<p><img src="//relias.innocraft.cloud/piwik.php?idsite=2&amp;rec=1" style="border:0;" alt=""> What You Need to Know About New Guidelines for Diagnosing FASD
By | September 8, 2016

Fetal alcohol spectrum disorders (FASD) refer to conditions a person develops as a result of a women who drank alcohol during pregnancy, explains the Centers for Disease Control and Prevention (CDC). Unfortunately, a lack of education and conflicting information has left many mothers with uncertainty as to the safety of drinking alcohol while pregnant. Some argue minimal amounts of wine are acceptable, but this is nothing more than an urban legend.

Drinking any amount of alcohol while pregnant is unsafe.

A panel of industry experts, including physicians, clinicians, therapists and other health professionals, reports the National Institutes of Health (NIH), has taken new steps to eliminate inconsistencies and problems caring for children with FASDs. This new set of guidelines will have a lasting impact in how diagnoses, treatments and documentation are handled, and you need to understand why.


Driving Forces Behind Creation of the New Guidelines

Before the new guidelines were released, the criteria for diagnosing FASD was vague. It left doubt in whether a woman may have consumed alcohol during pregnancy. But, additional problems were evident in the type of criteria reviewed during diagnosis.

For example, one physician may have solely based a diagnosis on the presence of difficulties or challenges in cognitive functioning of a child. Consequently, there may not have been proof alcohol consumption during pregnancy, which implies a different type of intellectual or developmental disability (IDD) may be occurring.

There is no such thing as a “safe time” to drink alcohol while pregnant. Even if a woman does not know she is pregnant, alcohol can cause drastic, severe harm to the developing child. As a result, the general recommendation is to avoid alcohol completely when a chance exists for becoming pregnant. In fact, almost 50 percent of all pregnancies in the U.S. are unplanned.

This means all women of child-bearing must completely avoid alcohol to reduce the prevalence of FASDs, but this is impractical. So, women must be proactive in managing their ability to get pregnant.

For example, women of child-bearing age must be more vigilant on their use of contraceptives, including condoms, intrauterine devices (IUDs), oral contraceptives and implanted “birth control” devices in the skin to prevent an unplanned pregnancy. However, there will still be cases where unplanned pregnancy occurs.

The CDC estimates up 3 cases of fetal alcohol syndrome (FAS) are identified per 1,000 live births in the U.S. But, additional research indicates the rates may be higher when considering the medical records of school-age children. According to the American Academy of Pediatrics, as many as 5 percent of children in the U.S. may be diagnosed with FAS. In other words, a disconnect has existed between what is and is not considered FAS-diagnosing criteria. But, the new guidelines will alleviate these problems.


How Do the Guidelines Affect Pregnant Women?

The new guidelines do not expand on existing punishments for women who knowingly drank alcohol while pregnant. However, they do place a greater burden on diagnosing providers to prove a mother consumed alcohol during the pregnancy. This includes documented prenatal exposure to alcohol. Yet, this does not mean proof must exist of a woman’s intoxication. Instead, it simply reflects the need to identify alcohol-related birth defects (ARBDs) as soon as possible after delivery.

For example, a child with physical malformations, such as a small-sized head, may indicate ARBD. However, providers must also determine if the physical malformations may be the result of a non-alcohol issue, such as infection with the Zika virus.

Pregnant women with a history of alcohol abuse, including binge drinking and heavy drinking, may find themselves subject to increased scrutiny if a child is born with ARBDs. Obviously, the initial reaction, given the current issue with Zika virus, will be to determine if there are any other causes of the given birth defects. If no other causes can be identified, the immediate aftermath will include documentation of the associated defects as potentially indicative of FASD.

Additionally, women may be subject to blood tests for the presence of alcohol at the time of birth, and family members or friends may be asked about a woman’s drinking habits. Due to the sensitive nature of this issue, police or social workers may be required to conduct this part of the investigation into a child’s possible ARBD. Moreover, a history of legal problems involving alcohol during pregnancy can be used as part of this documentation.

If someone is at risk for drinking while pregnant, the CDC has created an anonymous survey to help mothers learn more about how drinking while pregnant affects the baby.


The Role of the Guidelines as Part of Early Intervention

Once documentation of alcohol consumption during pregnancy has been established, pediatricians and behavioral therapists will have a greater idea of what children may or may not develop the signs and symptoms of FAS, which include the following:

  • Lower IQ.
  • Inhibited growth.
  • Facial malformations, including a thinner upper lip and a lack of the groove in its center.
  • Speech and language delays.
  • Poor judgment skills.
  • Problems sleeping.
  • Auditory or visual hallucinations or problems.
  • Unexplained organ failure or development.
  • Hyperactivity.
  • Poor coordination.

Overall, the guidelines are meant to help diagnosis FAS on the basis of physical characteristics. As mentioned previously, prior guidelines may have let some children with FAS slip through the cracks. However, the new guidelines connect physical problems with a known exposure to alcohol during pregnancy. Consequently, behavioral therapists can begin early intervention treatments before cognitive impairments become evident.

This allows therapists and pediatricians to work to reduce the development delays associated with FASDs. In other words, therapists do not have to wait until a child can speak or perform other skills that require higher thought-processing skills. Imagine a child with FASD being able to start early intervention programs before even achieving major milestones, which could be key in reducing the impact of FASD in the long run.


How Could Mobile Tech Change FAS Documentation and Prevention Methods?

Mobile tech is quickly changing how society uses information. With respect to FASD documentation, a mother’s actions on mobile devices could be called into question when determining if she consumed alcohol while pregnant.

Some jurisdictions may not press charges against a mother whose baby suffers from FASD, assets the National Institute on Alcohol Abuse and Alcoholism’s (NIAAA) Alcohol Policy Information System. However, some states may classify FASD as an indicator of child abuse, neglect, harm, exposure to dangerous substances or worse. This may result in the removal of child custody or additional legal repercussions, including incarceration or the assessment of fines.

More importantly, mobile technology does not have to be the cause of a drinking mother’s downfall. Instead, it could be used to help at-risk mothers avoid situations or environments where alcohol consumption is likely. This may include behavioral-health apps, such as the CDC’s FASDs app, or sobriety-maintenance courses on smartphones. Ultimately, pregnant women could use these apps to help avoid the “public shaming” that often accompanies pregnant women with substance abuse issues.


The Big Picture

Diagnosing criteria for FASD has become more reliant on proof of alcohol consumption and physical malformations. This step will enable millions of children suspected with FAS to get access to treatment measures earlier, and it will help avoid misdiagnoses of other intellectual disabilities. But, the guidelines will place added pressure on expectant mothers to stay away from alcohol.

Ultimately, you need to be aware of pregnant women who may be reaching for help to stay sober during pregnancy, and you can help children with FASDs have a better chance at life by learning more about FASD signs, symptoms and diagnosing criteria.

Jason Vanover

Working in health care since 2005, Jason's body of experience encompasses dozens of care settings, including Senior care, psychiatric facilities, nonprofit health service centers, group homes for those with developmental disabilities and beyond. Jason understands the need to tailor his skills to each setting to encourage the best treatment outcomes and promote an inclusive, healing environment.

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