Substance Abuse

Question 1

FASD

Answer 1

• umbrella term used to describe the range of physical characteristics, mental, behavioral and/or learning disabilities associated with prenatal alcohol exposure
• includes a variety of diagnoses, all due to maternal alcohol consumption
• NO safe amount or safe time
• 100% preventable: leading known preventable cause of birth defects and intellectual disabilities

Question 2

terminology

Answer 2

• fetal alcohol syndrome (FAS): with or without confirmed exposure
• prenatal FAS: with or without confirmed exposure
• alcohol related neurodevelopmental disorders and alcohol related birth defects (ARND and ARBD): no physical characteristics of alcohol

Question 3

characteristics of FASD

Answer 3

• growth deficiencies (<10th percentile)
• facial features
• CNS dysfunction

Question 4

facial features

Answer 4

• smooth philtrum (tip of nose)
• short palpebral fissures (small eye space)
• thin vermillion border/ upper lip

Question 5

CNS dysfunction

Answer 5

• microcephaly (small head)
• tremors/seizures
• hyperactivity/ attention deficits
• gross/fine motor difficulties (OT/PT)
• learning/intellectual disabilities, developmental delays
• memory difficulties/ processing information
• impulsivity/distractibility
• difficulty with abstract thought
• executive function deficits

Question 6

primary disabilities

Answer 6

due to brain damage - structure and function
- basal ganglia: memory, time perception, problem solving
- cerebellum: coordination, balance, movement
- corpus callosum: between 2 lobes
- frontal lobe: executive functions, impulse control, judgement
- hippocampus: learning and memory
executive functioning

Question 7

secondary concerns

Answer 7

• mental health problems
• disrupted schooling (suspension)
• alcohol/drug use themselves
• legal problems
• increased sexual behaviors
• dependent living
• employment problems

Question 8

hearing

Answer 8

• railroad track ears
• recurrent middle ear infections (75-93%)
• sensorineural hearing loss (27-29%)
• central auditory processing

Question 9

speech and language

Answer 9

• articulation errors
• expressive and receptive language
  
  • semantics: not surface level vocab, figurative language
• syntax
• pragmatics
• executive functioning skills: make stories up, can’t process

Question 10

treatment

Answer 10

• individualized
• deficit-specific
• strength based
• team approach
• consistency
• positive praise
• protective measures: early diagnosis/intervention, involvement in special education/social services, loving/nurturing/stable home environment, absence of violence

Question 11

strategies

Answer 11

• be direct, concrete, specific
• simplicity
• structure

Question 12

neonatal abstinence syndrome

Answer 12

• group of problems that occur in a newborn who was exposed to addictive opiate drugs while in the womb
• prescription (prescribed and not)
• non-prescription

Question 13

withdrawal

Answer 13

• 30 to 50% of babies
• CNS: high pitched cry, tremors, sleep pattern differences
• metabolic/respiratory: sweating, yawning, hyperthermia
• gastrointestinal disturbances: excessive/uncoordinated suck, reflux, loose stools

Question 14

prenatal opiate/cocaine exposure

Answer 14

• lower weight, height, head circumference (slower growth)
• problems with habituation, state regulation, reflexes, tone
• cognitive deficits at 18-36 months
• lower social maturity at 36 months
• language delays: specifically grammar, complex language at 3-4 years
• auditory system: cocaine (can cause nerve issues)
• meth shows similar

Question 15

prescription drug exposure

Answer 15

• subtle motor and growth differences
• subtle behavior and social adaptability problems
• methadone (opiod replacement): results in motor deficits, reduced social responsibility, shorter attention span

Question 16

cannabis

Answer 16

• any form of THC can pass through and harm the baby’s development
• babies can be born with low birth weight/premature (2.3 times greater risk of stillbirth)
• at birth, show signs of nervous system issues (altered responses to visual stimuli, increased trembling, high pitched cry)

Question 17

cannabis impact at school

Answer 17

• problems with problem solving, memory, and attention
• however: more needs to be done to rule out environmental impact

Question 18

cannabis and breastfeeding

Answer 18

• THC stays in breastmilk at least 1 week after ingestion
• moderate amounts pass through breastmilk
• some studies report decrease in motor development in first year of life
• don’t know about later impact

Question 19

cannabis and dad

Answer 19

• studies in rats show that when male rats ingest cannabis it changes the makeup of the sperm
• this then changes brain development and causes reduced brain activity