Foetal Alcohol Spectrum Disorder — House of Commons, 2019-01-17
Topic: Health
William Roffen Esterson (Labour, Centre-left): It is a shame that the Children’s Minister, the hon. Member for Stratford-on-Avon (Nadhim Zahawi), could not stay for the debate, because I think that it follows on very naturally from the last one "Babies being born brain-damaged by alcohol is a national emergency". So ran the title of a piece in today’s edition of The Times about this debate. It is justified by a recent study conducted by Bristol University, which suggests that some 79% of women say that they drank alcohol while pregnant, and that between 6% and 17% of the 14,000 or so children covered by the study have foetal alcohol spectrum disorders. Scaled up—and this is why the term "national emergency" is not misplaced—that gives a figure of between 42,000 and 120,000 children a year So what is foetal alcohol spectrum disorder? It is an umbrella term for a range of effects that prenatal alcohol exposure can have on an individual. FASD is the commonest non-genetic cause of learning disability in the United Kingdom, yet it is entirely preventable. It lasts a lifetime: this is not just about babies. What does it look like? People often think that they understand the syndrome. They say to me, "Yeah, we know about that. It is a really bad problem when women have drunk heavily during pregnancy." It is true that there are often facial and physical features characteristic of children with FASD, but, relatively speaking, that applies to a very small proportion of the wider spectrum The impact on the brain, although usually not immediately obvious from the outside, affects language, memory, attention, processing and understanding, and creates emotional, behavioural and learning difficulties. Children often struggle with complex concepts such as time, metaphor or consequences. Rewards and sanctions mean very little to children with this kind of brain damage, and consequences do not mean very much either A constituent of mine adopted two children. One of them, who is 16, had no idea of the consequences of his actions, and got into trouble. He has no idea that he has done anything wrong—the idea is meaningless to him—but because of a wider lack of understanding, including a lack of understanding in our criminal justice system, he very nearly went to prison. He was spared that, more by luck than by judgment. His victims did not understand—for good reason: why would they—and I think that there was very little understanding in the system A 17-year-old who gave evidence to the all-party parliamentary group on foetal alcohol spectrum disorders, which I chair, described the effect on her emotions. When she gets angry, she has no control whatsoever. I know that is true of many people, but controlling anger can be harder for those with this kind of brain damage. She described to our all-party group how she sees herself from the outside, as somebody else almost; it is a sort of out-of-body experience, and she has no control over it. I have heard that repeated by a number of children and young people affected by FASD, including my own adopted daughter; I have two adopted children, both of whom are affected by this, which is why I have become aware of it and taken so much interest in it. There are implications for society as well as individuals, because this disorder does not go away when children become adults. In Canada, they have estimated that half of their prison population has FASD; I wonder whether the situation is very different here. FASD affects people’s ability to get qualifications, and I wonder how many of those who are sleeping rough or are otherwise homeless have FASD. Returning to the point I made about not understanding time or consequences, I wonder how many people who are sanctioned for not attending appointments with the Department for Work and Pensions have FASD. There is likely also to be a strong link between FASD and having difficulties with holding down a job or maintaining a stable relationship In the United States, a study last year estimated an annual personal cost of $24,000, before considering the cost to the criminal justice system. That is a relatively small element of the cost for some of the people with FASD in the United States. For years in the United States they have described people with FASD as million-dollar babies, often multi-million dollar babies, because of the long-term societal costs as well as that to the individual We have just had a very good debate on children’s social care, and I wish I had been able to take part instead of just listening to it. Population evidence to the all-party group suggested—this is a relatively low estimate —that at least a quarter of the children in the care system are affected by FASD. I have heard other adopters and people who run adoption agencies describing adoption as a family-finding service for children with FASD, because it is so common among the adopted children population. May I add to the tribute paid in the last debate to adopters, foster carers and all professionals who do what they can to support the children, young people and, indeed, adults who continue to face the challenges of FASD What am I asking for? I am asking for action on prevention and diagnosis, and action to cut the numbers, and for a sea change in our approach and our building of awareness among the population, including and especially among health professionals.