FASD support offered

Jenny Salmon.
Jenny Salmon.
Dr Jenny Salmon, RCpN, BN, PhD, of Vauxhall, makes some points about the diagnosis and treatment in the South Island of foetal alcohol spectrum disorder.

Blair Donkin's letter to the editor ''Frustrated by 'brick wall' on assessments'' (ODT, 30.11.13) is correct in its content.

There is no diagnostic clinic for foetal alcohol spectrum disorder (FASD) in the South Island. This is to be found in Auckland.

I have been researching in this field in New Zealand for the past 10 years, with 2012 being spent as post-doctoral research fellow to Prof Albert Chudley (geneticist/paediatrician), University of Manitoba, a leader in the field.

It was while I was working there that Auckland Judge Tony Fitzgerald came to consult.

FASD is an umbrella clinical term, not a diagnosis. Under the umbrella there are four diagnoses: Foetal alcohol spectrum disorder (the severe end of the spectrum when the characteristic craniofacial morphology is present); Partial foetal alcohol syndrome (pFAS); Alcohol-related neurodevelopmental disorder (ARND); and Alcohol-related birth defects (ARBD), for example heart, kidney problems, cleft palate, scoliosis, etc.

My research shows the diagnosis which is usually given to an individual with a clinical presentation of FASD in the South Island is attention-deficit hyper-activity disorder (ADHD) for which Ritalin is prescribed.

This is not the correct drug of choice for FASD. I should perhaps add many individuals with FASD also suffer from ADHD as well as 90% having dual mental health problems.

The correct diagnosis is required before the age of 6 so potential secondary disabilities can be avoided (such as trouble with the law, involvement with the justice system, alcohol and drugs) and for the affected individual to receive government benefits and support, including relevant schooling.

Unfortunately, even if the correct diagnosis is made, there are no community resources to assist the individual other than counselling.

In addressing Dr Juan Garcia's comments, I wish to state a correct diagnosis of either FAS, pFAS, ARND or ARBD is vital, as this bodes well for the future of the individual.

The diagnosis is also important in relieving stress within families who have struggled to find a correct diagnosis for their loved one.

Important also is the fact the affected individual will know what he has, rather than be in a state of daily wondering.

The symptoms of FASD are well documented, with a main one being impulsivity at an early age.

The symptoms usually manifest themselves when the child starts school or in some cases kindergarten, when they display lack of friendships with other children.

Animals then take this role.

They are good at art and swimming, so these activities should be encouraged.

The characteristic facial features of FAS are totally visible rather than invisible as argued by Dr Garcia.

Admittedly, the other subsets of the disability are difficult to assess unless fully conversant and experienced in the disability.

Even then the individual should be assessed by a multidisciplinary team with a geneticist using Astley's four-digit assessment scale or Chudley's Canadian Guidelines for Diagnosis.

I have recently set up a support group in Dunedin to assist families who have a member with the disability.

We are looking for new members to come and join us.

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