37% of babies have been exposed to multiple episodes of binge drinking (5+ drinks per session) during pregnancy. An additional 42% have been multiply exposed to 1 to 4 drinks per session during pregnancy. It is probable that about 15% of children are significantly enough affected by prenatal alcohol exposure to require special education.

Presentation to the Legislative Assembly of Ontario, Standing Committee on Social Policy, Bill 118, Accessibility for Ontarians with Disabilities Act, 2004, London, February 3, 2005.
FASlink presentation, streaming video: Issues : Bruce Ritchie for High Speed or Dial-up
Recommendations: Kathy Lewis for Dial-up .
Hansard Transcript of presentation
Accessibility for Ontarians with Disabilities Act, 2005 (now law)

FASD presentation by Bruce Ritchie. If you have the PowerPoint Viewer on your computer, simply click on Open in the next screen. If not, you can
Download PowerPoint 2007 Viewer (Works with Windows 2000, XP and Vista)

"It is estimated that up to 20% of women consume alcohol regularly while pregnant". Meconium is the first fecal excretion from the newborn baby. GC/MS Meconium assays can detect Fatty Acid Ethyl Esters that act as a biomarker of maternal alcohol consumption during the final 20 weeks of pregnancy. Studies by United States Drug Testing Laboratories using the Avitar MecStat-ETOH meconium testing for FAEE's that have shown 15% to 18% of newborns have been exposed to significant levels of alcohol in the final 20 weeks with 4% having been exposed to very high levels of alcohol. "Neonatal Screening for Prenatal Alcohol Exposure - The Grey Bruce Study" by Joey Gareri, HBSc, MSc student confirms that 4% of infants were exposed to very high levels. The lower level incidence was not reported. See also "Fatty Acid Ethyl Esters in meconium: An emerging biomarker for in utero alcohol exposure". - Joey Gareri, Graduate Student, Department of Pharmacology, University of Toronto.

"Formic Acid in the Drinking patient and the expectant mother"
The use of high levels of Folic Acid was found to inhibit brain damage.

Research Investigating Effects of Alcohol and Developing Brain Cells

Original link

Better Endings. New Beginnings. - Jodee Kulp's excellent website

The Language of Fetal Alcohol Spectrum Disorders

From birth, a baby's brain cells proliferate wildly, making connections that may shape a lifetime of experience. The first three years are critical. - J. Madelaine Nash

Peggy Seo Oba's extensive study of the history of FASD. From antiquity to present times, alcohol consumption during pregnancy has been known to affect the baby. Why has it only been relatively recently that it has been given a name?
Original and most up-to-date:

Original HTML and PDF

Search the Faslink Archives

This facility is only available online.

The FASlink Archives are a searchable collection of more than 110,000 FASD related letters and articles. FASlink is a listserv Moderated by Bruce Ritchie. Members include biological, foster and adoptive parents and caregivers as well as a wide range of professionals including those in medicine, social work, education and justice. Our members also include a number of individuals who have FASD. They help us to see the world through their eyes, so that we can develop more effective strategies to help our children and others. FASlink's character has developed into a very supportive "family". It is a unique experience.

Canadian guidelines for diagnosis of FASD
Download PDF version

Recent MRI studies by Dr. Anne Streissguth comparing structural anomalies in the corpus callosa of FAS vs FAE individuals have shown the same level of brain injury, regardless of "facial markers". Over time, the facial markers of FAS may fall into the same disuse as Phrenology. FAS facial features are not fully reliable indicators of the nature and level of disabilities. This research could completely change the definitions of FAS, FAE, ARND, FASD, etc.

"Although we hypothesized that our image analysis methods would reveal significant mean differences in brain form between FAS/FAE and Controls, we were surprised to find that the most significant finding was a hypervariation of form of the Corpus Callosum (CC: a white matter pathway connecting the two hemispheres of the brain). Subjects with FAS and FAE had callosa that were generally thicker or thinner than control counterparts. In addition 3 of the subjects with FAS/FAE showed frank dysgenesis (incomplete development) of the corpus callosum. This study also found that there was a complete intermingling of (lack of discrimination between) the alcohol exposed subjects with and without the facial features of FAS in terms of representations of the shape of the CC. There was no difference in CC neuroanatomy between subjects with FAS and those with FAE or ARND."

"When the shape measurement of the Corpus Callosum was combined with results of neuropsychological testing, we found further surprising results. The variation in the shape of the corpus callosum was related to two specific patterns of neuropsychological performance. Those subjects with FAS/FAE whose callosa were thinner than controls demonstrated deficits in motor coordination but had relatively normal executive function abilities. Conversely, those subjects with FAS/FAE whose callosa were thicker than controls demonstrated relatively normal motor coordination but had deficits in executive function abilities." - Dr. Ann Streissguth, Principle Investigator

Understanding Fetal Alcohol Spectrum Disorders - Getting a Diagnosis

Because most people with FASD have no visible signs of alcohol exposure, their problems may be wrongly blamed on poor parenting or on other disorders. Early diagnosis and intervention contribute to positive long-term outcomes. The Fetal Alcohol Spectrum Disorders (FASD) Center for Excellence is a project of the Substance Abuse and Mental Health Services Administration (SAMHSA).

Professional Designations

Terminology of Medical Professionals' Degrees - Eleene Davis

Binge drinking in Canada

Frequency of drinking 5 or more drinks on one occasion in the last 12 months, by age group and sex, household population aged 12 and over who are current drinkers, Canada, 2000/01. Data source: Statistics Canada, Canadian Community Health Survey, 2000/01. The definition of binge drinking in Canada has now been changed to 4 drinks per occasion.

U.S. definition of Binge Drinking

Alcohol and illicit drug dependence

Disease of Alcoholism Chart
GIF screen view
PDF for printing

Even though alcoholism and drug addiction are clearly defined as disabilities under Ontario’s Human Rights Code, thousands of Ontarians have been denied disability benefits for substance abuse addictions. That has now changed following a Supreme Court of Canada ruling establishing that addiction is a disability under Canadian law.

Alcohol and the Human Body

Alcohol is a general term denoting a family of organic chemicals with common properties. Members of this family include ethanol, methanol, isopropanol, and others. This introduction discusses the physical, chemical, and physiological aspects of the most commonly ingested of these - ethanol. Alcohol is a central nervous system depressant and it is the central nervous system which is the bodily system that is most severely affected by alcohol (see chart below). The degree to which the central nervous system function is impaired is directly proportional to the concentration of alcohol in the blood.    

Teen Binge Drinking Can Do Long-Term Brain Damage By Amy Norton

NEW YORK (Reuters Health) - Mounting evidence shows that the still-maturing teenage brain is particularly susceptible to damage from heavy drinking. A number of recent studies have shown that teenagers who abuse alcohol have problems with memory, learning and other brain functions compared with their peers, while animal research suggests such effects could last into adulthood. Original article

CDC Study - Alcohol Consumption Among Women Who Are Pregnant or Who Might Become Pregnant --- United States, 2002

-- with comments by Teresa Kellerman and Bruce Ritchie

To determine the alcohol consumption patterns among all women of childbearing age, including those who are pregnant or might become pregnant, CDC analyzed data for women aged 18--44 years from the 2002 Behavioral Risk Factor Surveillance System (BRFSS) survey (5). The results of that analysis indicated that approximately 10% of pregnant women used alcohol, and approximately 2% engaged in binge drinking or frequent use of alcohol. The results further indicated that more than half of women who did not use birth control (and therefore might become pregnant) reported alcohol use and 12.4% reported binge drinking.

Meconium Testing - comments by Bruce Ritchie
Meconium is the first bowel movement by a newborn infant. The meconium based assay incorporates a panel of Fatty Acid Ethyl Esters as bio-markers of maternal alcohol use during the last 20 weeks of pregnancy. Studies with the MecStat-EtOH assay (Avitar Technologies Inc., United States Drug Testing Laboratories) found fetal exposure to alcohol in 15-18% of newborns tested, approximately 4% of the newborns had elevated results. These results do not include those women who were drinking in the first trimester and quit when they discovered they were pregnant. People lie about their alcohol use.

Alcohol: Global Burden on Health Similar to Tobacco and High Blood Pressure
04 Feb 2005

The amount of death and disability caused by alcohol globally is similar to that caused by tobacco and high blood pressure, concludes a review in The Lancet (Vol. 365 No. 9458, Feb. 5, 2005). Overall, four percent of the global burden of disease is attributable to alcohol, 4.1% to tobacco and 4.4% to high blood pressure. Alcohol is causally related to more than 60 different medical conditions, including breast cancer and coronary heart disease. In most cases alcohol has a detrimental effect on health.

This volume is the culmination of three years of dedicated collaborative work of the WHO Department of Mental Health and Substance Abuse and a WHO Collaborating Centre, the Swiss Institute for the Prevention of Alcohol and Drug Problems in Lausanne, Switzerland. It is an overview of the available data on alcohol consumption and drinking patterns worldwide. It gives valuable new perspectives on the recent status of health and social consequences of alcohol use and levels and patterns of alcohol consumption worldwide. WHO_global_alcohol_status_report_2004.pdf

Warning Signs Now Law in Ontario

The following types of premises must post the warning sign:

• Restaurants and bars licensed to sell beverage alcohol (wine, beer and spirits);
• LCBO stores and other retail stores authorized to sell beverage alcohol
  (i.e., The Beer Store and wine, beer and spirits manufacturers’ stores); and
• Licensed brew-on-premise facilities.
  
  This document provides the mandatory English sign referred to in Regulation 718, Subsection 26.1(1). The sign can be displayed in colour or black and white. A French sign may also be displayed in colour or in black and white.
  To download the warning sign, please click on one of the links below:

Submission February 25, 2005 to the Beverage Alcohol System Review Panel by the following Ontario public health organizations: Addictions Ontario (AO); Association of Local Public Health Agencies (alPHa); Centre for Addiction and Mental Health (CAMH); Mothers Against Drunk Driving (MADD Canada); Ontario Drug Awareness Partnership (ODAP); Ontario Public Health Association (OPHA); Parent Action on Drugs (PAD); Toronto Public Health.

Alcohol is a drug that causes about as much harm as tobaco. It is linked to more than 60 medical conditions and imposes a heavy burden on public health and finances. Alcohol should not be sold as an ordinary commodity. Recent public discourse on alcohol has focused on increasing government revenues and has largely overlooked public health impacts. Public health and safety issues deserve to be at the forefront in a balanced review of beverage alcohol policy. The Ontario review should, as a guiding principle, seek to improve, not mortgage, public health and safety. Alcohol policy research has come of age, and now provides governments a toolkit of policy options that research show to be effective in reducing alcohol-related problems. Policies that increase alcohol consumption generally lead to higher levels of public harm, while policies that decrease consumption reduce harm. Relying on public education and persuasion alone is not effective in reducing alcohol-related harm. Among the most effective policies to reduce alcohol problems are:

• maintaining public alcohol retail monopolies with a strong duty of social responsibility, and
• increasing alcohol taxes.

Putin urged to address "Russia's curse"
"The Lancet" medical journal

Both separately and in concert, smoking and drinking cause harm to the brain -- bad news for the majority of alcoholics who also smoke. Original article

This Adobe PDF format booklet is designed for caregivers and professionals who, in their everyday lives, encounter children and youth affected by Fetal Alcohol Spectrum Disorder. Readers should be aware that this Booklet provides strategies and suggestions for people who already have a base understanding of FASD. If you would like more information on FASD, please visit www.region6fasd.ca.

Let's Talk FASD :Parent-Driven Strategies in Caring for Children and Adults with FASD.
(PDF format)

Maternal alcohol consumption even at low levels adversely related to child behavior. The effect was observed at average exposure levels as low as 1 drink per week.

Worship With All of God’s Children
by Keith Ham

What could churches / religious organizations do to help families affected by FASD?
How do you teach abstract spiritual ideas to people with FASD?
What could churches / religious organizations do to help families affected by FASD? Original documents

Conduct Disorder: A Challenge to Child Psychiatry

The 2 papers in this section review the etiology and treatment of conduct disorder (CD), one of the most common disorders in child psychiatry with an incidence of between 5.5% and 6.9% (1). Even with the best- known treatment, the success rate on follow-up does not exceed 74% (2). The failure in treatment often results in the adolescent becoming an adult with antisocial personality disorder (APD) and a criminal record. Youths with this disorder cause immense suffering to society because of their antisocial behaviour and the enormous costs associated with treatment, court procedures, probation, detention, and incarceration. The Canadian Journal of Psychiatry - Home Page

Ontario Government funding programs for Children With Special Needs
Available online only - very comprehensive

This web page is intended to assist parents and caregivers seeking information about services funded and/or provided by the Ontario government for children with physical, intellectual and/or developmental disabilities, mental health disorders, medical problems or those who need specialized services to participate in daily living activities.

This article is not about FASD but is about parenting issues that apply to all children. Rosalind Wiseman is trying to protect “Wannabes” from “Queen Bees.” To that end, she has established the Empower Program, which is aided by the Girls’ Advisory Board. Are girls meaner than boys?

This pamphlet is a summary of nutritional measures which have helped our three children with FASD over the past five years. None of these measures are new, indeed many of these ideas come from literature on alcoholism, autism, schizophrenia or other mental disorders. I am a biochemical researcher, not a physician, so I cannot give medical advice. If any of the ideas in this pamphlet seem applicable to your child, I encourage you to discuss them with your doctor, nutritionist, or naturopath.

Main meals are quite easy, of course, with your basic meat, potatoes or rice, and vegetable, although you may need to adapt some recipes a bit for sauces, etc. The biggest problems we faced were breakfast and supper.

Get rice and tapioca flours at the Chinese store, potato starch flour in the baking section of any grocery store, chick-pea flour (labeled as gram flour or besan) at the middle-eastern or Indian store. Millet flour or flakes may be available at your health food store; otherwise buy millet and grind it in an electric coffee grinder. Sorghum flour (Jowar) from an Indian store can be used in place of millet.

Eight Magic Keys: Developing Successful Interventions for Students With FAS

IEP and Inclusion Tips for Parents and Teachers
(4 MB PDF download - 82 printed pages)
Anne I. Eason, Esq. and Kathleen Whitbread, Ph.D.

This manual provides parents with systematic strategies they can use to become more active participants in the Individualized Education Plan (IEP) process and contribute to the development of a meaningful educational program for their sons and daughters. The strategies delineated in this manual are not expensive nor do they require that parents obtain degrees in education or advocacy in order to be effective. The strategies offer common sense approaches as to how to effectively advocate for inclusive education for their sons and daughters with disabilities.

By Ellen Notbohm - This should be required reading for all social service workers, teachers and relatives of children with autism. There is great need to understand the world as special needs children experience it. So the voice of our child returns now to tell us what children with autism wish their teachers knew.

Helpful hints when working with AE Students

Extensive list of Special Education websites

FASD and the Youth Criminal Justice System - A discussion paper - by Paul Verbrugge

Youth Criminal Justice Act - Canada

The Canadian Charter of Rights and Freedoms guarantees the rights and freedoms set out in it subject only to such reasonable limits prescribed by law as can be demonstrably justified in a free and democratic society.