Nursing Interventions to Prevent Secondary Disabilities in FASD
Fetal alcohol spectrum disorder (FASD), an umbrella term used to describe the constellation of effects that occur because of prenatal alcohol exposure, is a serious and widespread problem. First described in 1973 as fetal alcohol syndrome (FAS), a great deal is now known about prenatal alcohol exposure and its prevalence. Children with FAS represent only a portion of children exposed prenatally to alcohol. Research has documented a spectrum of effects of prenatal alcohol exposure, and multiple terms have been developed to cover the different effects. Recently, governmental and advocacy organizations in the United States and Canada developed a consensus definition to cover the multiple terms previously used including fetal alcohol syndrome (FAS), alcohol related neurodevelopmental disabilities (ARND), fetal alcohol effects (FAE), alcohol related birth defects (ARBD), and partial fetal alcohol syndrome (PFAS). The Consensus Statement is as follows:
Fetal alcohol spectrum disorder (FASD) is an umbrella term describing the range of effects that can occur in an individual whose mother drank alcohol during pregnancy. These effects may include physical, mental, behavioral, and/or learning disabilities with possible lifelong implications. The term FASD is not intended for use as a clinical diagnosis (Bertrand et al., 2004, p. iv).
Guidelines (Bertrand et al., 2004) giving specific criteria for referral and diagnosis of FAS versus other problems due to prenatal alcohol exposure can be found at the Centers for Disease Control and Prevention (CDC) Web site: www.cdc.gov/ncbddd/fas/faspub.htm.
FASD is the leading known preventable cause of mental retardation in western civilization and one common reason a child's development and learning is affected. The need to address the prevention of secondary disabilities caused by prenatal alcohol exposure has become a national priority (CDC, 2002). Secondary disabilities are those not present at birth but that occur because of the primary disability. Research has demonstrated that secondary disabilities associated with FASD can be prevented or lessened by a better understanding and appropriate interventions (Streissguth, Barr, Kogan, & Bookstein, 1996).
Nurses encounter children and families throughout all parts of their lifespan who are at risk for or who have FASD, and nursing interventions are key to the prevention and treatment of this problem. Secondary and tertiary nursing interventions have proven to prevent secondary disabilities and enhance outcomes for high-risk children in multiple research studies (see Alexander, Younger, Cohen, & Crawford, 1988; Brooten et al., 1988; Brooten et al., 1986; Brooten et al., 1994; Lipman, 1988; Melnyk et al., 2001; Olds, Henderson, Chamberlin, & Tatelbaum, 1986; Weisman, 1992). While many of the interventions in these studies apply to children and families with FASD, we only included those strategies specifically aimed at children and families with FASD in this review.
Fetal alcohol spectrum disorder (FASD), an umbrella term used to describe the constellation of effects that occur because of prenatal alcohol exposure, is a serious and widespread problem. First described in 1973 as fetal alcohol syndrome (FAS), a great deal is now known about prenatal alcohol exposure and its prevalence. Children with FAS represent only a portion of children exposed prenatally to alcohol. Research has documented a spectrum of effects of prenatal alcohol exposure, and multiple terms have been developed to cover the different effects. Recently, governmental and advocacy organizations in the United States and Canada developed a consensus definition to cover the multiple terms previously used including fetal alcohol syndrome (FAS), alcohol related neurodevelopmental disabilities (ARND), fetal alcohol effects (FAE), alcohol related birth defects (ARBD), and partial fetal alcohol syndrome (PFAS). The Consensus Statement is as follows:
Fetal alcohol spectrum disorder (FASD) is an umbrella term describing the range of effects that can occur in an individual whose mother drank alcohol during pregnancy. These effects may include physical, mental, behavioral, and/or learning disabilities with possible lifelong implications. The term FASD is not intended for use as a clinical diagnosis (Bertrand et al., 2004, p. iv).
Guidelines (Bertrand et al., 2004) giving specific criteria for referral and diagnosis of FAS versus other problems due to prenatal alcohol exposure can be found at the Centers for Disease Control and Prevention (CDC) Web site: www.cdc.gov/ncbddd/fas/faspub.htm.
FASD is the leading known preventable cause of mental retardation in western civilization and one common reason a child's development and learning is affected. The need to address the prevention of secondary disabilities caused by prenatal alcohol exposure has become a national priority (CDC, 2002). Secondary disabilities are those not present at birth but that occur because of the primary disability. Research has demonstrated that secondary disabilities associated with FASD can be prevented or lessened by a better understanding and appropriate interventions (Streissguth, Barr, Kogan, & Bookstein, 1996).
Nurses encounter children and families throughout all parts of their lifespan who are at risk for or who have FASD, and nursing interventions are key to the prevention and treatment of this problem. Secondary and tertiary nursing interventions have proven to prevent secondary disabilities and enhance outcomes for high-risk children in multiple research studies (see Alexander, Younger, Cohen, & Crawford, 1988; Brooten et al., 1988; Brooten et al., 1986; Brooten et al., 1994; Lipman, 1988; Melnyk et al., 2001; Olds, Henderson, Chamberlin, & Tatelbaum, 1986; Weisman, 1992). While many of the interventions in these studies apply to children and families with FASD, we only included those strategies specifically aimed at children and families with FASD in this review.
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