• Canadian Children and Youth in Care: The Cost of Fetal Alcohol Spectrum Disorder
Aug 21, 2013
Children and youth1 in care represent a unique population with disproportionately increased rates of developmental disabilities, congenital malformations, mental health diagnoses, and social maladjustment (Chernoff et al. 1994; Fuchs et al. 2008; Harman et al. 2000; Hostetter et al. 1991; Lindblad et al. 2003).
Children who are placed in care often are due to a number of unfavourable circumstances, such as, parental and/or drug problems, child abuse and/or neglect, child abandonment, and young maternal age. Such circumstances are likely to increase the likelihood that a child was exposed to alcohol in utero (Burd et al. 2011; Herrick et al. 2011). Thus, the risk of fetal alcohol spectrum disorder (FASD) in this population is likely to be high. FASD is not a diagnostic term, but is an umbrella term encompassing four categorical diagnostic entities: fetal alcohol syndrome (FAS), partial FAS, alcohol-related neurodevelopmental disorder, and alcohol-related birth defects (Chudley et al. 2005; Stratton et al. 1996). FAS is the most severe and visibly identifiable form of FASD. Prenatal alcohol exposure can affect any organ or system of the fetus, therefore, individuals with FASD may have a broad array of physical defects, cognitive, behavioural, emotional, and adaptive functioning deficits, as well as congenital anomalies, such as malformations and dysplasia of the cardiac, skeletal, renal, ocular, auditory, and other systems. These impairments are likely to have lifelong implications.

In a recently conducted study by the authors of this article, utilizing the current epidemiological and medical literature, over 300 disease conditions coded in the International Classification of Diseases, version 10 were identified to occur in individuals with FASD (Popova et al. in progress). The demonstrated complexity and chronicity of FASD draws attention to the fact that these affected individuals require a wide range of assistance from multiple service systems, including health care, community organizations, remedial education, and others. Without crucial support, people affected by FASD are at an increased risk of developing secondary disabilities, such as mental health problems, trouble with the law, school drop-outs, unemployment, homelessness, and/or alcohol and other drug problems (Streissguth et al. 2004). When combined with the child’s primary deficits, these secondary disabilities increase the complexity of care and result in significant social and economic costs to society (Abel and Sokol 1987; Harwood 2000; Legge et al. 2001; Lupton et al. 2004; PHAC 2003, 2005; Popova et al. 2011b, 2012b; Stade et al. 2009).

Read more: http://link.springer.com/article/10.1007/s10566-013-9226-x/fulltext.html