Controversies in Maternal Substance Use in Pregnancy and its Impact on the Child

What we need to know but are afraid to talk about!

Although it has been more than 40 years since the modern recognition of the ill effects that alcohol and drug use during pregnancy can have on pregnancy, the developing fetus, and the child long term, there still is a great deal of controversy surrounding some aspects of the science and the associated clinical practice.  In this webinar series designed specifically for families and professionals in Israel, NTI Upstream is turning away from expectations and focusing on topics that no one really likes to talk about because of the controversy they engender. These webinars will be an opportunity to explore the science that supports each side of a specific research quandary and explore both sides of the question as they impact practical applications to practice.  Rather than relying on only the presenter, the webinars will be presented in an interactive way that brings all participants into the discussion. Ultimately, we hope to raise as many questions as answers, stimulating participants’ willingness to look at things in a different way. Scientific inquiry is based in curiosity Join us, as we share our curiosity and learn together!

1. FASD Diagnostic Dilemma: How do you diagnose within the Fetal Alcohol Spectrum?

Multiple diagnostic systems and the alphabet soup that is used to label children affected by prenatal alcohol exposure make it difficult to decide where a child belongs in the spectrum and, most importantly, to communicate this to others. When looking through the scientific literature, you find that many articles fail to clearly define what exact group within the fetal alcohol spectrum they are investigating.  Key questions:  What are the competing systems and how do they affect access to clinical services? Is there any agreement between the competing diagnostic systems?  Does the diagnosis affect potential for insurance or Medicaid coverage? Do diagnostic criteria vary between countries? How do we ensure that we communicate clinical findings clearly and correctly?  The original term for FASD is plural; i.e., Fetal Alcohol Spectrum Disorders.  However, it has now morphed to common usage in the singular: Fetal Alcohol Spectrum Disorder.  Does this matter?

2. Co-occurring vs. multi-occurring mental health disorders in FASD

There is a big difference between co-occurring mental health disorders, which are etiologically related to a specific syndrome, and multi-occurring mental health disorders, which occur alongside the primary syndrome. The implications for prevention are embedded in this difference and affect our attitudes toward intervention for this population of children and youth affected by prenatal alcohol exposure.  Key questions:  What is the difference between co-occurring and multi-occurring mental health disorders?  Through considering this difference, can you differentiate the biological impact of prenatal alcohol exposure from environmental factors that affect long term mental health outcome?  Is early intervention a form of prevention? What can research tell us about the role the child welfare system plays in the balance between nature and nurture?

3. Providing appropriate levels of treatment to children and youth affected by prenatal alcohol exposure

There are emerging treatment strategies that have been shown to positively enhance outcome for children and youth with FASD.  In fact, a recent study documents changes in brain functioning in children treated with approaches that emphasize self-regulation. But, the great majority of children diagnosed within the fetal alcohol spectrum are not receiving appropriate interventions or treatment.  Key questions: How do we decide what level of treatment and what type of treatment is needed for a specific child affected by prenatal alcohol exposure?  When do we rely on public systems of care, such as school-based intervention, and when do we turn to individual child and family interventions?  How do we narrow down a differential diagnosis, and are there guidelines as to when medication should be used?

Webinar available for download as part of package:

    Adolescents with FASD