Fetal alcohol syndrome Flashcards
Alcohol-related neurodevelopmental disorder
Intellectual disabilities or behavioral and learning problems caused by drinking alcohol during pregnancy
Alcohol-related birth defects
Physical birth defects caused by alcohol during pregnancy
Fetal alcohol syndrome (FAS)
Severe end of FAS disorders which includes both neurodev. disorder and birth defects caused by alcohol during pregnancy
Partial fetal alcohol syndrome
Presence of some signs of FAS by alcohol during pregnancy, but criteria for dx are not met
Neurobehavioral disorder associated with prenatal alcohol exposure (ND-PAE)
Problems functioning due to neurocognitive impairments, such as problems with mental health, impulse control, communication, daily living skills, caused by alcohol during pregnancy
Pathophysiology of FAS
- Passed through bloodstream to fetus via umbilical cord
- Baby unable to metabolize alcohol like an adult - stays in body longer
- Alcohol kills fetal cells, interferes in neural cell development, constricts blood vessels, results in toxic byproducts when alcohol is processed
Physical signs and symptoms of FAS
- Short palpebral fissures
- Mid-facial hypoplasia
- Thin upper lip
- Microcephaly
- Intellectual impairment
- Agenesis/dysgenesis corpus callosum
- Cardiac septal defects
- Kidney problems
- Visual/auditory deficit
- Spine and limb abnormalities and delayed bone development
- Short body height and weight
- Pectus excavatum
- Focal cortical thickening
Cognitive signs of FAS
- Delayed speech and language development
- Difficulty concentrating and short attention span
- Difficulty telling the difference between reality and fantasy
- Hyperactivity
- Learning disabilities
- Low IQ
- Poor coordination
- Poor reasoning and judgement skills
- Poor school performance
- Poor short-term memory
PT/OT intervention for FAS
- Early intervention - developmental milestone acquisition
- Motor planning
- Sensory issues - difficulty filtering out extraneous input
- Task-focused activity
- Aquatic therapy
Medications for FAS
- Stimulants - for hyperactivity, attention, impulse control, behavior
- Antidepressants
- Neuroleptics - aggression, anxiety, behavior
- Anti-anxiety drugs
Behavioral and educational support for FAS
- Good buddies - friendship training, social skills
- Families moving forward (FMF) - family support
- Math interactive learning experience (MILE)
- Parent and children together (PACT) - improve self-regulation and executive function
What is neonatal abstinence syndrome (NAS)?
- Occurs when a baby is born and abruptly stops receiving drugs they were exposed to in the womb, leading to withdrawal symptoms
- Opioids, stimulants, or other substances
- Can appear within a few days after birth, symptoms vary depending on exposure
Symptoms of NAS
- Irritability and fussiness
- High-pitched crying
- Tremors or shaking
- Sleep problems
- Poor feeding
- Vomiting or diarrhea
- Stiff muscles
- Seizures
- Yawning, stuffy nose, sneezing
How long can symptoms related to NAS last?
- One week to 6 months
- Sometimes 4-6 months
What affects duration of symptoms for NAS?
- Type of medicine
- Amount
- Multiple substances
Treatment for NAS
- Supportive care such as meds to help manage withdrawal
- Early intervention for developmental delay
- Goal is to slowly wean the baby off the drug and relieve withdrawal symptoms
Early intervention for NAS
- Gently rocking
- Reducing noise and light
- Skin to skin, swaddling in a blanket
- Breastfeeding - infants with NAS who receive human milk require less pharmacologic treatment and have shorter hospital stays
Complications NAS babies are subjected to
- Dev. delay
- Motor skill prpoblems
- Learning and behavior problems
- Speech and language problems
- Sleep disorders
- Hearing and vision problems
- Weight < 5 lb 8 oz at birth
- Jaundice
- Seizures
- SIDS - unexplained death of a baby under 1 yr old, often during sleep
