Article Summary: Fathers’ Role in Alcohol-Exposed Pregnancies

We received a reader question about the effect of fathers’ alcohol use on child outcomes. Luckily, there was a review article published in 2016 on this very topic (included in our Top 20 FASD Articles of 2016). The CanFASD Prevention Network Action Team blog Girls, Women, Alcohol, and Pregnancy also highlighted the article in their post Alcohol and FASD: It’s not just about women.

Father’s Role in Alcohol-Exposed Pregnancies: Systematic Review of Human Studies

Authors: Nyanda McBride and Sophia Johnson                                                                 Journal: American Journal of Preventative Medicine   https://www.ncbi.nlm.nih.gov/pubmed/27017419

The authors review three research areas in terms of fathers’ alcohol use as it relates to alcohol-exposed pregnancies and FASD:

  1. Men’s role in the social facilitation of maternal alcohol use during preconception and pregnancy:
  • Pregnant women who drink heavily were more likely to have a partner who is a heavy drinker (U.S study).
  • More than 75% of women who drank during pregnancy usually drank with their partner and 40% of drinking occasions were initiated by their male partner (Australian study).
  • Women who drank during pregnancy were more likely to have a live-in male partner who consumed alcohol (Ukraine and U.S studies).
  • If male partners were actively supportive of involvement with preconception health, then women were nearly 20% more likely to actively follow the preconception healthcare protocol provided at the clinic, including reducing alcohol consumption (Hungarian study).

Authors’ take home message: Decisions about alcohol use during preconception and pregnancy are not the sole responsibility of women but occur within the context of the home and the broader social environment, and thus require more complex policy to assist in reducing alcohol-exposed pregnancies and increasing the potential for healthy fetal and infant outcomes.

CanFASD produced a two-page information sheet with some suggestions for how men can make a difference in preventing maternal alcohol use:

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Access the info sheet here: https://fasdprevention.files.wordpress.com/2014/02/what-men-can-do-_final-feb-2014.pdf

This post on the CanFASD Girls, Women, Alcohol, and Pregnancy blog also discusses the shared responsibility of FASD prevention and has several resources for how partners can support women during pregnancy.

2. Paternal alcohol consumption on sperm and fetal outcomes:

  • Drinking by men in the period prior to undergoing conception procedures such as in vitro fertilization was highly associated with failure to achieve a live birth and spontaneous miscarriage (U.S study).
  • There is evidence that alcohol has a direct effect on sperm volume, but less evidence regarding sperm density count, progressive motility, and morphology.

Authors’ take home message: Policies recommending biological fathers to reduce or abstain from alcohol during the preconception phase, particularly during the period of sperm development prior to conception, have value.

3. Paternal alcohol consumption on fetal and infant health outcomes:

  • It is important to note that the findings from the following studies have not yet been replicated, so the authors considered them as theoretical at this point.
  • The authors highlighted seven studies that looked at paternal alcohol consumption during the preconception period and it’s relationship with the following outcomes:
    • Spontaneous abortion was associated with both low (1 to 6 drinks per week) and moderate (14 drinks per week) levels of paternal drinking during the preconception period.
    • There was no association between paternal preconception consumption of alcohol and intellectual disability outcomes in children.
    • Not achieving a live birth, low birth weight, low gestational age were associated with moderate paternal preconception alcohol use. Another study showed no association between paternal alcohol use and low birth weight.
    • Acute lymphoblastic leukemia was associated with high paternal alcohol use during the preconception period.
    • Ventricle malformation was associated with daily paternal alcohol use during the preconception period.

Authors’ final take home message: Fathers’ preconception alcohol consumption is an important focus for healthcare and future policy dealing with reproductive, prenatal, fetal, and infant health.  

 

 

CanFASD Offers Online Training

Reminder: We’re looking for more adults to participate in our study about employment success in FASD. The ad and study information is in this post. Here is the study link for quick access:

https://www.surveymonkey.com/r/employmentstudy

The adolescent self-regulation study in Edmonton and Vancouver is also still recruiting. Please see this post for the ads and more details.

CanFASD Multidisciplinary Team Training for Diagnosis of FASD: An Online Curriculum

We’re spreading the word about the CanFASD online training curriculum. Have any readers taken the training? We’d love for you to leave a comment sharing your experience! Find more information about the training here: https://estore.canfasd.ca/

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What is the training for? 

The curriculum was designed to assist professionals:

  • Learn the processes and procedures of multidisciplinary FASD assessments.
  • Develop the skillset needed to be effective members of a multidisciplinary diagnostic team.

Who should take this course? 

  • The curriculum is designed for clinical and allied health professionals who are either currently working in FASD clinics or for those who will soon become members of multidisciplinary diagnostic clinic in Canada.
  • The online course includes common concepts that apply to all disciplines comprising the diagnostic team and focuses on the core concepts that are required for professionals who are involved in making FASD diagnoses.
  • The expectation is that the participants will have a working knowledge of the field, professional competency in their own area of specialty, and exposure to the relevant research literature.
  • Diagnostic teams are encouraged to take this course together and there are places for discussion and deliberation among the team within the curriculum.
  • This is not an introductory course on FASD.

Who developed the curriculum?

  • CanFASD co-developed this course with the Society of Obstetricians and Gynaecologists of Canada (SOGC) and was planned to achieve scientific integrity, objectivity and balance. Remember to visit MAINPORT to record your learning and outcomes. You may claim a maximum of 12 hours (credits are automatically calculated).
  • This course is MOC-3 accredited and provides standardized training based on current evidence and the new Canadian guidelines for FASD diagnosis.

 

 

Just Published: Neuropsychological Aspects of Prevention and Intervention for FASD in Canada

We’re highlighting a brand new article published by two of CanFASD’s research leads (Dr. Jacqueline Pei and Dr. Nancy Poole), CanFASD Executive Director (Audrey McFarlane), and two University of Alberta PhD students (Melissa Tremblay and Allison McNeil).

Neuropsychological Aspects of Prevention and Intervention for FASD in Canada is part of a special issue in the Journal of Pediatric Neuropsychology covering international perspectives on FASD prevention and intervention. Other contributions to the special issue cover research in USA, Australia, China, Great Britain, South Africa, and Poland.

The authors overview the current landscape of FASD research and programming in Canada. Their article highlights notable efforts in many areas:

Diagnosis:

Health Care:

  • The FASD National Strategic Project Fund was added to the federal budget in 1999.
  • CanFASD, Canada’s first comprehensive national FASD research network, has been in operation since 2005 and has status as a national Canadian charitable organization.
  • The Canada Northwest FASD Partnership (alliance of 4 western provinces and 3 northern territories) has been working together since 1998.

Justice:

  • Provincial Mental Health Courts in Ontario and Quebec divert individuals with FASD (and other mental illnesses) from the regular system to one that offers a more holistic approach.
  • Community Wellness Court in Yukon Territory works with individuals with addictions, mental health problems, and/or FASD.

Intervention Research:

  • Daily supports are often provided based on general wisdom and eclectic models that are not based in solid research evidence.
  • Research-based interventions include the Alert Program for Self-Regulation (see previous post for recruitment posters for adolescents with FASD), the Math Interactive Learning Experience, Cognitive Carnival, and other memory and attention programs.

*Keep an eye out for our upcoming CanFASD Connect series on the latest FASD intervention research, and what you can take from them to apply in practice. Our goal is to make research evidence more accessible to the public.*

Intervention Programs:

  • Breaking the Cycle in Toronto is an early identification and prevention program designed to reduce risk and enhance development in substance-exposed children (prenatal to 6 years old). The program provides support for maternal addictions and mother-child relationships through a community-based cross-systems model.
  • Catholic Social Services in Edmonton offers numerous FASD programs. Two that have been formally evaluated and show encouraging results are Step by Step for parents with FASD, and Coaching Families for families raising children with FASD.

Prevention Framework:

  • The 4-level prevention framework was adopted by the Public Health Agency of Canada.
    1. Building awareness
    2. Discussing pregnancy, alcohol use, and related risks with women of childbearing age
    3. Providing specialized, holistic supports for pregnant women who have addictions and other health problems
    4. Supporting new mothers to maintain healthy changes made during their pregnancies and women who are not able to stop drinking and need ongoing support

Prevention Research:

  • 27% of pregnancies are unintended in Canada (Oulman et al. 2015; Singh et al. 2010) and alcohol use during pregnancy ranges from 10.8% (Walker et al. 2011) to 60% (Muckle et al. 2011).
  • There have been 262 prevention campaigns in northwestern Canada (e.g., the posters you see at the doctor’s office), but research suggests that these campaigns alone are not enough to change drinking behaviour during pregnancy. Other levels of prevention are needed to reinforce changes in behaviour.

Prevention Programs:

  • Project Choices is a Winnipeg program about alcohol, sex, and birth control for girls and women who are not currently pregnant, but are sexually active and drinking alcohol.
  • The Prevention Conversation trains healthcare and social service providers on how to support women of childbearing age in a non-judgemental and conversational way. They have a blog too!
  • The Parent Child Assistance Program is a cost-effective mentorship program for women with alcohol use and other social/health problems.
  • There are over 800 community-based pregnancy outreach programs across our country. Tell us about yours!

More work needed:

  • FASD prevalence rates in Canada are not well defined, and estimates range from 0.26% to 26.9% in various communities and settings. We need to improve our documentation and data collection processes and use more consistent diagnostic methods.
  • Health care systems would better serve women if there was increased interagency cooperation and coordination across various systems of care.
  • Best practices for interventions are not yet clear.
  • We do not know how prevention efforts are leading to changes in preventing FASD in Canada.
  • We need to ensure that appropriate supports and interventions are offered to students with FASD in provinces with inclusive special education approaches.

 

 

 

 

Looking for Adolescents with FASD for an Intervention Study in Vancouver and Edmonton!

The University of Alberta and University of British Columbia are doing an intervention study in self-regulation for adolescents with FASD in the Edmonton and Vancouver areas.

They are looking for participants aged 11 – 17 who have a diagnosis of FASD.

The intervention will take place over about 12 weeks and will include weekly 1-hour one-to-one intervention sessions focusing on improving self-regulation.

VANCOUVER STUDY AD:

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EDMONTON STUDY AD:

Upcoming Conferences and Events

Mark your calendars for these upcoming FASD relevant events! Click on each picture for more information. 

 

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The FASD Network of Saskatchewan is hosting “Challenge the Conversation” this week. Please leave us a comment about your experiences and conversations if you’re attending this event. We’d love to hear from you!

 

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The 22nd Annual National Supported Employment Conference is May 30 to June, 2017. CanFASD researchers are attending this conference and we will share what we learn on the blog. We’re looking forward to learning about tangible strategies for supporting successful employment as well as advances to the Collective Impact Framework priority areas that were developed at last year’s CASE conference.

Collective Impact is defined as the commitment of a group of actors from different sectors to a common agenda for solving a specific social problem, using a structured form of collaboration. The concept of collective impact hinges on the idea that complex social problems are beyond the capacity of any one sector, working alone, to effectively address them.   In order to create lasting solutions to such social problems on a large-scale, a coordinated effort is needed across multiple sectors willing to work together towards a clearly defined goal. From the CASE Conference, held in Edmonton, Alberta in June, 2016 there were six clear priority areas identified by delegates of this event. These are areas where continued dialogue within a Collective Impact Framework improvement is perceived to have the potential to leverage greater outcomes.

 

 

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The 2017 National FASD Conference will be in Calgary on October 24 -27, 2017. The Government of Alberta will be hosting this event on behalf of the Canada Northwest FASD Partnership (CNFASDP) and the Alberta FASD Cross-Ministry Committee. It will combine the CNFASDP and the annual Alberta FASD Conferences.

The call for abstracts is open until April 5, 2017 and registration for the conference opens in May 2017.

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CanFASD presented a poster at the 2017 Early Years Conference and we’re looking forward to the 2018 conference.

 

Update: Survey link for our Employment Success Study!

We’re doing a study with the University of Alberta to look at employment successes of adults with FASD.

There are two parts to the study:

  1. A short survey. This can be completed on the phone, online, or on paper. Adults with FASD who have a job or caregivers/service providers for an adult with FASD who has a job can participate.
  2. A video. We will be taking short clips of people talking about their successes at work. This part of the study is optional.

LINK TO THE SURVEY: 

https://www.surveymonkey.com/r/employmentstudy

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LINK TO OPEN THE AD TO PRINT OR CIRCULATE:

Employment Project Online Ad

CanFASD Advocates for an Accessible Canada for Individuals with FASD

Did you know that the Government of Canada is developing new accessibility legislation? The goal is to promote equality of opportunity, and increase inclusion and participation of Canadians who have disabilities or functional limitations. They asked Canadians,

What does an accessible Canada mean to you? 

To create a more accessible Canada for individuals with FASD and their families, CanFASD believes that the proposed Accessibility Act should:

  1. Recognize invisible disabilities such as neurodevelopmental disorders, regardless of IQ.

  2. Ensure equitable access to FASD diagnostic services regardless of age or geographical location.

  3. Allow for specialized funding and/or tax benefits for FASD specific/FASD informed interventions in education, recreation, addictions, housing, health and justice regardless of age or IQ.

  4. Address stigma (i.e., without prejudice so women who drink during pregnancy are offered assistance and not subject to punitive measures). Without protecting the legal status and rights of the mother, how can we expect them to provide information on alcohol consumption during pregnancy?

  5. Recognize the lifelong complexity of FASD and that the need for services and supports does not diminish with age.

  6. Speak to the need for services and supports (social, physical and financial) for those who care for individuals with FASD including caregivers and siblings.

  7. Encourage/support applied FASD research, particularly intervention, diagnostic based research, and longitudinal studies.

  8. Previously mentioned, but worth reinforcing, is the need for access to services and supports regardless of IQ for those “at risk” or diagnosed with FASD.

  9. Speak to the need for cross-sectorial information sharing while respecting the individual’s right to privacy. There needs to be a process by which health information can be shared with social services, justice, education, etc.

  10. Consider confirmed eligibility for disability tax credit for individuals with FASD and their caregivers. Disability tax credit or alternative tax credits should be available to parents who are financially supporting their children regardless of the residency or age of the individual with FASD.

  11. Support guaranteed living allowances for people with disabilities. Persons with disability allowances should not be disallowed or discouraged from seeking part time work.

  12. Allow for some form of representational agreements, which are interprovincial in scope.

  13. Recognize the mental health complexity of FASD and resulting ramifications for health, education, and justice. This may include the need for a collaborative funding agreement between the federal, provincial, and territorial governments.

  14. Facilitate the development of supported living options for individuals with FASD. This could be encouraged through tax benefits for landlords renting to individuals with disabilities or the provision of funds for the development and ongoing operation of low barrier, supportive housing options for individuals with FASD.

  15. Require an individualized support plan be developed upon diagnosis which would address not only the needs for support but also the strengths of the individual diagnosed with FASD.

  16. Require screening for FASD for all those involved with the Criminal Justice System and require the CJS to provide FASD diagnostic services, FASD informed interventions, and specialized case management for any individual identified as potentially having FASD.

  17. Ideally, include the appointment of an FASD advocate who could speak to the needs of individual with FASD on a national level, with subsequent provincial counterparts. Since the incidence of FASD is so high, it is warranted to have a specific FASD advocate.

Find out more about the accessibility legislation here.