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Foetal alcohol spectrum disorders describes a group of disorders caused by the consumption of prenatal alcohol. The range of outcomes and the clinical management of these disorders vary in both the complexity of their presentations, associated disorders and management outcomes. This article seeks to review the literature around some of the more difficult areas associated with the condition and present some insights into possible ways of managing the psychiatric and neurodevelopmental disorders seen in the context of the UK system and the NHS.

There needs to be an increased recognition of fetal alcohol spectrum disorder (FASD) in services that deal with young people with disruptive and offending behavior, not just those services that deal with adolescents with a recognized intellectual disability. The paper aims to discuss these issues.

This is a general review of the current available evidence on FASD and how it is likely to predispose affected young people to have contact with secure mental health services and the criminal justice system.

FASD is likely to have become a more common cause of intellectual disability and behavioral disturbance but the history of significant alcohol exposure in utero if often missed. There is evidence that the hyperactivity is less responsive to psychotropic medication and may represent a different condition to conventional ADHD. However the majority of those affected are in the low normal IQ range.

There is so far very limited research in what is likely to be a relatively common disorder with significant costs to criminal justice, mental healthcare and social services. Epidemiological information from the UK is lacking and urgently needed.

Professionals who work with mentally disordered young people need to be more aware of FASD and its potential contribution to the problems and disabilities in their population.

Social workers, foster carers and adoptive parents need to be more aware of FASD and how it can contribute to the breakdown of social care.

There is currently no other review of FASD and the implications for criminal justice, secure mental health and social care for young people.

Foetal alcohol spectrum disorders is the term for the range of complications that can arise when alcohol and pregnancy mix. As Alexandra Constantinou reports, women are receiving different messages about what is safe to consume, and what isn't.

The purpose of this paper is to outline the development of an evidence-based training and support course for caregivers of children with foetal alcohol spectrum disorder (FASD) in New Zealand, and a brief evaluation undertaken. The seven-week caregiver training course takes an empowerment and advocacy orientation, and the aim is to assist caregivers who are caring for children with, or suspected to have FASD, develop greater resilience and strategies to help their families live successfully with impairments in a disabling society.

A total of 13 parents and caregivers received a seven times two-hour weekly group programme of talks, exercises and case study discussions focused on the following objectives: an increased knowledge of FASD; an increased knowledge of successful strategies and interventions that can be used to help families; and having an opportunity to foster strong peer-support relationships with others who share the lived experience of FASD. A brief interview-based evaluation was undertaken to ascertain caregivers’ views of the course, its benefits and limitations.

Caregivers valued both the content and process of the training course. They highlighted that strength of the training was the delivery by experienced, professionally trained caregivers of children with FASD. They valued the opportunity to spend time with peers in similar circumstances who understood the challenges of parenting a child with FASD.

A short evidence-based specialist training course for parents and caregivers with an empowerment and peer-support orientation is beneficial to parenting children with FASD.

Associations between fetal alcohol syndrome (FAS) and other conditions have been reported, but the links between FAS and autistic spectrum disorders (ASD) remain unclear. This study explored the relationship between FAS and ASD in individuals attending a specialist diagnostic clinic. Consecutive referrals over 24 months to a specialist neurodevelopmental clinic were evaluated using gold standard methods for FAS diagnosis and ASD. The first 18‐month cohort who met criteria for ASD were compared with controls attending the same clinic but who had not experienced prenatal alcohol exposure (nested data). Data for the whole group were also collected. Twenty‐one fetal alcohol spectrum disorder (FASD) individuals were assessed and 16 (72%) met ICD‐10 criteria for childhood autism. Further significant differences between the prenatally exposed and non‐exposed group with ASD were found in the nested study. The research shows an association between heavy prenatal alcohol exposure and ASD. As this is a small sample in a specialist clinic, the study suggests that a larger, more population‐based study of those exposed to heavy prenatal alcohol is warranted.

The purpose of this paper is to provide an overview of a Learning Programme designed around the animation film-making process, contextualising abstract concepts to address the cognitive limitations of children with foetal alcohol spectrum disorders (FASD).

Animation production is tactile, multimodal and multisensory which allows for wide application alongside traditional learning tools, targeting multiple learning pathways with its visual, auditory and kinaesthetic approach. Individuals with FASD require information to be explained in a concrete way to enable them to process and understand. Most information can be drawn, providing a visual to assist the individual, but we must also consider abstract concepts which require further explanation or a series of drawings to display the concepts development. Animation, however, allows us the opportunity to make abstract concepts concrete, contextualising the concept in a visualisation of the child’s story, narrated with their voice and designed to represent their world, in a film produced entirely by them, therefore allowing opportunity for a therapeutic approach to learning through storytelling. This learning tool is designed to be implemented in a specifically designed therapeutic learning environment to enhance the benefits of participation from both educational and therapeutic perspectives.

A review of relevant literature highlights a significant connection between animation, the learning needs of those with FASD and the need for a therapeutic learning environment. This is a proof of concept study, demonstrating the value and potential of animation film making in this new area of practical application. The study closely considers the learning environment from a therapeutic perspective and aims not only to develop a learning tool but to also define the optimum therapeutic learning environment. The study is therefore untested at this stage.

Phase 2 of this ongoing research study seeks to explore additional benefits of participation and engagement with the process in an educational and therapeutic context. Considerations of the therapeutic learning environment will be further explored to determine the optimum setting to support the ongoing learning of this pedagogically bereft (Carpenter, 2011) population. Phase 2 also aims to clarify therapeutic benefits as additional outcomes of participation in this programme.

The proposed learning tool and therapeutic learning environment outlined in this paper is an original contribution to knowledge and if found to be successful, could offer significant opportunities for a therapeutic approach to education for this population and others.

The purpose of this qualitative case study was to explore perceptions of the impact of program participation on parenting styles and behavioral changes using observations and in-depth semi-structured interviews with Black and Coloured staff and mothers at a community-based organization (CBO) in the Western Cape Province (WCP) in South Africa (SA). Purposive sampling was utilized in this research via the CBO and narratives from a total of twenty-three (twelve mothers and eleven staff) interviews form the basis of this manuscript. Data was collected between January – February 2017 and was analyzed through the phenomenological and inductive thematic analysis approach. The staff interviews revealed that child abandonment and neglect and the abuse of women are the two main environmental contextual factors that impact program participation. According to staff, improved self-esteem and positive life changes were identified as successful outcomes of participant involvement. The parent interviews provided examples of emotional issues such as domestic abuse and personal issues with alcohol and drugs as individual factors that impact their program participation. Changes in parenting styles was identified as successful outcomes among parent participants. The goal of this study was to provide much-needed insight into this community by presenting a variety of voices, specifically Black and Coloured men and women, that are underreported in the literature. Findings from this research adds to the knowledge of community-based parenting programs (CBPPs) for low-income and underserved populations in SA and internationally.

The purpose of this paper is to explore the profiles of behaviours and adaptive functioning in the UK children and young people with fetal alcohol spectrum disorders.

Data of 106 participants registered from 2005 to 2015 were extracted from a clinic database. In total, 99 individuals with confirmed prenatal alcohol exposure (PAE), aged from 5 to 25 years, were analysed using scaled scores of the Vineland Adaptive Behavior Scales-Second Edition (VABS-II), and the Developmental Behaviour Checklist-Primary Carer Version (DBC-P) and Teacher Version (DBC-T). Differences due to age, gender, IQ and family structure (adopted/living with birth parents) were also explored.

The mean composite adaptive behaviour score on the VABS-II was classified as “low” at 68.2 (SD=8.5), with the socialisation domain being the most impaired. Significantly lower VABS-II composite scores were found in individuals with lower IQ’s, older ages and in males. Disruptive behaviours were the most commonly observed on the DBCs, whereas primary carers scored significantly higher than teachers across all subscales. IQ, age and gender were not associated with the total percentile scores of both DBCs. Adoption made no differences compared to living with birth parents.

Future studies would replicate these findings in a larger sample size including individuals without PAE and those living with birth parents.

This study is the first UK report that examines this issue.