot of changes compared to healthy infants. It starts with external facial abnormal changes and end with brain dysfunctions that such infants experience.
4.a. Physical changes. The first change occurring to a fetus and observable after birth are physical changes. These are the first signs of Fetal Alcohol Syndrome, which become the base for the following set of tests. FAS physical changes vary greatly, because the transformations completely depend on the alcohol exposure of the fetus. Sometimes the physical appearance of a baby is completely irreparable even with the means of cosmetic surgery. As it has been already said, the facial abnormalities of a newborn may vary. But the basic ones are the next: small head for age smaller eye openings, flattened cheekbones, indistinct philtrum, short eye slits, droopy eyelids, widely spaced eyes, nearsightedness, crossed eyes, short upturned nose, thin upper lip, flat midface and a small or underdeveloped jaw [Dowshen, 2005]. These facial changes may come in different combinations and sets. Along with a very small weight, length and other growth retardation, the facial changes occurring to newborns with FAS may even take the following forms: the ears may be large of transformed, infants may have a very short neck, fingernails and toenails may be underdeveloped and also have general bone abnormalities which causes body pathology and even a greater amount of functional disabilities of a FAS newborn . The motor skills of a baby are damaged, which leads the physical development of the newborn to an incorrect “direction”. The list of defects also spreads over organs of the newborn. Along with liver and kidney and other organic dysfunctions the newborn faces cardiac defects, too. The physiology of newborns with FAS is completely changed and even sometimes some defect may be not visible and the child may look “normal” their inner defects which are not observable cannot be remain unseen. A child with Fetal Alcohol Syndrome does not differ from ordinary children with their physical appearance abnormalities and other dysfunctions. The major difference is the behavioral component, which is controlled by a damaged Central Nervous System. The corruption of the development of the Central Nervous System affects the mental health of the newborns with FAS. Their life expectancy is way shorter than of an ordinary person. Children with Fetal Alcohol Symptom posses low IQ or present the symptoms of mental retardation. This irreparable damage to the brain it is evaluation is way stronger than the facial changes that the FAS produces.
4.b. Changes in mental development
If a women abuses alcohol during the period of her pregnancy this means that her baby will be severely affected by this substance. Changes in mental development start occurring from the very beginning of the alcohol exposure of a fetus. As the cells are affects and the functioning becomes unhealthy, brain cells experience difficulties, too. This interference into the brain cells functioning results in certain shifts in the cognitive sphere of the child’s development. In a long run, patients with FAS demonstrate a number of intellectual dysfunctions. Ann P. Streissguth reports that severe changes happen in this sphere resulting in low IQ scores. The range of the scores starts with 16 and ends with 105. An overage IQ of a child with FAS is 65 points [Streissguth, 1998]. Those children that have the lowest scores cannot even learn the skills of self-service. It goes without saying that such a deformed intellectual sphere causes serious problems in the everyday life of a child. The learning disabilities children face makes the abilities way more limited. As they cannot learn anything they constantly need someone to be with them and take care by providing sometimes even their basic biological needs. Their hyperactive uncontrolled behavior by providing ungrounded and illogical thoughts make it very hard to communicate with such children. Mental retardation of such children makes it in some cases impossible to attend a school. They start talking late and have a hard time expressing what they want. FAS patients have a hard time with puzzles, drawing, planning, and with making correct conclusions out of the phrases. Sometimes they may use inappropriate word constructions with they can remember. As all the mental processes are tardy. They start talking late and have a hard time expressing what they want.
Here is an example of the thought of a boy with FAS – his dream was to break all the windows in the house of his parents, to throw the parents out of the window to the garden, where they were supposed to turn into what was growing in the garden. The world perception of children with FAS is completely changed and sometimes completely mentally ill. For some children the educational process will end up not even finishing high school because this will be their intellectual “ceiling”.
These children experience the damage of logical thinking. Sometimes they cannot find the difference and resemblance between two objects, cannot exclude an object that does not belong to a given group and have a mixed classification of notions. Children with FAS present insufficient self-regulation, inadequate emotional reactions on different or certain irritants. Their behavior and mood are often instable and sometime unpredictable. FAS children lack attention, cannot focus on what they need to. Are often very irritable and get mad easily. All these manifestations of mental disorders emphasize the damage that metal development alcohol corruption causes.
All the processes are unstable, tardy and some are absent at all. FAS patients are sometimes unable to accept social norms of behavior, which makes their life even harder not within their families but especially in external relations with other people.
5. Fetal Alcohol Syndrome “barriers”
Growth retardation, facial abnormalities and mental disorders caused by irreversible minimal brain dysfunctions, which occur under the influence of alcohol, do produce countless barriers in the lives of FAS patients. FAS patient cannot life they life of an ordinary person. They cannot finish school properly, find a good job, cannot provide themselves with money enough at least for their treatment. These people do not have normal personal life and cannot live by themselves. FAS prevent people from being able to communicate properly. The result is that all these barriers convert them into people without any job, personal life and future. And the only reason for that is their exposure to alcohol in their fetal stage development. Ordinary people are afraid of interacting with FAS patients because they simply do not know how to behave with them and not every person posses the patience to understand and take these people for what they are. Another barrier is that some attempts of FAS patient to socialize with other people, especially in the young age end up with acts of violence addressed to them. This “unsuccessful experience” increases their aggression directed to the outside world and in connection with certain mental underdevelopment produces a very strong barrier which is almost impossible to overcome. Nevertheless, there is some hope for people with FAS under the condition that they will receive correct education and social skills examples. This is the basic reason these two major barriers need to be analyzed by ordinary people, which would help FAS patients a lot.
5.a. FAS children and social adaptation
The process of social adaptation of FAS patient is rather complicated and is not successful in majority of the cases. This is primarily due to the fact that social skills are the most valuable nowadays FAS patients sometimes do not “fit” as they cannot perform the right combination of these skills. It has already been mentioned that people with FAS have problems with logical thinking. This is especially observable through their inability to make judgments and constant poor reasoning they perform.
The list of the social “defects” classified as “challenging behaviors” that prevent FAS patient from social adaptation is very long. Nevertheless, it is possible to indicate the major ones: inability to maintain self-control, inability to build and maintain friendship, inability to belong to social groups, lack of curiosity, learning difficulties, and poor memory, impulsivity, inability to understand such concepts as time and money, poor problem-solving skills, poor language comprehension, inability to concentrate, stubbornness, anxiety and others . So by analyzing the list of listed social ”defects” it is possible to say that the main reason of social withdrawal of such people is their immaturity and inability to behave like adults even being adults. These were separate “defects” but there exists a set of behaviors that are very characteristical for FAS patients: the attempts of FAS patient to engage social contacts are sees and taken as intrusiveness. As FAS patients cannot interpret social cues, therefore do not understand non-verbal messages they do not see when for instance a person is not interested in something anymore. They just perceive what they want to perceive, which is the result of a mental underdevelopment. Therefore people with FAS do not know how to act and at the same time they strive for social contacts. Psychological analysis of this phenomenon reveals that they start doing something just to get any kind of attention. Healthy adults usually have the patience to establish social contacts with FAS children but children of the same age tend to reject them. As people with FAS are rather immature and gullible mercenary people can use these qualities to achieve their aims. This is the way FAS affected people start having troubles with the law. They see that somebody needs them; they believe these people and do whatever they are told to3.
People with FAS are not able to perform any activity for a long time; this is primarily due to their inability to concentrate. In connection with their characteristic qualities such as organizational difficulties they are ordinarily unable to work normally at all. Still, they can learn how to produce hand-made things. FAS patients may be also “error-prone” in the sphere of sexuality.
Nevertheless, there is a way to make the life of FAS patients sociable enough. This is achieved only through teaching them appropriate ways of social behavior and helping them in creating healthy social contacts in environments with positive feedback. In most cases FAS patients get so irritated because they cannot deliver their needs to other people. So one of the primary goals of social contacts is the formation of the ability to explain what is that the patient needs at this period of time.
FAS patients should not change their place of living, because due to their peculiarities such changes are very “painful” for them. It takes time before they start trying to socialize and the take-off of an accustomed enviroment may result in serious complications. The significance of negative social experiences is often exaggerated due to the desire to get attention. As a whole the social interactions cause great difficulties for FAS patients and all the restrictions they posses make their assimilation in society very problematic.
5.b. Predictable academic achievements
The academic capability issue of FAS patients has been discussed in several passages above. Nevertheless, there are several aspects that need to be elaborated. It goes without saying that the level of possible academic achievements of children with FAS is lower than academic achievement rate of healthy children. Although sometimes the IQ level allows students with FAS to study almost normally, in most of the cases the language and social barriers prevent these children from getting the knowledge they need [Streissguth, 1998]. Often, not being capable to present good knowledge and get corresponding academic reward these student experience sharp academic frustration. At its peak patients tend to have “bursts” of spontaneous aggressive behavior, which endures their frustration later on. The desire to be successful in reality and the tendency to avoid frustrating situations make them lie. Lying to parents and teachers makes the process of education even more complicated than it is. In addition to that FAS patients sometimes start stealing things. No school is interested in having students who steal things and this causes a problem that needs a solution, which seems completely unsolvable. Nevertheless, this problem does have a solution. Of course nothing will bring recovery to a FAS affected child, but proper attention from the side of teachers and parents can eliminated a number of negative m manifestations from the side of such students.
Children with Fetal Alcohol Syndrome may also need to get sufficient sexual education, due to their tendency to have casual sexual encounters in an adult age as a measure of preventing it .It is obvious that children with FAS will not be able to understand all of the subjects that are taught at school. So the basic priority of their education should be language skills practice. It does not matter whether FAS patients talk normally or communicated only through signs. The approach should be in any case a personality-oriented one. FAS patient desperately need communication and the process of education is always a great opportunity to acquire knowledge and express their opinions and desires. FAS students do have troubles is learning mathematics and other exact subjects. In other words, the process of education of FAS patient is a special process that requires special attitude and guidance. The key to the most productive education is appropriate placement in special classes. As children with FAS require a lot of individual attention in order to achieve, these classes should be able to provide them starting from preschool.
It goes without saying that even the best education that children with Fetal Alcohol Syndrome get will not significantly improve their abilities, although the analysis shows that education is a measure that prevents FAS patients from further degradation. FAS patients need to learn how to operate with money, how to perform basic living skills and be whatsoever independent. This will give their relatives and caregivers the time to rest and to be ready to continue helping these people. Education becomes the key to achieve the potential that FAS patient have. Without it their lives will be very hard.
5.c. Suggestions how to deal with FAS-children
It is obvious that children with FAS do not quiet fit in the contemporary society with all its requirements. That is the reason these children may require special personal attention of valued grown ups in order to be able to cope with the problems that they face everyday fighting for the right to be “almost normal”. There is a group of condition that such children need in order to succeed.
• They require a structured environment in the firs place. This means that every child with FAS should be shown how to cope with everyday routine.
• Another important factor is supervision. This supervision is supposed to prevent an FAS-child from getting into a life threatening situations.
• The instructions that FAS-children get from their supervisors need to be clear and said or showed in a way that guarantees the child’s understanding of what he/she is supposed to do. The instructions need to be exact and not ambiguous.
• Big tasks should be broken into smaller ones. This small “operations” later one may be united and performed on a higher level [Murphy, 1991].
Another thing to remember is that children affected with FAS need to be talked to about the disease. Knowledge will destroy their fear in front of the diagnoses. Direct contacts between children with FAS and people educating them are very important. The relations need to be confidential and full with kindness.
As these children may have problems following a curriculum the best way to overcome this difficulty is to create a curriculum-like life at home. Everything needs to be done at the same time and in the same order. This accustoms the child to the organized, which is a big problem for children with FAS.
6. FAS genetic factor
The analysis of the Fetal Alcohol Syndrome in terms of genetic predisposition leads to a rather striking conclusions. Although FAS is not considered to be genetic or inherited for some reason the frequency of FAS of black and white children differs. The risk of a black woman to give birth to a child with FAS is seven times higher than of a white woman. This works even after setting control over the alcohol intake of black pregnant women [Sokol, 1996]. What does this mean? Basically it simply means that all ethnical groups may suffer from this syndrome without any exceptions. Some scientists used to think that what it means is that some ethnical groups due to their historical development have a higher genetic predisposition to FAS. From their opinion such a historical predisposition could have been be an issue for young mothers belonging to different ethnical groups. Nevertheless, it has nothing to do with genetics. And no matter what ethnical group the pregnant woman belongs to she is always to remember that she can put her baby in a great danger and that the alcohol damage done to the child is irreversible and that she will have to watch her child suffer throughout all life and suffer herself. Genetic field of the Fetal Alcohol Syndrome has already been deeply examined. Genetics is not to be blamed but young mothers consuming alcohol thinking that it will not affect their fetus. Therefore the genetic factor simply falls off. Nowadays, the major goal physicians try to focus on is alcohol abuse prevention. It is all about drinking or not drinking alcohol during pregnancy.
7. FAS possible treatment
Fetal Alcohol Syndrome is diagnosis that puts a mark with it consequences of the person’s life and converts it into s serious “test”. But order to help a person pass it doctors need to know that they are facing this problem. Diagnosis of Fetal Alcohol Syndrome is what is a guarantee of well-timed help that a child may get from the doctors. It is better to diagnose the syndrome right after the birth of the baby, because the diagnosing at a later period of time may become problematic and the accuracy of the diagnosis will not be as high . A mistake in the diagnosis can cause significant complications. Knowing the correct cause is always the “door” to proper treatment. Special needs that a FAS patient requires can never be provided in case of a wrong diagnosis. Monitoring the medical, nutrition, educational needs of a baby with FAS at early stages of the baby’s life can make an immense difference in the development of the infant.
Early diagnosis increase the possibility for a FAS affected child to become social adequate. Role-playing all the possible social situations starting from early preschool and a correct “sensory” diet of a FAS patient combined with Auditory Integration Training (AIT) give a hope of a possible positive socialization of a future FAS-adult. The most important part of a correct diagnosis and treatment is taking proper medication by the FAS-patient. As it is impossible to cure the syndrome, doctors may work with separate symptoms, which can be reduced owing to a correct medication set. Therefore, this gives the child an opportunity to have a “normal” life of his highest potential.
There is no cure from Fetal Alcohol Syndrome. There is nothing that can be done in order to eliminate the effects that alcohol has had on the fetus during the period of its development. This affects are irreversible and will accompany the child throughout his whole life. Symptom manifestation improvement is what can be achieved under the condition that the diagnosis is made in time and appropriate attention in given to the FAS-patient from the side of the physicians. All these measures facilitate the life of FAS patients but still nothing can be done to recover the newborn’s organism from the alcohol exposure.
The consumption of alcohol beverages has strongly entered the tradition of celebration any significant events in the life of people. Anybody can hardly imagine celebrating Christmas or a birthday without a gulp of champagne. Seemingly, there is nothing bad in that and nothing bad can happen after a gulp of champagne or a gulp during a routine “social drinking”. But the reality is cruel… And nowadays children with the Fetal Alcohol Syndrome are not necessarily children of alcoholics. Therefore even small doses of alcohol can do harm to a pregnant woman and her future baby. The following triad characterizes Fetal Alcohol Syndrome: the delay of growing of the infant, CNS damages and facial abnormalities. Children diagnosed with FAS have mental development disorders. And the reason of these disorders is completely preventable – alcohol abstention. Most women do not understand the consequences alcohol abuse can have of the fetus nevertheless the abuse occurs primarily because young mothers do not know the destructive power of alcohol. The consequences of the FAS do not decrease with time, though specific manifestations change when the child grows up. Attention disorder and hyperactivity along with CNS changes and facial mutation happen in 75 percent of the FAS patients. These factors prevent the child from proper social adaptation and therefore make its life incomplete. Social impracticability of people suffering from the Fetal Alcohol Syndrome is one of major problems of the contemporary medical society. And the only way to solve this problem is to prevent pregnant females from drinking alcohol in any amounts. So as the women takes alcohol during the prenatal period the postnatal period of the child will be full of health difficulties. As all the effects are preventable then each women should strictly maintain alcohol free living during her pregnancy. There is no cure a better cure for FAS than alcohol abstention!
1 Women have lesser enzyme that known as alcohol dehydrogenate and that is the reason about 30% more alcohol is absorbed into their bloodstream than in men.
2 Alcohol is known to be soluble in both water and fat; therefore it can penetrate all cell membranes and move throughout all body tissues .
3 This is the indication of the potential for both social isolation and exploitation.