There are different characteristics that accompany FAS in the
different stages of a child’s life. “At birth, infants with intrauterine
exposure to alcohol frequently have low birth rate; pre-term delivery; a
small head circumference; and the characteri stic facial features of the
eyes, nose, and mouth” (Phelps, 1995, p. 204). Some of the facial
abnormalities that are common of children with FAS are: microcephaly,
small eye openings, broad nasal bridge, flattened mid-faces, thin upper
lip, skin folds at
the corners of the eyes, indistinct groove on the upper lip, and an
abnormal smallness of the lower jaw (Wekselman, Spiering, Hetteberg,
Kenner, & Flandermeyer, 1995; Phelps, 1995). These infants also display
developmental delays, psychomotor retardatio n, and cognitive deficits.
As a child with FAS progresses into preschool physical, cognitive
and behavioral abnormalities are more noticeable. These children are not
the average weight and height compared to the children at the same age
level. Cognitive manifestations is another problem with children who have
FAS. “Studies have found that preschoolers with FAS generally score in
the mentally handicapped to dull normal range of intelligence” (Phelps,
1995, p. 205). Children with FAS usually h ave language delay problems
during their preschool years. Research has also shown that these children
exhibit poorly articulated language, delayed use of sentences or more
complex grammatical units, and inadequate comprehension (Phelps, 1995).
There are many behavioral characteristics that are common among children
with FAS. The most common characteristic is hyperactivity (Phelps, 1995).
“Hyperactivity is found in 85% of FAS-affected children regardless of IQ”
(Wekeselman et al., 1995, p. 299 ). School failure, behavior management
difficulties, and safety issues are some of the problems associated with
hyperactivity and attention deficit disorder. Another behavioral
abnormality of with children with FAS, is social problems. “Specific
diffic ulties included inability to respect personal boundaries,
inappropriately affectionate, demanding of attention, bragging, stubborn,
poor peer relations, and overly tactile in social interactions” (Phelps,
1995, p. 206). Children are sometimes not diagnosed with FAS until they
reach kindergarten and are in a real school setting. School-aged children
with FAS still have most of the same physical and mental problems that
were diagnosed when they were younger. The craniofa cial malformations is
one of the only physical characteristic that diminishes during late
childhood (Phelps, 1995).
“Several studies have evaluated specific areas of cognitive
dysfunction in school-age children exposed prenatally to alcohol.
Researchers have substantiated: (a) short term memory deficits in verbal
and visual material; (b) inadequate processing of inf ormation, reflected
b sparse integration of information and poor quality of responses; (c)
inflexible approaches to problem solving; and (d) difficulties in
mathematical computations” (Phelps, 1995 p. 206).
The behavioral manifestations of a child with FAS during the early
years of life are still apparent in children who are in grade school.
Hyperactivity is still the most common characteristic portrayed by these
children. Some of the descriptions used to
explain these school-aged children’s behaviors include: distractible,
impulsive, inattentive, uncooperative, poorly organized, and little
persistence toward task completion (Phelps, 1995).
As a child reaches puberty and develops into an adult, some of the
physical, mental and behavioral characteristics change. These adolescents
begin to gain weight, but still remain short and microphalic (Phelps,
1995).
Cognitive abilities of children with FAS continue to be low
through adolescence and adulthood. Low Academic performance scores of
adolescents and adults are persistent throughout their lives. Many
cognitive tests have been done on adolescent/adults wi th FAS, and each of
them have found deficiencies in mathematics and reading comprehension
(Shelton & Cook, 1993).
The behavioral manifestations of adolescents and adults with FAS
continue to concentrate around the problem of hyperactivity.
Inattentiveness, distractibility, restlessness , and agitation are the
main behaviors stem from hyperactivity. “Vineland Adap tive Behavior
Scales results suggest that communication and socialization skills average
around the seven year old range”(Phelps, 1995, p. 207).
The prevalence of children with FAS is on the rise. More than
ever, children are being diagnosed with FAS. Better techniques and
knowledge by physicians are accountable for the increase. Physicians are
diagnosing more babies today with FAS, because th ey have more knowledge
and resources to evaluate the children at risk. FAS has no racial
barriers and has been reported by variable ages from neonatal to young
adult (Becker, Warr-Leeper, & Leeper, 1990). Estimates in the United
States of people with FA S vary from 2 live births per 1,000 to 1 per 750
(Shelton & Cook, 1993). “In a medical review of 5602 women, six instances
of FAS were identified among 38 children of alcohol abusing women.
Although 22 of the 38 were traced at follow-up, the outcome fo r the 6 FAS
cases per se was not specified. Nevertheless, 18 of 22 children of the
alcohol-abusing women were found to be in state hospitals” (Emhart,
Greene, Sokol, Martier, Boyd, & Ager, 1995, p.1550). For a doctor to
identify a child as having FAS, he/she must have the proper education. A
test to see if a child has a central nervous system dysfunction or growth
deficiency is not enough for a reliable diagnosis. An accurate diagnosis
would also involve a facial phenotype study (Astley & Clarren, 1 995).
The Southwestern Native Americans have the highest incidence of FAS in the
United States (Shelton & Cook, 1993). “Native Americans are three times
as likely as Caucasians to produce FAS children” (Shelton & Cook, 1993, p.
45). Tribes that have a loose social organization reflect a higher rate
of FAS compared to a structured organization because the structured
organization views a alcoholic female in the tribe as socially
unacceptable (Shelton & Cook, 1993). More cases of FAS are being
diagnosed , but there is many children who slip through the cracks and do
not receive the support that is needed.
There are few interventions and programs to help children that are
affected by FAS. “Most states fail to identify FAS program coordinators,
it is difficult to ascertain respective program parameters” (Shelton &
Cook, 1993, p. 45). Many children with FAS are living with an alcoholic
parent. Children of alcoholics are at greater risk for developing social
and emotional problems that need intervention options so they do not
follow in their parents footsteps and become alcoholics (Wekselman et al.,
199 5). “Even though public schools are attempting to work with FAS, the
bottom line is that more research needs to be done on treating FAS”
(Shelton & Cook, 1993, p.46).
Educators and administration personnel working in the school
system should be knowledgeable about FAS and the different age
characteristics, degrees of incidences , and interventions that are
available to their students. All children with FAS are at ri sk for
failure in school and in every day life. With proper diagnosis and
treatment that is available, some of these failures will be avoided.
The main element that is causing FAS is addiction. Children with
FAS did not have the choice of saying no and have to live with their
mothers decision to drink every day of their lives. Something needs to be
done with mothers who have babies that are ad dicted at birth. Laws and
other regulations will probably not solve the problem, but make it more
complex. A mother shouldn’t have a child if she has an addiction problem.
Woman should be able to receive free abortions if they are addicts and
don’t wan t to quit drinking during their pregnancy. A child should never
be born with fetal alcohol syndrome.
References
Astley, S. J., & Clarren, S. K. (1995). A fetal alcohol syndrome screening tool. Alcoholism: Clinical and Experimental Reearch. 19, 1565-1571.
Becker, M., Warr-Leeper, G. A., Leeper, H. A. (1990). Fetal alcohol syndrome: a description of oral motor, articulatory, short-term memory, grammatical, and semantic abilities. Journal of Communication Disorders. 23, 97-124.
Ernhart, C. B., Greene, T., Sokol, R. J., Martier, S., Boyed, T. A., Ager, J. (1995). Neonatal diagnosis of fetal alcohol syndrome: not necessarily a hopeless prognosis. Alcoholism: Clinical and Experimental Research. 19, 1550-1557.
Phelps, L. (1995). Psychoeducational outcomes of fetal alcohol syndrome. School Psychology Review. 24, 200-211.
Shelton, M., Cook, M. (1993). Fetal alcohol syndrome: facts and prevention. Preventing School Failure. 37, 44-46.
Wekselman, K., Spiering, K., Hetteberg, C., Kenner, C., Flandermeyer, A. (1995). Fetal alcohol syndrome from infancy through childhood: a review of the literature. Journal of Pediatric Nursing. 10, 296-303.
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