Fetal Alcohol Syndrome

Alcohol plays a major role in our society. There are alcohol advertisements everywhere whether its commercials or billboards. Alcohol plays a role in our holidays and even in our social lives. Alcohol is consumed for many purposes, for example: celebrations, to increase romance, out of boredom, or just a way to relax. Alcohol is a drug that is depended upon by the majority of our society. Nevertheless, alcohol has very damaging effects in our body. It can cause harmful diseases such as alcoholism or cirrhosis of the liver but the most serious harm caused by alcohol is the harm that it can cause to the fetus. Many women drink alcohol purposely even though they know that they are pregnant. On the other hand, women also drink when they do not realize they are pregnant yet. Alcohol can cause disorders such as Fetal Alcohol Spectrum Disorder. FASD is define as "a set of congenital psychological, behavior and physical abnormalities that tend to appear in infants whose mothers consumed alcohol during pregnancy. It is characterized by typical craniofacial, and limb defects, cardiovascular defects, intrauterine growth retardation and retarded development." (Anderson, Keith, & Novak, 2002). This paper will review two articles by authors who explored about the characteristic of the issue regarding children with FASD. Franklin, Deitz, Jirikowic and Astley (2008) "describe the sensory-processing and behavior profiles of a clinic-referred sample of children with fetal alcohol spectrum disorders (FASD) and examine the relationship between sensory processing and behavior." While Olswang, Svensson, and Astley (2010) "examined how social communication profiles during classroom activities differed between children with fetal alcohol spectrum disorders (FASD) and typically developing pair-matched peers."

The article that Franklin et al (2008) there where two questions that the they were analyzing. First was to explain the sensory-processing characteristics and problem behaviors of children who have FASD from ages 5 through 10 years old. The second was to explore the relationship between sensory-processing deficits and problem behaviors in children with FASD by testing several hypotheses. There are four hypotheses that the authors listed that they investigated. They are:

1) A significant negative connection will exist between the CBCL total score (high scores document impaired outcome) and the SSP total score (low scores document impaired outcome).

2) Children with FASD in the SSP definite or probable group will score significantly different from children with FASD in the SSP typical group on the CBCL in the following areas: two of the syndrome scales (attention problems and social problems), the total problems score, and the externalizing problem score.

3) Children with FASD in the CBCL clinical or borderline group will score significantly different than children with FASD in the CBCL normal group on the SSP total score and five of the seven section scores (i.e. tactile sensitivity, movement sensitivity, under responsive/seeks sensation, auditory filtering, and visual/auditory sensitivity).

4) Children with FASD who have scores that fall within the categories of definite or probable differences on the SSP will be more likely to demonstrate borderline or clinical ranges on the CBCL than children who demonstrate SSP scores within the typical performance category.

The methods that Franklin et al (2008) used to analyze the topic was to study the outcomes of 44 children, from ages 5-10years and compare the Short Sensory Profile (SSP) and Child Behavior using retrospective data analysis. They restricted the population range of children included in the study to those that have been diagnosed since 2000. The other method used in this study was to collect data from all children in the FAS DPN database who met the following additional criteria, which are listed below:

a) Male or female of any race or ethnicity

b) 5 through 10 years of age at the time of diagnosis

c) Having one of the FASD diagnoses using the 2004 FASD 4-Digit Diagnostic Code (FAS, partial FAS, static encephalopathy-alcohol exposed, or neurobehavioral disorder-alcohol exposed)

d) Having complete data available in the database for the SSP (sensory-processing behavior) and the CBCL (child behavior checklist).

Sensory-processing behaviours were measured using the SSP (short sensory profile). The SSP is a 38-item questionnaire for the caregiver that serves as a tool for identifying a child's sensory-processing behaviours. It links these behaviours with the child's functional performance in their activity of daily living. The SSP, a shorter version of the Sensory Profile, was developed as a screening tool to identify children with sensory difficulties more quickly and for use as a sensory-processing measure for research purposes. A 5-point Likert scale ranging from always to never was used to record caregiver responses. Low raw scores reflect sensory-processing problems. Moreover, the SSP includes a classification system made up of three categories (normal, probable difference, and definite difference). The Achenbach CBCL (child behaviour checklist). Functional behaviours were measured using the CBCL (Achenbach, 1991) for ages 4 to 18 years and the Achenbach System of Empirically Based Assessment CBCL for ages 6 to 18 years (Achenbach & Rescorla, 2001). These are standardized tools used to assess behavioural and emotional problems that have occurred during the past 6 months.

There were several errors in this study that should be considered. First, the study sample was drawn from a clinical population of people referred for diagnostic evaluation. Therefore, participants do not necessarily represent all people with FASD. Second, the sample was small, limiting power in some of the analyses, and the possibility of error is increased for analyses involving multiple comparisons. Third, the Short Sensory Profile (SSP) and Child Behavior Checklist (CBCL) are standardized measures based on caregiver report. Outcomes can vary depending on which caregiver completes the report.

The diagnostic classifications of these 44 children covered the full range under the umbrella of FASD. Eighteen children reportedly had associated mental health or psychiatric diagnoses, including oppositional defiant disorder (n = 6), posttraumatic stress disorder (n = 5), adjustment disorder (n = 4), conduct disorder (n = 2), and bipolar disorder (n = 1). In addition, 23 children were reported to have a diagnosis of attention deficit disorder (ADD) or attention deficit/hyperactivity disorder (ADHD). Analyses confirmed that the 44 children included in the study population were a representative subset of all 205 children (5?C10