Discuss about the Foetal Alcohol Spectrum Disorder.
According to Doney et al. (2016), alcohol produces by far the most complicated and dangerous neurobehavioral challenges to the fetus when compared to all the substances abused such as marijuana, heroin, and cocaine. Prenatal exposure occurs when the alcohol crosses the placenta leading to the rise in the alcohol level in the blood of the fetus that in worst cases can reach maternal blood level. Kavanagh and Payne (2014) denote that alcohol being a teratogen, it can cause any malfunctions to the infant leading to behavioral, physical, or learning challenges when the child is born. Fetal Alcohol Spectrum Disorders is a major disorder that occurs due to fetal exposure to alcohol by the parent (Mutch, Watkins, & Bower, 2015). This paper evaluates the occurrence of Fetal Alcohol Spectrum Disorders among the Australian Indigenous Communities, impacts it can cause to an individual and the community, and its diagnosis and treatment. The paper also evaluates some of the contributing factors that can prevent its effective treatment and possible ramifications in the case of poor management.
Fetal Alcohol Spectrum Disorders (FASD) is an umbrella term used in describing a spectrum of conditions that affects an individual due to fetal exposure to alcohol by the mother during pregnancy as pointed out by Salmon (2011). The study also denotes that every condition related to the disorder and its diagnosis is often based on characteristic feature presentations which are always unique to the person affected and may be neurobehavioral, physical, or developmental. As an umbrella term, the FASDs consist of the following conditions that all arise due to prenatal alcohol exposure;
According to Abbs (2015), alcohol can cause great damage to the unborn infant at any level during pregnancy, an aspect that also determines the level of harm an individual can experience. The level of harm that can be experienced is also determined by the frequency and amount of alcohol exposure which is moderated by parental age, nutrition of the mother, and intergenerational alcohol use. For instance, Freckelton (2016) points out that the use of alcohol by the mother while living under poor diet or smoking cigarettes will worsen the condition of the fetus towards the exposure. The same study points out that the environmental factors affecting the mother such as stress, poverty, and exposure to violence are likely to worsen the condition of the FASD related infections to the fetus. In their study, Latimer et al. (2015) point out that many indigenous communities and individuals within the indigenous communities in Australia living with FASD often face a primary, secondary, and tertiary challenges. The primary conditions that can be observed in an individual include impulsiveness, memory lapse, learning difficulties, difficulties in relating actions to different consequences, delays in development of a child, and even damage to major organs in the body
With modern technology and its adoptions within the medical industries in Australia, Fitzpatrick et al. (2015) point out that clinicians across Australia adopted the use of FASD diagnostic instrument as part of the Australian Guide to the diagnosis of the disease. In 2016, the Australian medical expert review panel harmonized the Australian diagnostic subcategories based on those recommended by the Canadian guidelines with the aim of accepting the overarching FASD diagnostic subcategories. These categories include;
Like any other physical disability condition, Burns et al. (2013) point out that FASD is a physical brain-based disorder that requires environmental accommodation. With early neurobehavioral interventions and a correct diagnosis as well as appropriate parental support and care in early stages of childhood, the quality of life and learning outcomes for individuals suffering from FASD can vastly improve. In his study, Salmon (2011) recommends interdependence rather than the independence objective for many adults affected by FASD as an acknowledgment of the need for appropriate support in the attempt of sustaining the individual capacity of engaging in economic and social life. It is also crucial to develop accommodation in full consultations with the people living with FASD since every individual has a particular need. Burns et al. (2013) also identify some case management approaches and support strategies in the treatment of FASD to include;
The physical, neurobehavioral, and developmental features with the FASD are rarely apparent at birth unless there are facial growth factors related to the disorder are observed and may be difficult to notice until the child attains the school age when learning and behavioral difficulties become problematic (Mutch, Watkins, & Bower, 2015). In their study, Kavanagh and Payne (2014) also denotes that there is often unrecognized impairments f the brain with primary symptoms that often cause misunderstanding by those in authority who cast laziness or defiant behavior to individuals living with FASD. In the effort of trying to meet unrealistic expectations, the individual often develops secondary defensive behaviors that are then paradoxically used to label and stereotype the affected individuals based on the observed behaviors.
Being an invisible disability, FASD often goes undetected and can often be ignored, overlooked, or attributed to other non-genetic conditions, a factor that brings challenges to the process of management and treatment of the disorder according to Doney et al. (2016). Other challenges are often caused by blaming them on poor parenting and unhealthy post birth environments that predispose the children to other infections. There is also a lack of proper understanding by the community providers towards FASD since the service provisions and assessments are often evidence based on the behavior of the incapability of the affected individuals. According to Latimer et al. (2015), problem behavior presentations, as well as the absence of biomarkers, often result in assumptions concerning the individuals that are often unfair instead of being helpful. It hence means that most of the community healthcare providers within the Australian Indigenous population do not have a clear understanding that FASD is a physical brain-based disorder with symptomatic behaviors to the brain, an aspect that prevents successful treatment.
When poorly managed in an individual, there are both primary and secondary conditions that can last a lifetime depending on the amount of alcohol exposure during pregnancy according to Mutch, Watkins, and Bower (2015). The primary conditions that can be observed in an individual include impulsiveness, memory lapse, learning difficulties, difficulties in relating actions to different consequences, delays in the development of a child, and even damage to major organs in the body such as the kidney. Freckelton (2016) also denotes that the unfairness they face reinforces the invisibility of their brain-based conditions hence perpetuating their sense of failure to believe that they can’t do rather than they won’t do. As a result, other tertiary conditions are likely to occur due to the failure in meeting the expectations while developing defensive behavioral mechanisms. The tertiary conditions likely to be faced by such individuals include sexual victimization, early and unplanned parenthood, economic and family dependence, incomplete education, alcohol and other drug abuse, and involvement in criminal justice systems.
Conclusion
Fetal Alcohol Spectrum Disorders is a serious challenge among the Australian Indigenous communities who still struggle with the challenge of drug and substance abuse and the related effects to the society. Like any other physical disability condition, FASD is a physical brain-based disorder that requires environmental accommodation so as to help the affected individuals view life positively. With early neurobehavioral interventions and a correct diagnosis as well as appropriate parental support and care in early stages of childhood, the quality of life and learning outcomes for individuals suffering from FASD can vastly improve.
References
Abbs, P. (2015). Widening the gap: The gulf between policy rhetoric and implementation reality in addressing alcohol problems among Indigenous Australians. Drug & Alcohol Review, 34(5), 461-466. doi:10.1111/dar.12299
Burns, L., Breen, C., Bower, C., O’ Leary, C., & Elliott, E. J. (2013). Counting Fetal Alcohol Spectrum Disorder in Australia: The evidence and the challenges. Drug & Alcohol Review, 32(5), 461-467.
Doney, R. r., Lucas, B. b., Watkins, R. r., Tsang, T. t., Sauer, K. k., Howat, P. p., & … Elliott, E. e. (2016). Visual-motor integration, visual perception, and fine motor coordination in a population of children with high levels of Fetal Alcohol Spectrum Disorder. Research In Developmental Disabilities, 55346-357.
Fitzpatrick, J. P., Latimer, J., Ferreira, M. L., Carter, M., Oscar, J., Martiniuk, A. C., & … Elliott, E. J. (2015). Prevalence and patterns of alcohol use in pregnancy in remote Western Australian communities: The Lililwan. Drug & Alcohol Review, 34(3), 329-339.
Freckelton, I. Q. (2016). Sentencing Offenders with Foetal Alcohol Spectrum Disorder (FASD): The Challenge of Effective Management. Psychiatry, Psychology & Law, 23(6), 815-825. doi:10.1080/13218719.2016.1258752
Kavanagh, P. S., & Payne, J. S. (2014). Education, safe drinking practices and fetal alcohol spectrum disorder in the Kimberley region of Western Australia. Journal Of Paediatrics & Child Health, 50(9), 701-706. doi:10.1111/jpc.12615
Latimer, J., Carter, M., Oscar, J., Ferreira, M. L., Carmichael Olson, H., & … Elliott, E. J. (2015). Prevalence of fetal alcohol syndrome in a population-based sample of children living in remote Australia: The Lililwan. Journal Of Paediatrics & Child Health, 51(4), 450-457. doi:10.1111/jpc.12814
Mutch, R. C., Watkins, R., & Bower, C. (2015). Fetal alcohol spectrum disorders: Notifications to the Western Australian Register of Developmental Anomalies. Journal Of Paediatrics & Child Health, 51(4), 433-436. doi:10.1111/jpc.12746
Salmon, A. (2011). Aboriginal mothering, FASD prevention and the contestations of neoliberal citizenship. Critical Public Health, 21(2), 165-178. doi:10.1080/09581596.2010.530643
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