How to recognize fetal alcohol syndrome?

We have always heard that drinking during pregnancy is harmful to the baby, but little has been said about the possible consequences. Nowadays fetal alcohol syndrome it is a phenomenon which, fortunately, gains in visibility for a greater and earlier detection by the professionals, and for the families to feel better supported and guided in the education of their children reached of this disease.

    What is SAF?

    The so-called fetal alcohol syndrome, also known as FAS, was identified in 1973 by Kenneth Lyons Jones and David W. Smith. These researchers discovered a common pattern of facial features and extremities, cardiovascular defects associated with impairments in prenatal growth and developmental delays (Jones et al, 1973, p. 1267).

    Among the common traits found, but not always as we will see later, there is a characteristic appearance: low height, low weight, small head, poor coordination, low IQ, driving problems and deafness or visual impairment. The faces of these children have a slightly greater separation between the eyes than other children, and perhaps as a more characteristic feature, the nasolabial groove is smooth.

    How to identify fetal alcohol syndrome?

    The main reasons why parents consult Fetal Alcohol Syndrome are:

    • Learning problems and difficulty in school.
    • Speech and language delays.
    • Hyperactive behavior.
    • Attention and memory problems.
    • Difficulty controlling impulses, transgression of rules due to difficulty in learning the consequences.
    • Not feeling heard, it seems that they always have to tell them the same thing and always ignore it.

    Whenever alcohol is drunk, can the baby get FAS?

    Not all, but some chronically alcoholic women can have children who at birth have so-called fetal alcohol syndrome (FAS), the highest degree of involvement in the spectrum of alcohol spectrum disorders (ASD). It is a pathology present at birth consisting of a set of malformations in the development of the cerebral cortex. It can appear on brain scans as a normal brain image because sometimes they are subtle.

    Due to its difficulty in learning damage to the systems involved in the proper functioning of memory, these children have trouble learning and therefore, they may engage in disruptive or unlawful behavior that causes them to commit crimes, not through undue aggression, but through a lack of distinction between what is right or wrong, by engaging in inappropriate conduct and with the risk of being very influential by others. .

    These boys and girls also show a statistical tendency to engage in risky sexual activities and are more vulnerable to substance abuse.

    It is common for them to have difficulties with their studies, to be involved in problems with the police and even to spend time in boarding schools or juvenile centers, and can end up in jail and families in debt for pay a bond or fines.

    SAF type

    There are currently 4 classifications within the TEAF.

    1. PUR

    This category includes cases with or without a confirmed history of fetal alcohol exposure.

    2. Partial SAF fleet

    It occurs with or without a confirmed history of fetal alcohol exposure.

    4. Alcohol-related birth defects (ARBD)

    Presence of physical anomalies and other organic malformations related to alcohol require confirmation of prenatal alcohol exposure (By declaration of the mother or by laboratory analysis).

    5. Alcohol-related neurodevelopmental disorder (Arnd)

    There are no physical abnormalities or growth retardation. Requires confirmation of prenatal alcohol exposure (by mother’s statement or by laboratory analysis).

    Difficulty of diagnosis

    Many children who present with FAS are adopted children, Especially according to recent data from Russia and Ukraine. However, for non-adoptive parents there is a stigma and at the same time a certain prejudice on the part of the professional who has to ask the compromised question about alcohol consumption during pregnancy, speaking out to all from a classist syndrome typical of parents. of a disadvantaged or marginal social level.

    In recent years, the same adoption associations and government agencies have started providing information and training on the possibility that adopted children may have FAS, especially if they come from high-risk countries such as the so-called obtain psychological preparation from adoptive parents and that they can know that such a possibility exists.

    Most parents come to see us after a long pilgrimage and various diagnoses. Recently, things are improving because, in Barcelona, ​​the Vall d’Hebron and the Joan de Déu hospital are doing excellent research work where they have units of professionals specializing in the diagnosis and research of FAS.

    The common definition would be a difficult child, who has difficulty concentrating and maintaining his attention, often diagnosed with attention deficit disorder with or without hyperactivity, ADHD. However, the child with ADHD generally has more preserved, day-to-day care habits, greater social skills and more sustained care issues, while in TEAF there are more shared care issues.

    We can also find children who have been diagnosed with ASD, Autism spectrum disorder. However, unlike AME, children with FAS do not have echolalia, stereotypes, there is social desire and clearly express a wide range of emotions, although it is true that it is difficult for them. regulate, especially in intensity, and have difficulty in things pertaining to theory of mind. Described by psychologist and anthropologist Gregory Bateson, terror of the mind is defined as “the ability to reflect and understand one’s own feelings and those of others” usually acquired between the ages of 3 and 4 (Pou JI, 1998).

    And once we have the diagnosis?

    Common guidelines for families that have been shown to be most effective in their children’s behavior are as follows.

    • Consistency, with stable guidelines, clear routines, Concise and if possible with visual support.
    • The written rules, with visual support and with consequences also treated, immediate to the action that one wishes to reduce or increase.
    • Repeat, repeat and repeat. It is important to remember that they have serious learning problems due to memory impairment.
    • Affection and displays of affection.

    Author: Raquel Montero León. Psychologist for children and adolescents in ARA psychology.

    Bibliographical references:

    • Alonso Esteban, I. and Alcantud Marín, F. (2011). Fetal alcohol syndrome and fetal alcohol spectrum disorders: Level of knowledge and attitudes of health professionals Program III Cycle: Research in psychology.
    • Evrard, G. (2008). Brain development alterations in maternal-fetal alcoholism: role of the serotonergic system and astroglia. In: https://www.researchgate.net/publication/265965043_Alteraciones_del_desarrollo_cerebral_en_el_alcoholismo_materno-fetal_rol_del_sistema_serotoninergico_y_de_la_astroglia.
    • Landgraf MN, Nothacker M., Heinen F. (2017). Diagnosis of Fetal Alcohol Syndrome (FAS): German version of the guide 2013. Department of Neurology and Pediatric Developmental Medicine, Children’s Hospital Dr. von Hauner, Ludwig-Maximilians, University of Munich, Lindwurmstrasse 4, 80337 Munich, Germany .
    • Montoya Sales, K. (September 2011). Fetal alcohol syndrome. Med. Leg. Costa Rica. vol.28 n.2 Heredia. Extract of http://www.fundacionmencia.org/noticias/sindrome-alcoholico-fetal/.
    • Pou Municio, JI (1999) Apprentices and teachers. Madrid: Editorial alliance.
    • Svetlana Popova, PhD Shannon Lange, MPH Charlotte Probst, MSc Gerrit Gmel, MSc Prof Jürgen Rehm. (2017). Estimation of national, regional and global prevalence of alcohol use during pregnancy and fetal alcohol syndrome: systematic review and meta-analysis. Volume 5, NUMBER 3, Pe290-e299. PhD Open Access Published: DOI: https://doi.org/10.1016/S2214-109X (17) 30021-9.

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