COSIG CONFERENCE BROCHURE.pdf - Drexel University College ...

COSIG Co-Occurring Disorders Conference, Hershey PA, May 15-17, 2006
Regions of the Brain Most Commonly
Affected By Prenatal Alcohol Exposure
Frontal Lobes
Parietal Lobes
Corpus Callosum
Basal Ganglia
Cerebellar Vermis
EEG Findings
• Down’s and FAS compared
– EEG used to measure alpha waves
– Lower alpha wave activity in both groups
– Pattern was different however
–Down’s
•Slower
• Posterior cerebral cortex
–FAS
• Weaker wave activity
• Left hemisphere of the cerebral cortex
O’Malley, 2000
Central Nervous System Effects of
Prenatal Alcohol Exposure
Hope derives from new concepts of treatment:
– Psychopharmacology (improving cognition, reduction of
anxiety and mood problems)
– Psychotherapy (family support, repetitive messages)
– Environmental manipulation (structure, mentoring, etc.)
– Parenting therapy
– Speech and Language (social skills practice)
– Occupational Therapy
– Behavioral Therapy (reward systems)
– Energy therapy (reduction of anxiety)
Diagnosing the Patient with FASD
• Get as much background information as
possible before the appointment (OT, S and L,
previous psychiatrics, educational records)
• Presenting complaint (evaluate historians)
– Let the caretakers ventilate for part of the session
– Look for anger, frustration, “burn-out”, or giving up
Diagnosing the Patient with FASD
• Elements of the HPI
– Check for usual Axis I major mental illness and Axis II
disorders but also check for the following:
– executive functioning problems (ability to organize, insight, ability to shift
attention, “cause and effect” reasoning, short term memory)
– adaptive living skills problems (ability to be alone, taking care of oneself)
– Social Skills problems (boundaries, treating other children properly,
touching, hitting, biting, etc.)
– Motor Skills Problems (fine and or gross motors skills i.e. graphomotor
skills problems)
– Speech and Language problems (pragmatic speech, receptive and
expressive language)
– Environmental stress and expectations (chaos, abuse, neglect, etc.)
– How long the child was in every placement
– Parent expectations and attitude towards the child-quality of attachment
Development History
• Birth history( type of exposures, quantity,
concentration, timing, frequency)
• Stress and nutrition of the mother (prenatal care?)
• Birth conditions (non-traumatic, traumatic or high
risk, prematurity, meconium staining, Apgars)
• NICU, “Billy” lights, feeding problems, height and
weight parameters)
• Quality of acquisition of developmental milestones
• Easy or difficult baby (colic, quality of sleep,
appetite, allergies, infections)
10