Developmental assessment at 9 months of age can predict fetal alcohol syndrome

1. In this prospective cohort study, infants underwent developmental and dysmorphologic assessments at various times throughout early life. Researchers found that starting at 9 months of age, the total dysmorphology score was able to discriminate between children with and without a diagnosis of fetal alcohol spectrum disorders (FASD) at age 5.

2. Significant differences in developmental scores emerged between children with and without FASD between 18 and 42 months of age.

Evidence Rating Level: 2 (Good)

Study Rundown: Fetal alcohol spectrum disorders are the most common environmentally-induced category of intellectual disability in the world, and early identification and referral of at-risk children is crucial. Nonetheless, diagnosis of FASD is typically deferred until children are school-aged due to the challenges of evaluating phenotypes earlier in life. In this prospective cohort study, researchers used repeated longitudinal developmental and dysmorphology assessments of infants after birth at 6 weeks and 9, 18, 42, and 60 months of age and maternal interviews in order to identify infant features that predict a diagnosis of FASD at age 5. Starting at 9 months of age, the total dysmorphology score was able to discriminate between children with and without a diagnosis of FASD at age 5 to a significant degree. Several developmental differences became significant between 18 and 42 months of age.

The assessments were completed by expert dysmorphologists, of whom there are few, limiting the generalizability of the findings to resource-poor areas. Nonetheless, the study is strengthened by its prospective design and inclusion of both and unexposed children from the same community. For physicians, these findings highlight a promising tool to identify and aid in referring FASD at-risk infant at earlier ages than is currently possible.

Click to read the study, published today in Pediatrics

In-Depth [prospective cohort]: Researchers recruited pregnant women from primary health care clinics and hospitals in two communities in South Africa with a high prevalence of FASD. (Read more…)

Teachers, It’s Not His Attitude, It’s His FASD

“I don’t want to say it’s his attitude but….”

Here we were. Parents’ evening, Year 11. We’ve come so far in the many years of school. We’ve gone from parenting a young child whose needs we did not understand at the time, fighting back against those nursery teachers who thought he didn’t know any words and that first educational psychologist who told us he was ‘incapable of learning.’ We’ve made it through the initial diagnoses of ADHD (where the retiring teacher told us he was the first child she’d ever had with ADHD in her 30 years of teaching) and past the autism diagnosis that turned out to be incorrect (where one of the country’s leading children’s hospitals somehow missed the fact he has 100% of the facial features identified with Foetal Alcohol Syndrome). We finally got the FASD diagnosis that then took a while to sink in and to comprehend. After that, we started the phase of arriving at teachers’ meetings loaded with binders of information having highlighted relevant bits of his cognitive profile for anyone educating him (a task made harder once he hit secondary school with the multiple teachers and more fragmented home/school communication). There were superstars in his story but for the most part most teachers didn’t get it. Then we had the very welcome switch to a specialist school three years ago, with a whole new playing field that has changed so much for the better.

And yet, even here, at the last parents’ evening of his school experience before he heads to an inclusive learning programme at a sixth form college, here we were sitting across from a young teacher who simply was not listening, who had us pegged as parents who were making excuses for a teen who “knows what he needs to do” to get changed and ready for PE. She rattled on, convinced of her belief that he “just needs to join in and he’ll be fine.” (Read more…)

Doctoral Students Earn National Awards For Alcohol-Related Research

Two doctoral students in behavioral neuroscience have received prestigious NIH National Research Service Awards from the National Institute on Alcohol Abuse and Alcoholism (NIAAA).

The grant awards — each about $60,000 — will enable Siara Rouzer and Andrew Vore to support their dissertation research, fund travel, equipment and supplies, and take part in professional development.

“It’s a beautiful seal to your graduate-school career that a funding agency says: ‘You are producing good science,’” Rouzer said. “It’s not just your mentor or your department that has a clear interest, but an objective, external source.”

Rouzer, who received her undergraduate degrees in psychology and English from the University of Mary Washington in Fredericksburg, Va., arrived at Binghamton University in 2015 and began working with Marvin Diaz. The assistant professor of psychology’s Alcohol and Development Lab focuses on understanding neurobiological, physiological and behavioral adaptations that result from exposures to alcohol and stress during development.

Rouzer’s dissertation investigates how moderate, sub-intoxicating levels of alcohol exposure during pregnancy increase the expression of anxiety behaviors in offspring, especially sons.

“Can we demonstrate that there are negative consequences from women drinking, even in moderation, during pregnancy?” she said.

Some women drink while not yet knowing that they are pregnant, she added.

“Even that early, the child is actively undergoing development,” Rouzer said. “And alcohol is impacting them.”

Vore, who received his undergraduate degree in psychology from Indiana University-Purdue University Indianapolis, has worked with Psychology Professor Terrence Deak since arriving on campus in 2014. Deak’s Stress, Alcohol and Aging Lab aims to better understand the consequences of early-life stress and alcohol exposure.

Vore’s dissertation looks at the long-term consequences of adolescent alcohol consumption with a specific focus on binge patterns of drinking. He is examining whether individuals with a history of binge consumption display different “blood-brain barrier permeability.”

“The blood-brain barrier is one of the gatekeepers to the brain — and even relatively small changes in what can access the brain could have large consequences on general health,” he added. (Read more…)

Targeting specific signaling pathway could provide new avenue for treating fetal alcohol syndrome

Fetal alcohol spectrum disorders are an array of conditions that can occur in a person whose mother consumed alcohol during pregnancy. Fetal alcohol syndrome (FAS), the most severe of these conditions, often results in physical abnormalities, behavioral development issues and intellectual disabilities.

Researchers at the University of Kentucky College of Medicine have discovered that targeting a specific signaling pathway could potentially provide a new therapeutic avenue for treating FAS. (Read more…)

Dufferin County has a drinking problem

Wellington-Dufferin-Guelph Public Health launches awareness campaign.

Alcohol almost killed Julie Elsdon-Height. She went from being the life of the party to not knowing who she was or what she was doing.

“I knew that drunk Julie was too powerful,” she said, remembering one morning nearly a decade ago when she woke up and found a suicide note she had written in a blacked-out state the night before. “I needed help.”

Elsdon-Height is one of a countless number of Dufferin County residents who have struggled with drinking.

Wellington-Dufferin-Guelph Public Health has known about Dufferin County’s high rates of alcohol consumption for a number of years and now they’re trying to do something about it.

The department has launched a public awareness campaign called Last Call Dufferin showcasing a number of stories about how alcohol has affected the lives of people in the county.

“The rate of high-risk consumption in Dufferin County is higher than the provincial average, which is concerning,” said Dr. Matthew Tenenbaum, associate medical officer at Wellington-Dufferin-Guelph Public Health.

“We know that in the current environment, certain attitudes … the marketing of alcohol and the availability of alcohol, it seems it’s a very normal thing to drink,” said Tenenbaum. “That can lead to harms unfortunately.”

The campaign features Scott Davis, spokesperson for the Orangeville Police Service.

“The rippling effect of the use of alcohol can be very traumatic and devastating,” he said, explaining that residents do need to be concerned.

According to a 2015 report from the public health department, Dufferin County residents consumed more alcohol on average than the rest of the area, as well as the provincial average.

It also showed that nearly 60 per cent of Grade 10 students admitted to binge drinking.

Prolonged alcohol use, even in moderation, can cause diseases, addiction and cancers.

It can have damaging social effects, lead to highway safety issues and is responsible for 35 per cent of domestic violence cases in the region. (Read more…)

Re-post from Orangeville, November 13, 2019

Why Dr. Brian Goldman bought cigarettes for his underage son who has FASD

On Friday, Dr. Brian Goldman found himself making a difficult decision.

In the interest of harm reduction, he wrote on Twitter, “I bought my first pack of cigarettes. Not for me. For my son.”

Goldman’s son is 17, and he has fetal alcohol spectrum disorder (FASD).

The condition can make learning from past experiences tough, and hinders a person’s ability to make good long-term choices, said Goldman, the host of White Coat, Black Art and an emergency room physician in Toronto.

Goldman spoke with Metro Morning host Matt Galloway about what compelled him to buy those cigarettes for his son, and the challenges of raising a child with FASD.

Here is part of their conversation.

Why did you buy cigarettes for your son?

It’s complicated, for many reasons. My son, a couple years ago, was diagnosed with fetal alcohol spectrum disorder (FASD). We adopted both of our children from orphanages in Russia. It was a highly personal thing. There are many different kinds of harm reduction. I could have bought him a Juul. I could have bought him a vape. But I thought that it would be very easy to turn him into the equivalent of a three-pack-a-day smoker with the nicotine levels that you can acquire, and I didn’t want him to get used to that and comfortable with that, so that if he received vape liquid from other people he would graduate onto other things.

The thing about a cigarette is that you smoke them, there’s a finite amount of nicotine in it, and there’s only so much he can afford. There’s only so much that he’s going to be able to acquire on his own. So there is some limit there. I suppose if he became the equivalent of a pack-and-a-half or a pack-a-day smoker, I might consider switching him, you know, buying him a vape. There are other harms. As an average teenager with fetal alcohol spectrum disorder, he’s got the full range of issues that kids face. (Read more…)

Re-post from CBC Radio, by Kirsten Fenn, November 12, 2019

(in French) Alcoolisation foetale : l’implication polémique des alcooliers

L’association SAF France, qui lutte contre les troubles causés par l’alcoolisation fœtale, vient d’annoncer un partenariat avec les alcooliers pour diffuser ses messages de prévention. Cet accord hérisse certains médecins et associatifs, qui y voient un problème éthique majeur.

C’est une nouvelle qui fait grincer des dents. L’association Prévention et Modération, qui réunit des organisations professionnelles de la filière alcool (brasseurs de France, fédération des spiritueux, fédération des vins d’apéritif) vient de conclure un partenariat avec l’association SAF France pour contribuer à la sensibilisation des femmes aux Troubles Causés par l’Alcoolisation Fœtale (TCAF). SAF France regroupe des experts de ces troubles (familles, travailleurs sociaux , gynécologues obstéticiens, pédiatres…).

But affiché des alcooliers : amplifier la communication du message  “zéro alcool pendant la grossesse”, notamment à l’occasion des éditions du SAFTHON, l’opération de sensibilisation de l’association qui vise à récolter des fonds contre le TCAF.

Un soutien financier des alcooliers à SAF France

2.000 entreprises et 15.000 salariés de la bière, des spiritueux et des vins d’apéritif entendent ainsi contribuer à la prévention de ces troubles qui concerneraient 2% de la population. “Nous sommes partenaires avec SAF France, explique Alexis Capitant, porte-parole de Prévention et Modération. SAF France fait des choses très bien, mais manque de moyens. Dans les faits, nous leur versons une subvention pluriannuelle pour les aider à développer leurs actions, sans intervenir dans ces actions. Ce qui revient à faire du mécénat.”

Denis Lamblin, président de SAF France confirme la nature du lien entre son association et les alcooliers. “Nous avons reçu 250 000 euros pour 2019-2020, de la part de Prévention et Modération. Mais la convention qui nous lie est très claire et sans compromis. Leur seule demande, c’est que leur logo soit associé aux plaquettes et aux différents outils.”

Pour lui, les digues éthiques sont bien étanches. “Nous avons un comité scientifique indépendant et c’est nous qui dictons les messages de santé. Les experts font les propositions et les syndicats alcooliers leur donnent les moyens de les diffuser. Nous leur avons rappelé que ce n’était pas à eux de faire de la prévention, mais qu’ils pouvaient nous aider à en faire avec les gros moyens dont ils disposent.” (Lire plus…)

Republication de France Info, le 22 octobre 2019

Which Drug Is Actually The Most Harmful?

If someone asked you to bet on which drug is actually the most harmful, which one would you pick?

Fentanyl, a drug 50 to 100 times more potent than morphine – so powerful, even, that it can cause an overdose in a single breath? Or crack cocaine, with nasty side effects that include paranoia, organ failure, seizure, and death?

The correct answer is neither of the above. According to a paper recently published in the Journal of Psychopharmacology, the most harmful drug is alcohol.

A team of 25 experts came to this conclusion after scoring 22 drugs on 16 criteria, using a scale of 0 to 100. In this case, 0 represented “no harm” and 100 signified “most harm”. The analysis was based on a similar study conducted in the UK in 2010 but had been adapted for an Australian context.

As with the original study, nine criteria were based on harms to the drug user. Think: drug-specific mortality, dependence, drug-related impairment of mental functioning, and loss of relationships. While the remaining seven were based on harms to others. For example, injury, crime, economic cost, and community. The criteria were then weighted to produce a final score.

The analysis found that the drug most harmful to the individual was fentanyl, with a part score of 50 (out of 50). The runner-up was heroin (45), followed by alcohol (41), crystal meth (24), and tobacco, or cigarettes (14).

But when harm to others was factored in, the list changed. Alcohol came top (combined score 77), followed by crystal meth (66), heroin (58), fentanyl (51), and tobacco (32). Straddling the bottom was kava (combined score 3), e-cigs (3), LSD and mushrooms (5), antipsychotics (7), and ecstasy (7).

Interestingly, both UK and Australian studies found alcohol to be the most harmful drug. In this study, it scored especially high on the criteria of economic cost, family adversity, injury, drug-related morbidity, and drug-specific morbidity. (Read more…)

Re-post from IFL Science!, by Rosie McCall, May 15, 2019

Campbell: Hiring qualified disabled workers is good for business – and society

October is National Disability Employment Awareness Month. It’s the official month every year for celebrating and recognizing workplace contributions of people who have a disability and the business successes they help create. But it is significantly more than that.

It represents a critical opportunity for all businesses to examine their recruitment strategies and make improvements. Statistics show many companies are still missing out on a vast untapped pool of employees: skilled people who have a disability.

The time for sourcing the disability talent pool is now. In 2013, the Conference Board of Canada projected the labour shortage could be one million people by next year. And according to a 2014 Miner Management Consultants report, it could be almost two million by 2031.

Then why isn’t business sourcing the disability talent pool more? The national employment rate of people who have a disability is 59 per cent, compared to 80 per cent of people without a disability.

As a nation, we’re really good at making our education system accessible for students who have a disability. In Canada, 50 per cent of people who hold a university degree have more than one disability. So do 67 per cent of people with trade certificates or college diplomas. But to what end are we making our universities and colleges accessible? Because the post-graduation roadblocks are up.

“Why isn’t business sourcing the disability talent pool more? The national employment rate of people who have a disability is 59 per cent, compared to 80 per cent of people without a disability.”

There’s a lack of career support services within our post-secondary institutions for graduating students who have a disability. On top of this, the unemployment rate of university or college graduates who have a disability is twice that of their non-disabled counterparts. And even when they are hired, there’s a huge wage gap. A 2015 study by the University of Guelph noted that just two years after graduation, graduates who have a disability earn $4,000 less than non-disabled graduates. (Read more…)

Re-post from Ottawa Citizen, by Jeannette Campbell, October 7, 2019

(in French) De faux diagnostics pour obtenir des services

Des pédiatres se contraignent à poser de faux diagnostics pour que les enfants atteints du trouble du spectre de l’alcoolisation fœtale (TSAF) obtiennent un minimum de services au Québec.

Selon le plus récent avis public émis par la Direction nationale de la santé publique du Québec (2016), 4 % des naissances seraient affectées par le TSAF.

Pourtant, au Québec, selon tous les intervenants contactés par Le Journal, aucun service spécifique n’est offert aux personnes souffrant de ce trouble.

C’est l’absence d’un tel service qui convainc des professionnels de la santé de ne pas reconnaître le TSAF pour plutôt diagnostiquer un trouble du spectre de l’autisme (TSA) ou même un trouble de déficit de l’attention et hyperactivité.

Ce faisant, les enfants obtiennent davantage de services avec ces troubles qui peuvent s’apparenter au TSAF, par ses symptômes.

« Parfois, on va poser des diagnostics en fonction de l’aide dont le jeune a besoin. Pour obtenir des services d’accompagnement dans une école, par exemple, auxquels [les personnes atteintes du TSAF] n’auraient pas accès », a indiqué la pédiatre à l’Hôtel-Dieu de Lévis Valérie Labbé.

« Pas surprenant »

Le pédiatre au Centre Hospitalier Beauce-Etchemin, Pierre-C. Poulin, abonde dans le même sens.

« Ce n’est pas surprenant. Le diagnostic de trouble de l’autisme permet d’obtenir plusieurs services, comme l’intervention intensive avec un éducateur. Sans compter l’aide substantielle obtenue à l’école. »

De plus, comme les traits faciaux caractéristiques du TSAF ne sont présents que dans 20 % des cas, son dépistage est loin d’être aisé au Québec. Sans parler de l’absence de clinique spécialisée dans ce domaine dans la province.

« Il y en a pourtant 46 dans le reste du Canada », a déploré Louise Loubier-Morin, mère adoptive d’une femme atteinte du TSAF et directrice du SAFERA, un organisme de prévention du syndrome de l’alcoolisation fœtale.

« Ça fait 20 ans qu’on essaie de rentrer au ministère de la Santé et des Services sociaux pour leur demander de se pencher sur la question, et il n’y a rien qui se fait. » (Lire plus…)

Republication d’Actualité Santé, par Jérémy Bernier, le 21 octobre 2019