I'd like to see editorials like this one in every city's newspapers this week. This one is from a Tennesse newspaper (link below).
Guest editorial: Behavior problem can be detected
By Carolyn Szetela, Ph.D., and Roger Zoorob, M.D., MPH • April 18, 2010
The recent news of a 7-year-old boy adopted from Russia and returned to his home country because of alleged behavioral problems calls to mind a new family struggling to find the routine, comfort and acceptance that helps most families function.
Whether a child is adopted, foster parented or raised by biological parents, children with significant behavioral problems should be evaluated for alcohol-related birth disorders, called fetal alcohol spectrum disorders (FASD).
Alcohol is a teratogen, meaning that it can cause birth defects in the developing fetus. The level of risk is higher when alcohol is used in higher quantities and at critical times of fetal development. In the United States as well as Russia, the use of alcohol during pregnancy is common, and many pregnant women are not aware of the risks.
In the United States, about one out of every 10 women report drinking in the past month of pregnancy, and about one out of 25 pregnant women reports binge drinking of five or more drinks per occasion in the past month.
Children who have experienced foster care have higher rates of FASD. This may contribute to the findings of a recently announced Swedish study that more than half of 71 children adopted from Eastern European countries were affected by FASD.
Often overlooked problem
FASD is often overlooked and presents differently in every affected child and adult. It can manifest in mild to severe learning, mental, behavioral and/or physical disabilities. Children who are affected and their families often go through their lives without understanding the cause of their struggles to function and fit in, and without access to the interventions to help them manage.
While there is no single blood test or psychological screen that can tell if a person is affected, trained health professionals can typically identify when FASD is present and propose strategies and interventions for doing better. Meharry Medical College is host to the Southeastern FASD Regional Training Center, which urges more public attention to this health issue and trains health providers to identify and help manage the disorder.
It is not appropriate to offer an "armchair diagnosis" of the child spotlighted in the Russian adoption case, and multiple causes may influence any behavioral problems he may have. However, an FASD evaluation should be part of any child's health evaluation for persistent cognitive, developmental or behavioral challenges.
Parenting is difficult in the best of circumstances, and parenting high-needs children is sometimes overwhelming. When FASD is present, the question of blame is irrelevant. Acknowledging the possibility of FASD is an opportunity for the child and parents to understand the child's difficulties and help restore their best potential.
And one more thing: If you are pregnant or may become pregnant, remember that alcohol is a known teratogenic drug that targets the developing baby's brain. No mother wants to harm her child. FASDs are 100 percent preventable.
Carolyn Szetela, Ph.D., and Roger Zoorob, M.D., MPH are based at Meharry Medical College and the Fetal Alcohol Spectrum Disorders South East Regional Training Center.
