Perceptions of Fetal Alcohol Spectrum Disorder (FASD) at a Mental Health Outpatient Treatment Provider in Minnesota
Abstract
:1. Introduction
2. Materials and Methods
3. Results
3.1. Training
3.2. Diagnostic Knowledge
3.3. Treatment
3.4. Suggestibility and Crime
4. Discussion
Limitations
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
Appendix A
Survey Questions
References
- May, P.A.; Chambers, C.D.; Kalberg, W.O.; Zellner, J.; Feldman, H.; Buckley, D.; Taras, H. Prevalence of fetal alcohol spectrum disorders in 4 U.S. communities. JAMA 2018, 319, 474–482. [Google Scholar] [CrossRef] [PubMed]
- Benz, J.; Rasmussen, C.; Andrew, G. Diagnosing fetal alcohol spectrum disorder: History, challenges and future directions. Paediatr. Child Health 2009, 14, 231–237. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Fuglestad, A.J.; Whitley, M.L.; Carlson, S.M.; Boys, C.J.; Eckerle, J.K.; Fink, B.A.; Wozniak, J.R. Executive functioning deficits in preschool children with Fetal Alcohol Spectrum Disorders. Child Neuropsychol. 2015, 21, 716–731. [Google Scholar] [CrossRef] [PubMed]
- Hofer, R.; Burd, L. Review of published studies of kidney, liver, and gastrointestinal birth defects in fetal alcohol spectrum disorders. Birth Defects Res. Part A Clin. Mol. Teratol. 2009, 85, 179–183. [Google Scholar] [CrossRef] [PubMed]
- Kingdon, D.; Cardoso, C.; McGrath, J.J. Research Review: Executive function deficits in fetal alcohol spectrum disorders and attention-deficit/hyperactivity disorder—A meta-analysis. J. Child Psychol. Psychiatry 2016, 57, 16–131. [Google Scholar] [CrossRef]
- Manning, M.A.; Hoyme, H.E. Fetal alcohol spectrum disorders: A practical clinical approach to diagnosis. Neurosci. Biobehav. Rev. 2007, 31, 230–238. [Google Scholar] [CrossRef] [PubMed]
- Wheeler, S.M.; Stevens, S.A.; Sheard, E.D.; Rovet, J.F. Facial memory deficits in children with fetal alcohol spectrum disorders. Child Neuropsychol. 2012, 18, 339–346. [Google Scholar] [CrossRef]
- Spohr, H.L.; Willms, J.; Steinhausen, H.C. Prenatal alcohol exposure and long-term developmental consequences. Lancet 1993, 341, 907–910. [Google Scholar] [CrossRef]
- Spohr, H.L.; Willms, J.; Steinhausen, H.C. The fetal alcohol syndrome in adolescence. Acta Paediatr. 1994, 404, 19–26. [Google Scholar] [CrossRef]
- Steinhausen, H.C.; Willms, J.; Spohr, H.L. Long-term psychopathological and cognitive outcome of children with fetal alcohol syndrome. J. Am. Acad. Child Adolesc. Psychiatry 1993, 32, 990–994. [Google Scholar] [CrossRef]
- Denys, K.; Rasmussen, C.; Henneveld, D. The effectiveness of a community-based intervention for parents with FASD. Community Ment. Health J. 2011, 47, 209–219. [Google Scholar] [CrossRef]
- Jirikowic, T.; Olson, H.C.; Kartin, D. Sensory processing, school performance, and adaptive behavior of young school-age children with fetal alcohol spectrum disorder. Phys. Occup. Ther. Pediatr. 2008, 28, 117–136. [Google Scholar] [CrossRef]
- Sanders, J.L.; Buck, G. A long journey: Biological and non-biological parents’ experiences raising children with FASD. J. Popul. Ther. Clin. Pharmacol. 2010, 17, e308–e322. [Google Scholar]
- Famy, C.; Streissguth, A.P.; Unis, A.S. Mental illness in adults with fetal alcohol syndrome or fetal alcohol effects. Am. J. Psychiatry 1998, 155, 552–554. [Google Scholar] [CrossRef]
- Streissguth, A.P.; Barr, H.M.; Kogan, J.; Bookstein, F.L. Understanding the Occurrence of Secondary Disabilities in Clients with Fetal Alcohol Syndrome (FAS) and Fetal Alcohol Effects (FAE); Final report to the Centers for Disease Control and Prevention (CDC); University of Washington School of Medicine: Seattle, WA, USA, 1996; pp. 96–106. [Google Scholar]
- Crocker, N.; Vaurio, L.; Riley, E.P.; Mattson, S.N. Comparison of verbal learning and memory in children with heavy prenatal alcohol exposure or attention-deficit/hyperactivity disorder. Alcohol. Clin. Exp. Res. 2011, 35, 1114–1121. [Google Scholar] [CrossRef] [PubMed]
- Green, C.R.; Mihic, A.M.; Nikkel, S.M.; Stade, B.C.; Rasmussen, C.; Munoz, D.P.; Reynolds, J.N. Executive function deficits in children with fetal alcoholspectrum disorders (FASD) measured using the Cambridge Neuropsychological Tests Automated Battery (CANTAB). J. Child Psychol. Psychiatry 2009, 50, 688–697. [Google Scholar] [CrossRef] [PubMed]
- Clarren, S.K.; Lutke, J. Building clinical capacity for fetal alcohol spectrum disorder diagnoses in western and northern Canada. Can. J. Clin. Pharmacol. 2008, 15, e223–e237. [Google Scholar]
- Popova, S.; Lange, S.; Shield, K.; Mihic, A.; Chudley, A.E.; Mukherjee, R.A.; Rehm, J. Comorbidity of fetal alcohol spectrum disorder: A systematicreview and meta-analysis. Lancet 2016, 387, 978–987. [Google Scholar] [CrossRef]
- Morleo, M.; Woolfall, K.; Dedman, D.; Mukherjee, R.; Bellis, M.A.; Cook, P.A. Under-reporting of fetal alcohol spectrum disorders: An analysis of hospital episode statistics. BMC Pediatr. 2011, 11, 14. [Google Scholar] [CrossRef]
- Mills, R.M.; McLennan, J.D.; Caza, M.M. Mental health and other service use by young children with fetal alcohol spectrum disorder. J. FAS Int. 2006, 4, 1–11. [Google Scholar]
- American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th ed.; American Psychiatric Association: Washington, DC, USA, 2013; ISBN 978-0-89042-555-8. [Google Scholar]
- Brown, N.N.; Wartnik, A.P.; Connor, P.D.; Adler, R.S. A proposed model standard for forensic assessment of Fetal Alcohol Spectrum Disorders. J. Psychiatry Law 2010, 38, 383–418. [Google Scholar] [CrossRef]
- Murawski, N.J.; Moore, E.M.; Thomas, J.D.; Riley, E.P. Advances in diagnosis and treatment of fetal alcohol spectrum disorders: From animal models to human studies. Alcohol Res. Curr. Rev. 2015, 37, 97–108. [Google Scholar]
- Olson, H.C.; Oti, R.; Gelo, J.; Beck, S. “Family matters:” fetal alcohol spectrum disorders and the family. Dev. Disabil. Res. Rev. 2009, 15, 235–249. [Google Scholar] [CrossRef]
- LaDue, R.; Dunne, T. Legal issues and the fetal alcohol syndrome. FEN Pen 1995, 3, 6–7. [Google Scholar]
- Brown, J.M.; Haun, J.; Zapf, P.A.; Brown, N.N. Fetal Alcohol Spectrum Disorders (FASD) and competency to stand trial (CST): Suggestions for a ‘best practices’ approach to forensic evaluation. Int. J. Law Psychiatry 2017, 52, 19–27. [Google Scholar] [CrossRef]
- Conry, J.L.; Fast, D.K.; Loock, C.A. Youth in the Criminal Justice System: Identifying FAS and Other Developmental Disabilities; Final Report to the Ministry of the Attorney General; Province of British Columbia, Ministry of the Attorney General: Vancouver, BC, Canada, 1997.
- Conry, J.L.; Lane, K.A. Characteristics of Youth with FASD on Adjudicated Probation Orders; Final report to the Department of Justice Canada and British Columbia Ministry of Children and Family Development; Ministry of Child and Family Development: Vancouver, BC, Canada, 2009.
- Roach, K.; Bailey, A. The relevance of fetal alcohol spectrum disorder in Canadian criminal law from investigation to sentencing. UBCL Rev. 2009, 42, 1–68. [Google Scholar]
- Verbrugge, P. Fetal Alcohol Spectrum Disorder and the Youth Criminal Justice System: A Discussion Paper; Youth Justice Research; Department of Justice Canada: Ottawa, ON, Canada, 2003.
- Brown, J.; Harr, D.; Morgan, S.; Varga, S.; Fenrich, A. Fetal Alcohol Spectrum Disorder (FASD): A call on mental health treatment professionals to become informed. J. Psychol. Psychiatry 2017, 1, 1–3. [Google Scholar] [CrossRef]
- Wedding, D.; Kohout, J.; Mengel, M.B.; Ohlemiller, M.; Ulione, M.; Cook, K.; Rudeen, K.; Braddock, S. Psychologists’ knowledge and attitudes about fetalalcohol syndrome, fetal alcohol spectrum disorders, and alcohol use during pregnancy. Prof. Psychol. Res. Pract. 2007, 38, 208–213. [Google Scholar] [CrossRef]
- Tough, S.C.; Clarke, M.; Hicks, M. Knowledge and attitudes of Canadian psychiatrists regarding fetal alcohol spectrum disorders. Can. Child Adolesc. Psychiatry Rev. 2003, 12, 64–71. [Google Scholar]
Responses |
---|
Coordinated services |
Black and white and concrete answers |
Repetition |
Impulse control related strategies such as: “Stop and think about the consequences before acting” |
Narrative-based approaches |
Increase social supports and services provided; repetitive and simplified Cognitive Behavioral Therapy (CBT) and interpersonal interventions; social skills training and practice (repetitive) |
Client centered therapy |
ABA therapy (Applied Behavioral Analysis) |
Repetition of strategies, using visuals, parent education and support, connecting behavior to consequences and if it is a situation where we are discussing their behavior then discussing it without blame. For younger clients, token reinforcements seem to work well. For older clients, focusing on transition planning and ensuring continued support once they turn 18 |
Coordinating care with residential mental health support whenever possible (if client receives these services too, of course) |
Depends on the client |
Repetition, consistency, and mindfulness / coping skills |
Behavioral interventions, helping them express their feelings, skills related work |
Behavioral therapy |
Consistency, clear and concrete expectations and communication with client and/or parent or guardian. Use of visuals definitely help |
More in depth with questions and explanations. Working with the client on goals and treatment instead of choosing and having client adapt to my goals |
Repetitive social skill training. one on one discussion, in order to gain insight into an issue, discuss something in multiple pieces, building on the information until the perspective is seen differently with empathy |
SKILLS work, brain scanning and neurocognitive testing |
Repetition, basic skills, Independent Living Skills (ILS) |
Psych-education, slower pace of therapy, reducing own expectations, being flexible with strategies, exploring/developing support systems for client. |
Emotional regulation through body relaxation and awareness. Social skills |
CBT and skills-based supports |
© 2018 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
Share and Cite
Brown, J.; Harr, D. Perceptions of Fetal Alcohol Spectrum Disorder (FASD) at a Mental Health Outpatient Treatment Provider in Minnesota. Int. J. Environ. Res. Public Health 2019, 16, 16. https://doi.org/10.3390/ijerph16010016
Brown J, Harr D. Perceptions of Fetal Alcohol Spectrum Disorder (FASD) at a Mental Health Outpatient Treatment Provider in Minnesota. International Journal of Environmental Research and Public Health. 2019; 16(1):16. https://doi.org/10.3390/ijerph16010016
Chicago/Turabian StyleBrown, Jerrod, and Diane Harr. 2019. "Perceptions of Fetal Alcohol Spectrum Disorder (FASD) at a Mental Health Outpatient Treatment Provider in Minnesota" International Journal of Environmental Research and Public Health 16, no. 1: 16. https://doi.org/10.3390/ijerph16010016