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Fetal Alcohol Spectrum Disorder: Best Practices

Fetal Alcohol Spectrum Disorder: Best Practices. People affected by FASD are found within health, education, justice and social service sectors and receive inconsistent messages and often inadequate support There is a clear need for a collaborative approach to implementing current Best Practices.

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Fetal Alcohol Spectrum Disorder: Best Practices

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  1. Fetal Alcohol Spectrum Disorder: Best Practices FASEout Project 2006: www.faseout.ca

  2. People affected by FASD are found within health, education, justice and social service sectors and receive inconsistent messages and often inadequate support • There is a clear need for a collaborative approach to implementing current Best Practices FASEout Project 2006: www.faseout.ca

  3. What are Best Practices? • Meeting the needs of people who may be affected by FASD and ensuring that prevention of FASD is a component of everyday service delivery • Statements based on scientific evidence and/or on the perspectives of consumers, expert practitioners and educators - Health Canada (2001) FASEout Project 2006: www.faseout.ca

  4. Best Practices (cont’d) • In 2000, the Canadian Centre on Substance Abuse undertook a Situational Analysis Project on FAS/FAE for Health Canada • Literature reviews, research and national program interviews were conducted and Best Practices for FAS/FAE and the Effects of Other Substance Use During Pregnancy (Health Canada, 2001) was created FASEout Project 2006: www.faseout.ca

  5. Best Practice Statements • Best Practice statements were developed for: • Prevention • Identification • Intervention FASEout Project 2006: www.faseout.ca

  6. Prevention • Prevention activities address issues up to the birth of the child • are intended to promote health and prevent alcohol/drug use during pregnancy • prevent conception while substances are used • reduce harm arising from substance use during pregnancy FASEout Project 2006: www.faseout.ca

  7. Primary Prevention Activities undertaken with a healthy population in order to maintain or enhance physical and/or emotional health FASEout Project 2006: www.faseout.ca

  8. Secondary Prevention Activities aimed to address a problem before it becomes severe or persistent FASEout Project 2006: www.faseout.ca

  9. Tertiary Prevention Activities for individuals in whom the condition has already developed FASEout Project 2006: www.faseout.ca

  10. Identification • Activities that involve screening, referral and diagnosis of newborns, adolescents or adults affected by prenatal substance use FASEout Project 2006: www.faseout.ca

  11. Diagnosis • Diagnosis is done by medical specialists in conjunction with a multi-disciplinary team including a pediatrician or medical doctor, psychologist, social worker, physiotherapist, occupational therapist and speech therapist FASEout Project 2006: www.faseout.ca

  12. Intervention • Activities intended to prevent or reduce the harm associated with the primary and secondary disabilities • Intervention activities are specific to infancy, childhood, adolescence and adulthood FASEout Project 2006: www.faseout.ca

  13. Best Practice StatementsPrimary Prevention • Limit the availability of alcohol • Use warning labels and posters • Develop school wide substance use prevention programs as a means of preventing or delaying substance use among youth FASEout Project 2006: www.faseout.ca

  14. Best Practice ActivitiesPrimary Prevention • Public awareness campaigns • Warning signs and labels • Information dissemination • Public education workshops • Community-based projects FASEout Project 2006: www.faseout.ca

  15. Best Practice StatementsSecondary Prevention • Routine screening of all pregnant women for use of alcohol in various settings, including justice, housing and health • Training on FASD for physicians and health professionals working with women who have substance use problems • Use cognitive-behavioural intervention methods with women with early-stage alcohol problems FASEout Project 2006: www.faseout.ca

  16. Best Practice StatementsTertiary Prevention • Combine prenatal care with substance abuse programming • Promote gender specific substance abuse treatment programs • Advocate for services with a single point of access addressing social and health needs of pregnant women with substance use problems FASEout Project 2006: www.faseout.ca

  17. Best Practice StatementsTertiary Prevention (cont’d) • Intensive case management of service • Openness to intermediary harm reduction goals • No evidence to support the use of punitive measures, such as mandated treatment FASEout Project 2006: www.faseout.ca

  18. Best Practice ActivitiesSecondary and Tertiary Prevention • Programming specific to women who are pregnant and using substances • Routine screening to identify women who are at risk of having a baby born with FASD • Women centred substance abuse treatment programs for women who are pregnant • “One stop” programming • Home visitation case management FASEout Project 2006: www.faseout.ca

  19. Best Practice StatementsIdentification • Diagnostic services enhanced through specialized training, telemedicine and traveling clinics • Routine screening of maternal alcohol use during prenatal care • Supportive atmosphere when discussing substance abuse problems with pregnant women FASEout Project 2006: www.faseout.ca

  20. Best Practice ActivitiesIdentification • Accessible multidisciplinary diagnostic services • Standardized clinical guidelines • FASD - specific clinics • Psychosocial assessment services • Physician training specific to FASD FASEout Project 2006: www.faseout.ca

  21. Best Practice StatementsIntervention - Infancy • Use of a multidisciplinary team to address the range of complex needs for infants affected by FASD • Long-term, stable living environments where caregivers have FASD specific information, training and support • Low staff-child ratio programming • Access to early educational interventions FASEout Project 2006: www.faseout.ca

  22. Best Practice ActivitiesIntervention - Infancy • Infant development programs designed specifically for infants with FASD (low staff-child ratio, low sensory activities, etc.) • Support for caregivers of infants with FASD • Home visitation case management FASEout Project 2006: www.faseout.ca

  23. Best Practice StatementsIntervention - Childhood • Caregivers of children with FASD benefit from ongoing support and advocacy for medical, educational and psychological issues • Children with FASD benefit from an Individualized Education Plan (IEP) involving a range of collaborating professionals FASEout Project 2006: www.faseout.ca

  24. Best Practice StatementsIntervention - Childhood (cont’d) • Learning environments should be adjusted for children affected by FASD - calm, quiet, routine, structure, etc. • Individualized curriculums should include a focus on functional skills for independent living (problem solving, social interacting, etc.), behaviour management strategies and developing realistic expectations of the child FASEout Project 2006: www.faseout.ca

  25. Best Practice ActivitiesIntervention - Childhood • FASD specific school programs - adjusted curriculum and classroom requirements • Life-skills programs to include information on the consequences of drinking during pregnancy • Multidisciplinary case management teams for ongoing support FASEout Project 2006: www.faseout.ca

  26. Best Practice StatementsIntervention - Adolescence • Adolescents benefit from basic socialization and communication skills, tailored vocational counselling and employment supervision • Tailored programming for substance abuse treatment, mental health services and within the correction system FASEout Project 2006: www.faseout.ca

  27. Best Practice ActivitiesIntervention - Adolescence • Programming specific for youth affected by FASD (job readiness, alternative sentencing, supported employment, alternative training) • Supportive housing for youth affected by FASD (group homes) • Substance abuse treatment programs designed for youth affected by FASD FASEout Project 2006: www.faseout.ca

  28. Best Practice StatementsIntervention - Adulthood • Consistent case management and advocacy for adults (and their children) • Substance abuse programs, employment training, mental health and correctional services tailored for adults affected by FASD FASEout Project 2006: www.faseout.ca

  29. Best Practice ActivitiesIntervention - Adulthood • Supportive living environments (external brain managers) • Tailored employment programs • Programs within the correctional system directed for adults affected by FASD • Support for family members supporting an adult affected by FASD FASEout Project 2006: www.faseout.ca

  30. Implementation Guide:What is it? • a guide based on principles from Health Canada’s Best Practices and Situational Analysis for FAS/FAE and the Effects of Other Substance Use During Pregnancy (2001) • a step by step framework for policy and practice modification • a modified lens for looking at FASD FASEout Project 2006: www.faseout.ca

  31. Values Guiding our Work • Hope……. • Respect……. • Understanding…….. • Compassion……… • Cooperation………. (Adapted from the Saskatchewan FAS Coordinating Committee Guiding Principles 2001) FASEout Project 2006: www.faseout.ca

  32. Hope • Recognize that at whatever point a woman can stop or reduce her drinkingin pregnancy, there is hope for her to have a healthier child • Acknowledge that no matter what, supportive intervention is effective FASEout Project 2006: www.faseout.ca

  33. Respect • The abilities of individuals affected by FASD • The knowledge of those who parent individuals affected by FASD • The rights and capabilities of women and their partners to make obvious choices about their health and that of their children FASEout Project 2006: www.faseout.ca

  34. Understanding • Stay open to new information and be aware and reflective of your own attitudes and values • Inform yourselves about the issues and on-going research • Avoid sensationalizing FASD • Be sensitive to the impact of a diagnosis on an individual, their family and community FASEout Project 2006: www.faseout.ca

  35. Compassion • Be sensitive to the needs of individuals affected by FASD • Be open to learning people’s strengths and challenges • Be sensitive to the situation of women using alcohol • Be open to the individual process of recovery FASEout Project 2006: www.faseout.ca

  36. Cooperation Recognize the importance of building partnerships within communities in addressing all aspects of FASD FASEout Project 2006: www.faseout.ca

  37. Goals • Prevent FASD • Assist in development of appropriate policy and practice in relation to FASD Best Practices • Increase community capacity to provide care and support to those who are affected by FASD FASEout Project 2006: www.faseout.ca

  38. Objectives • Reduce incidence of FASD through increased awareness and knowledge • Train all staff regarding FASD and its impacts on children and adults • Increase public education activities in FASD prevention and intervention FASEout Project 2006: www.faseout.ca

  39. Objectives (cont’d) • Increase coordination between disciplines to ensure proper diagnosis and referral for services • Support individuals and families affected by FASD • Develop a committee dedicated to reviewing policy and practice in relation to Best Practices FASEout Project 2006: www.faseout.ca

  40. Methodology Watch Get help Do FASEout Project 2006: www.faseout.ca

  41. Watch - see the world differently • Become educated about FASD • Examine challenges to policy and practice implementation and find strengths within the organization and community • Make the paradigm shift required to view services through the FASD lens FASEout Project 2006: www.faseout.ca

  42. Education - Ask Yourselves... • Can you attend FASD conferences? • Can you train all staff about FASD? • Can you collect and review FASD resources? • Can you discuss Best Practices with families affected by FASD? • Can you educate community members regarding FASD? FASEout Project 2006: www.faseout.ca

  43. Challenges and Strengths • Is Federal or Provincial legislation limiting FASD work? • Are costs prohibiting access to services in your community? • Are consistent messages about alcohol and pregnancy visible in your community? • Are FASD diagnostic services obtainable? FASEout Project 2006: www.faseout.ca

  44. Challenges and Strengths (cont’d) • Are there already knowledgeable staff regarding FASD in your organization? • Are there existing community partnerships? • Do you have flexible programming? • Are there strong and committed family members and support people for individuals affected by FASD? FASEout Project 2006: www.faseout.ca

  45. Paradigm Shift • Need to change expectations that all behaviour can be changed • FASD needs to be seen as an invisible disability • Dependence is a factor of FASD • People with FASD need things to be repeated many times and to be reminded often FASEout Project 2006: www.faseout.ca

  46. Paradigm Shift (cont’d) • Individuals with FASD need to be informed of their disability • Support people need to stay involved • Early diagnosis is key to accessing appropriate services • Structure, supervision and simplicity are key • Models of alternative justice should be used FASEout Project 2006: www.faseout.ca

  47. Get Help - to take on the task Form Partnerships FASEout Project 2006: www.faseout.ca

  48. Partnerships • Can you join or create a multidisciplinary FASD committee? • Can you locate and refer to professionals who have an understanding of FASD in health, education, social work, mental health, addictions, justice, employment and housing? FASEout Project 2006: www.faseout.ca

  49. Partnerships (cont’d) • Can you locate positive role models for FASD in your community? • Can you seek information from FASD experts? FASEout Project 2006: www.faseout.ca

  50. Do - the work needed • Review existing policies and practices and modify them with regards to FASD • Remain consistent with Best Practices FASEout Project 2006: www.faseout.ca

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