Alabama Fetal Alcohol Spectrum Disorder (FASD) Initiative

Alabama Nurse,  Jun-Aug 2006  

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FASD is the leading known cause of mental retardation, and a leading cause of birth defects and learning disabilities. One in one hundred births in the United States will have some degree of preventable damage due to maternal alcohol exposure. FASD is an umbrella term describing the range of effects that can occur in an individual with prenatal alcohol exposure. These effects may include physical, behavioral, mental, and/or learning disabilities with possible lifelong implications.

The University of South Alabama (USA), Department of Medical Genetics' Alabama Birth Defects Surveillance and Prevention Program (ABDSPP) has been awarded funding to implement prevention of FASD, through the Alabama FASD Initiative (AFI). This was the result of a one year planning period financed by prior funding from the Substance Abuse and Mental Health Services Administration (SAMHSA) administered by Northrop Grumman. Of 22 states that applied, 10 were granted funding. In Alabama, the planning process took place during 2005. A network of 20 major State agencies developed a Task Force, conducted a Needs Assessment and developed a Strategic Plan. Key collaborating Task Force partners include:

Alabama Department of Public Health (ADPH), Alabama Department of Mental Health/Mental Retardation (ADMH/MR), Alabama Department of Rehabilitation Services (ADRS), Alabama Medicaid Agency, Center for Demographic and Cultural Research, Auburn University, Montgomery, AL, University of South Alabama, Dept. of Medical Genetics, Alabama Department of Children's Affairs, Alabama Department of Education, Alabama Department of Human Resources, Alabama Department of Youth Services, Alabama Partnership for Children, Alabama Public Television, Alabama Chapter of the American Academy of Pediatrics, Alabama Foster and Adoptive Parent Association, Alabama Multiple Needs Child Office, Alabama Alcohol Beverage Control Board, The ARC of Alabama, Inc., Alabama Chapter of the March of Dimes, The Children's Hospital, Birmingham, Governors Office of Faith Based Initiatives, and the Alabama Indian Affairs Commission.

Now Alabama has been funded to begin implementation of the Initiative. Years two through five are the Implementation Phase and four counties will be used for the target populations; Tuscaloosa, Jefferson, Montgomery and Mobile. The AFI program will focus on prevention by integrating the Initiative into existing State systems of care, to reduce the incidence of FASD in Alabama. Two target populations for prevention have been identified by the AFI Task Force:

1) The Family Planning programs of the Alabama Department of Public Health; where the goal is to reduce the number of alcohol-exposed pregnancies. Clients in these programs who consume alcohol will receive screening for alcohol use, dependence or abuse, FASD education, FASD counseling, case management and/or referral for intervention if needed.

2) The Special Women's Substance Abuse Programs of the Alabama Department of Mental Health/ Mental Retardation; where the goal is to reduce the number of alcohol-exposed pregnancies among women who are receiving treatment for alcohol addiction. Women in these programs will be provided FASD education, FASD counseling, contraception counseling and contraception services (through collaboration with the ADPH's Family Planning Program).

The Alabama Fetal Alcohol Spectrum Disorders Initiative began screening patients in the Alabama Department of Public Health's Family Planning clinics in the four target counties on April 3, 2006. The Alabama Department of Mental Health/Mental Retardation began their part of the Initiative including FASD, contraception counseling and case management at the same time.

Alabama Physicians can play a large role in reducing the impact and in the prevention of FASD. A high level of suspicion, leading to early diagnosis and early multidisciplinary interventions maximizes the quality of life for an individual affected by FASD. Women who already have a child affected by FASD are at the highest risk of having another. Adding questions on alcohol intake to the history portion of all exams opens the door for discussion and teaching for prevention.

In November 2005, The Alabama Association for Retarded Citizens (ARC) of Morgan County chose the Alabama FASD Initiative to be the recipient of their Peter Liebert Community Prevention Action Award for 2005. This award recognizes programs for their outstanding contributions to persons with developmental disabilities in the State of Alabama.

For additional information, please contact:

Barbara H. Oliver, CRNP

AFI Project Director

Wladimir Wertelecki, M.D.

ABDSPP Program Director

University of South Alabama, Dept. of Medical Genetics

(800) 624-1865, (251) 460-7500, boliver@usouthal.edu.

Barbara Oliver will be presenting this topic at the ASNA, AlaONL, AANS Convention on September 28,2006 at the Auburn University Hotel and Dixon Conference Center in Aubum, Alabama.

Copyright Alabama State Nurses' Association Jun-Aug 2006
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