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Teratogen: a substance capable of interfering with fetal development
Teratology: the biological study of birth defects
Toxicology: the science of dealing with the effects and detection of poisons
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Foolish, drunken, or harebrain women most often bring forth children like unto themselves Aristotle in Problemata
Behold, thou shalt conceive and bear a son: And now, drink no wine or strong drink.
Judges 13:7
Rosett, 1984
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Fetal alcohol syndrome
• Term first used in 1973 by Drs. Smith and Jones
• A medical diagnosis (760.71) in the International Classification of Diseases (ICD)
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http://www.aafp.org/afp/20050715/279.html
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Fetal alcohol syndrome
Fetal alcohol effects Clinical suspect but
appear normal Normal, but never
reach their potential
Adapted from Streissguth
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Umbrella term describing the range of effects that can occur in an individual whose mother drank alcohol during pregnancy
May include physical, mental, behavioral, and/orlearning disabilities with possible lifelongimplications
Not a diagnosis
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Pregnancy
+
Alcohol
May result in
• Alcohol-related neurodevelopmental disorder (ARND)
• Partial FAS (pFAS)
• Fetal alcohol effects (FAE)
• Alcohol-related birth defects (ARBD)
• Static encephalopathy (an unchanging injury to the brain)
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No one knows for certain how many individuals are born each year with an FASD – estimates of 6/1000.
No one knows how many individuals are living with an FASD.
Photo property of SAMHSA.
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The sole cause of FASD is women drinking alcoholic beverages during pregnancy
Alcohol is a teratogen
“Of all the substances of abuse (including cocaine, heroin, and marijuana), alcohol produces by far the most serious neurobehavioral effects in the fetus.”
—IOM Report to Congress, 1996
.
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FASDs are the leading known cause of preventable mental retardation.
FASDs effect an estimated 40,000 newborns each year in the United States.
FASDs are more common than autism. The effects of FASDs last a lifetime. People with an FASD can grow, improve, and
function well in life with proper support.
FASDs are 100% preventable.
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FSIQ VIQ PIQ
40
55
70
85
100
115
Sta
nd
ard
score
IQ scale
NC
PEA
FAS*
**
**
**
Mattson, S.N., 1997.
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2
1
3
1
2
3
Group0
2
4
6
Ru
le V
iola
tion
s NC
PEA
FAS
P<0.001
Move only one piece at a time using one hand and never
place a big piece on top of a little piece
Starting position
Ending positionMattson, et al.,
1999
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photo: Clarren, 1986
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***
**
Cerebrum Cerebellum
75
80
85
90
95
100
PEA
FAS <p 0.001
p < 0.010
Cerebrum
CerebellumCorpus Callosum
Mattson et al., 1994
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Mattson, et al., 1994; Mattson & Riley, 1995; Riley et al., 1995
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Lower IQ
Impaired ability in reading, spelling, and arithmetic
Lower level of adaptive functioning
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hyperactivity, response inhibition deficits, attentional problems, motor coordination deficits, executive function (planning) problems,
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Poor judgement Attention deficits Arithmetic
disabilities
Memory deficits
Problems with abstract thought
Impulsivity
Easily victimized unfocused or
distractible difficulty handling $$ difficulty learning from
experience difficulty under-
standing consequences poor frustration
tolerance
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= Age 6+ = Age 12+ = Age 21+
Percent of Persons With FAS or FAE Who Had Secondary Disabilities
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• Show many similar characteristics to human studies.
Courtesy: Ed Riley
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mammals◦ rodents (rats, mice, guinea pigs)◦ pig◦ sheep◦ primates
nonmammalian models◦ chicks◦ round worm◦ zebra fish◦ fruit flies
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Growth retardation Facial
characteristics Heart, skeletal
defects Microcephaly Similar CNS deficits
Hyperactivity, attentional problems
Inhibitory deficits Impaired learning Perseveration errors Feeding difficulties Gait anomalies
Driscoll, et al., 1990; Samson, 1986;