In an article published in the Aug. 12 edition of the Journal of Developmental and Behavioral Pediatrics, Streissguth, professor of psychiatry and behavioral sciences in the UW School of Medicine, said that her study of 415 subjects showed that of all the factors that might positively or negatively affect a child with FAS or FAE, these two factors are most important in helping them escape negative experiences. Those negative experiences can include confinement for criminal violations and other reasons, trouble with the law, inappropriate sexual behavior, alcohol or drug problems and disrupted education.
"This is the first study to show that despite the prenatal brain damage caused by their mothers' consumption of alcohol during pregnancy, these children can grow up to have relatively more successful lives," Streissguth said. "Our interviews with the caregivers of our study subjects, who ranged in age from 6 to 51 years, showed that the odds of escaping these adverse life experiences are improved two-to-four-fold by being diagnosed with FAS or FAE at an early age and by being raised in a good stable environment
FAS is characterized by structural or functional brain damage, growth deficiency and a unique pattern of facial features. Those with FAE have some brain damage, but often lack the physical and growth characteristics. FAS and FAE are birth defects with lifelong implications that can occur in children whose mothers drink alcohol during pregnancy. These children often have problems with learning, memory, attention and problem solving, as well as physical disabilities.
Streissguth and her colleagues designed a life history interview, which they administered with the caregivers or other knowledgeable informants about the life span experiences of 415 patients with FAS or FAE with a median IQ 86. From these interviews and previous clinical experience, the researchers designated five adverse life outcomes and 18 associated risk or protective factors in the environment that might influence these negative outcomes. For adolescents and adults, the life span prevalence was 61 per cent for disrupted school experiences, 60 percent for trouble with the law, 50 percent for confinement (in detention, jail, prison or a psychiatric or alcohol/drug inpatient treatment), 49 percent for inappropriate sexual behavior on repeated occasions and 35 percent for alcohol or drug problems.
"Unfortunately, many people feel that an FAS or FAE diagnosis is hopeless, and that maybe it's better to just let these children grow up without knowing that they have this disability," Streissguth noted. "In this study, we have done life history interviews on patients who were diagnosed in the 1970s, '80s and '90s. These two positive factors, living in a stable, nurturing environment and having an FAS or FAE diagnosis at an early age, are now documented for the first time as having a strong influence on what was previously assumed by many people to be an unchangeable situation."
The study was funded by the Centers for Disease Control and Prevention, the National Institute on Alcohol Abuse and alcoholism, the Indian Health Service and the Dana Foundation.
Co-authors of the study were Fred Bookstein, University of Michigan and University of Vienna; Paul Sampson, UW Department of Statistics; and Helen Barr, Kieran O'Malley and Julia Kogan Young, UW Department of Psychiatry and Behavioral Sciences in the School of Medicine.