Alaska takles FAS with $29 million federal project

Posted: Monday, November 05, 2001

FAIRBANKS (AP) -- Fetal alcohol syndrome is simple: The only way a child can acquire it is when a pregnant woman drinks alcoholic beverages.

Yet FAS is complicated: Just as alcohol affects individual drinkers differently, so it is with a fetus exposed to alcohol.

Some children are born with organic brain damage, central nervous system damage, growth deficiencies, abnormal facial characteristics and malformations of the heart and kidneys. Others, with no apparent physical characteristics, still have significant brain damage and will likely suffer frustrations because of it the rest of their lives. They will be judged ''lazy,'' ''learning disabled'' or ''delinquent'' when people fail to understand or recognize the root of their problems.

There is no cure for FAS, no miracle medicine that improves the condition.

But there is hope. FAS and its related conditions are completely preventable, and children with FAS can grow up to be responsible adults with fulfilling lives.

To deal with FAS, the state of Alaska is in the second year of a five-year $29 million project, with funding from the federal Substance Abuse and Mental Health Services Administration. The plan addresses prevention, diagnosis, services and documentation. The project is run entirely with federal funds.

A statewide FAS office for the Department of Health and Social Services opened in January 1998. Money to start the office ahead of the five-year plan came from the Alaska Mental Health Trust Authority. The office, located in Juneau, has six employees charged with setting up FAS programs around the state.

Alaska has the highest birth rate of FAS babies in the nation. Here, 1.4 babies per 1,000 are born with FAS annually, compared with the national rate of less than 0.7 per 1,000 live births each year.

An estimated 12 additional babies per 1,000 are born in Alaska each year with a lesser level of alcohol effects, known as fetal alcohol spectrum disorder.

Breakdowns by regions, cities or rural/urban categories in the state are not available, but it is known that the rate of FAS births for Alaska Natives is 4.8 per 1,000. The higher number could be credited to better tracking by Alaska Native health services, said Diane Worley Casto, director of the state FAS office in Juneau.

''Everyone knows FAS is a permanent disability,'' Casto said. ''This is not a new problem. These individuals have been around for years and years and years. It is 100 percent preventable, but we have an opportunity to make change.''

The evolving statewide plan for combating FAS focuses on existing agencies rather than on adding personnel and creating additional offices. A statewide curriculum is being prepared for correctional officers, teachers, social workers and judges.

The five-year plan has also led to creation of nine diagnostic teams around the state. Teams consist of volunteer parents, social workers and physical therapists.

''Up 'til the last three years there was no coordinated process for diagnosing this, so people were diagnosed with behavior problems, minimal retardation or mental illness,'' Casto said.

Consequently, there have been 120 diagnoses of FAS in the past two years in Alaska, up from virtually zero in-state diagnoses.

The Fairbanks Fetal Alcohol Community Evaluation Services Team is one of nine such teams placed around the state as part of the five-year plan. Its workers refer, screen and assess children experiencing difficulties related to prenatal alcohol exposure. The focus is on children living in the Fairbanks North Star Borough who are between 5 and 12 years old.

The team has two doctors, as well as a social worker, public health nurses, an occupational therapist, education specialists and parent advocates.

Formed two years ago, the 13-person team is led by coordinator Sheree Dohner, a public health nurse at the Fairbanks Regional Public Health Center.

With the team in place, Dohner said, it's possible to identify problems earlier and to point the children and their families toward services that can help them achieve their highest level of functioning.

''We're just getting rolling,'' she said.

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