Foetal Alcohol Spectrum Disorder (FASD) is the leading cause of preventable neurodevelopmental disorder in South Africa. As a country, South Africa has the highest prevalence of FASD in the world. FASD is caused by alcohol use and misuse during pregnancy. Alcohol is a teratogen, meaning it is a substance that can do permanent harm to the developing foetus. Alcohol crosses the placental barrier and reaches the developing foetus. The foetus is especially susceptible to alcohol-related damage during the first trimester of pregnancy, however, continued alcohol misuse will have a negative impact on in utero development throughout the course of pregnancy.
Alcohol may damage the foetus in the following ways:
Since there currently are no international guidelines on what amount of alcohol consumption is safe during pregnancy NO ALCOHOL USE during pregnancy is recommended. Frequently women find out they are pregnant towards the end of the second month of gestation which may lead to inadvertent alcohol exposure, therefore it is advised that women planning to conceive, or attempting to conceive should already abstain from alcohol use. During pregnancy, it is also safer to completely abstain from alcohol use to support optimal development of the foetus.
FASD is often missed at birth, but symptoms such as severe irritability and feeding difficulties shortly after birth may already be early indicators of the presence of FASD. Infants with FASD may go through a period of withdrawal after birth. Mothers who breastfeed should also abstain from alcohol use, since alcohol, also passes to the infant via breast milk. Speech-language therapists and lactation consultants can support mothers with infants with feeding difficulties. During infancy and early childhood children with FASD may present with oral motor difficulties, receptive and expressive language delays, recurrent middle ear infections, global developmental delays, behavioural difficulties and emergence of cognitive difficulties. Children with FASD also have strengths and are capable of learning and changed behaviour, they also tend to be quite friendly and sociable. Throughout early childhood and the preschool years children will benefit from continued speech-language therapy, occupational therapy and play therapy. Parents or caregivers may also seek counselling to support them in their journey as parents and to deal with their own emotional responses to the situation they are faced with.
As they become older and enter school children with FASD may be diagnosed with formal learning disabilities and may struggle to progress academically. These children may require specialized care and schooling. They may require support from remedial teachers, speech-language therapists, educational psychologists as well as occupational therapists. In their teens children with FASD tend to reach their academic ceiling and may often not be capable of enrolling in tertiary training and becoming fully independent as adults. Teenagers with FASD are also predisposed to alcohol and substance abuse and often develop juvenile delinquent tendencies if behaviour is not addressed and appropriately managed from an early age.
FASD can be diagnosed early if appropriate medical developmental team investigations are undertaken if FASD is suspected. It is recommended that the following evaluations take place:
If parents or caregivers want to seek out support for their infant or young child with FASD or suspected FASD various health care professionals can be contacted. Children with FASD have the potential to become part of society and productive members of their family and community if they receive appropriate medical, developmental and educational support from as early as possible in life.
The following organization can be contacted for parental/caregiver support:
Foundation for Alcohol Related Research FASD Support
Contact person: Laetitia Pool
Call: 021 686 2645
The following organizations can be contacted for information about FASD:
The following health care directories can be consulted for information on doctors and therapists in your area:
South African Speech Language Hearing Association – www.saslha.co.za
South African Audiology Association – www.audiologysa.co.za
Occupational Therapy Association of South Africa – www.otasa.org.za
Health Professions Council of South Africa – www.hpcsa.co.za
The following organizations can be contacted if a mother feels that she requires help with alcohol use/abuse or requires rehabilitation support:
Dr Mari Viviers (Speech-language therapist)
Discipline of Speech-Language Pathology and Audiology
Sefako Makgatho Health Sciences University
(B.CommPath, M.CommPath, DPHil)
With a special interest in FASD, early intervention and infant feeding difficulties
Contact information: email@example.com
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