TACT – the UK’s largest fostering and adoption charity, welcomes the findings of a recent study which shows that Foetal Alcohol Spectrum Disease (FASD) has a potentially very high prevalence in the UK. FASD is an umbrella term describing the range of effects that can occur in an individual whose mother drank alcohol during pregnancy. TACT has long expressed the concern that FASD is a more wide spread condition than has been acknowledged until now, especially in looked after children, with little awareness or training given to professionals.
The study by the University of Bristol, the first UK research into the predominance of FASD, was conducted by screening data of 13,495 children from the Bristol area who were born between 1991 and 1992. It has concluded that up to 17% of the children in the sample screened positive for symptoms of the disease. The study also found that based on maternal reporting of drinking in pregnancy, up to 79% of children in the sample were exposed to alcohol in pregnancy.
The researchers point out that ‘FASD is potentially a common problem in the UK that is under ascertained. Active case ascertainment studies of FASD are urgently needed to clarify the current epidemiology of FASD in the general population of the UK’.
Alcohol-related neurodevelopmental disorder (ARND) was found to be the most common FASD subtype in the study, ARND is very hard to diagnose, with children affected by it looking ‘normal’ but their thinking, behaviour and emotions may all be impacted upon by the alcohol. Unless this is picked up early, their actions – coupled with an outwardly ‘normal’ appearance, lead people to think that they are just simply ‘naughty’, or alternatively, that they are the result of poor parenting.
In the foster care sector, much attention is given to what a child may have experienced or witnessed since birth, which will obviously impact upon their behaviour. However, many children coming into care do so as a result of parents misusing substances such as alcohol, and so the numbers of foetally affected children in the care system is undoubtedly much higher than in the rest of the population.
TACT asserts that the consequence of children going into permanent foster placements with either a “missed diagnosis” or a “mis-diagnosis” could be dramatic and only with an increased awareness of FASD through training could social workers ensure that these issues were addressed.
What can be a problem for foster carers is that children are not automatically screened for FASD’s and often the information as to whether their mother drank during pregnancy is not available. Every child’s experience of mother’s alcohol use during pregnancy will be unique. Many foetally affected children will have limited ability to self-regulate their emotions and actions, and this inevitably leads to potential explanations and implementation of interventions which may not work and that may create extra frustration for both carer and child.
It is vital that social workers explore whether birth mum drank during pregnancy. If she did – as is very likely – then this might be a more plausible explanation for any behavioural or emotional issues the child presents. But it’s not just social care professionals who should increase their awareness and knowledge about FASD prevention, diagnosis and support. All professionals who are part of multi-disciplinary teams around the child – carers, teachers, GP’s and even health professionals involved in the prenatal stage, such as mid-wives and health-visitors, should be provided with the appropriate training that would equip them to assess and support families where there is a risk that a child might be affected by a FASD.