Unveiling Fetal Alcohol Spectrum Disorders in Mental Health
Channel: Doc Snipes
Date: 2017-03-29

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Unveiling Fetal Alcohol Spectrum Disorders in Mental Health

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00:00 Introduction to Fetal Alcohol Spectrum Disorders (FASD) in mental health settings
02:00 Understanding the impact of FASD in mental health and criminal justice systems
05:00 Prevalence of FASD in child welfare and general populations
08:00 Challenges faced by individuals with FASD in daily life and treatment
11:00 Cognitive and behavioral impairments linked to FASD
14:00 Issues with following program rules and remembering instructions
17:00 Impact of FASD on social and emotional development
21:00 Suicide prevention and intervention strategies for individuals with FASD
25:00 Strategies for reducing risks and improving stability for FASD clients
30:00 Addressing depression and impulsivity in FASD populations
33:00 Challenges in treatment programs and addressing misunderstandings
37:00 Role of caregivers and collateral supports in treatment
41:00 Techniques for improving decision-making and memory in FASD clients
44:00 Specific challenges in adolescence and adulthood for those with FASD
48:00 Identifying and supporting social and emotional needs of FASD clients
52:00 Long-term treatment goals and ensuring appropriate aftercare
56:00 Clinician strategies for building rapport and understanding with FASD clients
60:00 Conclusion and summary of key strategies for managing FASD in mental health settings

What is FASD
~    FASD is not a diagnostic term, but is an umbrella term encompassing four categorical diagnostic entities:
~    Fetal alcohol syndrome (FAS)
~    Partial FAS
~    Alcohol-related neurodevelopmental disorder
~    Alcohol-related birth defects
Impact of Functional Impairment
~    Problems in multiple domains interferes with treatment success, including inability to:
~    Remember program rules or follow multiple instructions.
~    Remember and keep appointments, or to get lost on the way there.
~    Independently make appropriate decisions about treatment needs/goals.
~    Appropriately interpret social cues
~    Observe appropriate boundaries, either with staff or other clients.
~    Attend to (and not disrupt) group activities.
~    Process information readily or accurately.
~    ‘Act one's age.’
~    When indicators occur in any these domains (and particularly when they occur across multiple domains), it is worthwhile to apply the FASD 4-Digit Code Caregiver Interview Checklist (Astley, 2004b)
Special Considerations for Adolescents
~    Evidence shows that adolescents will commonly exhibit learning and behavior challenges, especially in
~    Adaptive function/getting along from day to day
~    Remaining organized and regulated
~    Learning information slowly (especially what is said to them)
~    Tending to forget things they have recently learned
~    Making the same mistakes over and over.
~    Impulsivity/finding it hard to inhibit responses
~    Social communication (leaving out important details/being vague).
~    Suggestibility (and therefore easily influenced by others)
~    Immature social skills. (too friendly/trusting,/difficulty recognizing dangerous situations.
Differential Dx
~    There is some evidence for distinguishing between children with FASD and children with ADHD. Using the four-factor model of attention it has been shown that:
~    children with FASD have difficulties with encoding (taking in and processing information) and shift (shifting attention (hyperfocus))
~    children with ADHD have problems with focus and sustain.  (Using Mirsky (1989) 4 factor model of attention)
~    Distinguishing between attention-deficit hyperactivity and fetal alcohol spectrum disorders in children: clinical guidelines Neuropsychiatr Dis Treat. 2010; 6: 509–515.

Modifying Treatment (Making it Safe)
~    Even with compensatory strategies, the person with an FASD may Be less able to use judgment, consider consequences, or understand abstract situations...
Treatment Modificaitons cont…
~    Do not use metaphors or similes.
~    Do not use idiomatic expressions and proverbs.
~    “A day late and a dollar short.”
~    “People in glass houses shouldn't throw stones.”
~    Don't use sarcasm, and be careful about joking with the person.