Assessment, treatment part of Catholic FAS efforts

Program director Kathryn Shea continues to work with approximately 30 families on an ongoing basis, but noted that she is "limited in what we can do, because there's no direct funding for this program through the county or the state."

One problem, she said, is that children with fetal alcohol syndrome (FAS) or fetal alcohol effects (FAE) have symptoms that fall under the responsibility of many different agencies: mental health problems, special education needs, or placement in the foster care or social service system. Older children often end up in the juvenile justice system, as well.

"No agency wants to own these children as theirs," she said. "We don't have enough treatment programs, services or funding."

Assessment

Physical symptoms of children with FAS include microcephaly (an abnormally small head), a short nose with a low nasal bridge, eyes that appear to be wide-set because they are smaller than normal, a thin upper lip and an indistinct philtrum (the vertical lines between the nose and upper lip).

In its most severe form, FAS may result in major brain abnormalities; cardiac, kidney or liver defects; and growth abnormalities. Forty percent of children with severe FAS die in their first year of life. Other symptoms include hyperactivity and extreme impulse control problems.

"These kids are highly active," said Mrs. Shea. "They have short attention spans. They don't sleep at night. They're very emotionally reactive: They go off very easily, and it's hard to calm them down. They're aggressive; the typical picture is that the kids are out of control, and the parents are stressed and desperate."

While FAS can cause retardation, children with FAS or FAE may show a wide variety of symptoms and may not be retarded at all. "IQ doesn't really determine ability to function," Mrs. Shea explained. "People think if you're bright, you ought to be able to follow the rules, and that isn't the case."

Therapy

Since children with FAS have a hard time identifying their own or others' feelings, Mrs. Shea also explains how happy and sad expressions look, and what could make someone feel those feelings. Children even learn to take "time-outs" when they're overstimulated or can't sit still.

Some clients are success stories. One six-year-old came to Mrs. Shea completely out of control, needing to be hugged and rocked constantly just to calm down.

Today, she said, "you wouldn't believe it's the same kid. He can tell you how he feels; when he's about to lose control, he can say `stop' and go calm down. He's becoming more self-regulated and self-aware."

For others, however, change is nearly impossible. "We have a case of a 16-year-old in a shelter. He threatened to kill his parents," said Mrs. Shea. "An MRI showed brain lesions. The outcome for him is extremely poor; he is dangerous, and these impulses are to kill his parents."

Prevention

During the holidays, Mrs. Shea used that fact to issue a plea to future mothers: "There's a lot of alcohol consumption at this time of year. If you even are thinking of getting pregnant, don't drink."

(Contact the St. Catherine's fetal alcohol assessment and treatment program at 463-3730. Contact the National Organization on Fetal Alcohol Syndrome at 1-800-66-NOFAS.)

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