Академический Документы
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Secondary Effects
Result from negative consequences of primary disabilities and can often change For example, while learning disabilities might be a primary disability, depression may be the effect of repeated failures because of those disabilities
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Research Study
The following secondary effects were ascertained from life history interviews of 415 FASD affected individuals using 450 questions Dr Anne Streissguth, et al, University of Washington
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Secondary Disabilities
Mental health problems Disrupted school experiences Easily victimized Trouble with the law Inappropriate sexual behaviour Alcohol and drug problems Problems with employment and living independently
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Even when FASD is recognized, another diagnosis is often used in order to get reimbursement for treatment or services
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Possibility of Misdiagnosis
Individuals may have undiagnosed or misdiagnosed mental health disorders Individuals may be diagnosed with a mental health disorder without closely examining the total picture; FASD can look like many other mental health diagnoses Adults may have many other disorders that come from living with FASD without support
(Dubovsky, 2002)
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Potential Victimization
72% of individuals with FASD had been victims of physical, sexual and/or emotional abuse Difficulty with sound judgment and decisionmaking, along with the desire to please others, leaves them vulnerable to exploitation, manipulation and abuse
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Substance use disorders may have a genetic component leading to vulnerabilities in offspring
Therefore, the risk of a woman with a mental illness and an alcohol use disorder giving birth to a child with FASD and vulnerabilities for mental illness and substance use is significant
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Dependent Living
83% of those 21 and over in secondary disabilities study were unable to live independently Managing and understanding the value of money was the most frequent difficulty: tend to spend what they have Repeatedly need help with money for food or housing
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82% 78% 70% 68% 57% 52% 49% 48% 48% 37% 24%
STABILITY
SAFETY SECURITY
SUPERVISION
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Establish routines
Build transitions into the routine
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Routine
Simple tasks, explanations
Supervision
Decreased stimulation
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CARES Model
Cues Attitude Repetition Expectations Support (refer to www.annewright.ca; we CARES manual)
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Paradigm Shift
Need to change expectations that all behaviour can be changed FASD needs to be seen as an invisible disability
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Resources
Streissguth, A., Fred L. Bookstein, Helen M. Barr, Paul Sampson, Kieran OMalley, Julia Kogan Young. 2004. Risk Factors for Adverse Life Outcomes in Fetal Alcohol Syndrome and Fetal Alcohol Effects. Developmental and Behavioral Pediatrics Vol. 25, No. 4.
Streissguth, Ann. Fetal Alcohol Syndrome: A guide for families and communities. Baltimore, MD: Paul H. Brooks, 1997.
Streissguth, A., H. Barr, J. Kogan, F. Bookstein. Understanding the occurrence of secondary disabilities in clients with Fetal Alcohol Syndrome (FAS) and Fetal Alcohol Effects (FAE). Seattle: University of Washington, 1996.Streissguth, A.
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Books
Sara Graefe (ed.) Parenting Children Affected by Fetal Alcohol Syndrome: A Guide for Daily Living, The Adoption Council of Canada, 1994. Ann Streissguth, Jonathan Kanter. The Challenge of Fetal Alcohol Syndrome: Overcoming Secondary Disabilities, University of Washington Press, 1997. Bonnie Buxton. Damaged Angels: A mother discovers the terrible cost of alcohol in pregnancy, Knopf, 2004.
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Thank you!
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