“I just had one glass of red wine a night. Well, actually two glasses. That’s what the doctors suggest for good health. I never knew it could hurt my son.”
“I don’t think drinking makes any difference. Don’t you just pee it out?”
“We adopted our two children from an orphanage in Russia. We were told they were OK by a doctor in California. He watched a videotape of the kids and he told us that everything was good. They looked great! We brought Sasha and Katarina home from Russia when they were 19 months and three years old. However, when they started school, something was not ‘quite right’. Both of them bit other kids in preschool. They are now attending elementary school and are not invited by other kids or even parents for play dates. The other day the teacher called me about Katarina. She talked back to a teacher during recess and the teacher also told me that she gets in peers’ faces. It also seems as if she does not learn from experience. I’m worried that her self-esteem will suffer in the future because teachers are complaining about her and kids do not want to play with her. They also don’t pay attention. Sasha and Katarina are alike. We have two IEPs (Individualized Education Programs) coming up. They need help.”
These statements were recently expressed to me in my practice. Many parents are not aware that drinking alcohol heavily during pregnancy can result in many problems for their child. Numerous parents regardless of their intelligence and socioeconomic levels, are not mindful that drinking during pregnancy may result in significant problems in their child’s language, social skills, and ability to focus. Others adopt children and do not have any information about the birth mother’s pregnancy history.
Research indicates that many children exposed to high levels of alcohol in the womb may have distinct facial features seen in fetal alcohol syndrome (FAS)/spectrum disorders (FASD). However, recent research from the National Institute of Health reports that children may not have the facial features seen in FAS but may show features of abnormal intellectual and behavior development. The researchers documented an abnormality in one of the following four areas in approximately 44 percent of children whose mothers drank four or more drinks per day during pregnancy compared to those women who consumed no alcohol when pregnant.
The study also revealed abnormal facial features was present only in about 17 percent of alcohol-exposed children.
I have seen many fetally alcohol exposed children who exhibit problems with managing their temper (poor frustration tolerance) and attention. In addition, these children have problems understanding cause and effect and do not learn from experience. Their parents repeat, repeat, and repeat to them why their behavior is inappropriate. It does not seem to sink in! Trouble with maintaining social relationships with their peers is also a common occurrence and leads to bullying and/or victimization.
These children also exhibit problems with many aspects of executive functioning. Specifically, I have seen deficits with planning and organizational skills, impulsivity (poor inhibition), flexibility, time management skills, monitoring skills (self-awareness and checking skills), and learning from mistakes.
Research from my colleague, Amy Schonfeld, Ph.D., suggests that heavy prenatal alcohol exposure is associated with immature judgment in terms of moral judgment and elevated levels of delinquent behaviors. Behavioral studies of children with FASD also reveal a high rate of psychiatric problems and troubles inferring and understanding the mental state of others (theory of mind).
I urge you to consult with your pediatrician when something is not quite right with your child in the event you heavily drank during your pregnancy or adopted a child from a birth mother who drank throughout the pregnancy.
Early intervention makes a difference in these children. Psychological intervention in terms of moral reasoning intervention, social competence, and additional training with social skills training is needed for this population.
Happy Holidays to you and your family.
Karen L. Schiltz, Ph.D.
Psychologist (CA PSY 9508)
Private Neuropsychology Practice of Karen Schiltz Ph.D. and Associates
Associate Clinical Professor (Voluntary)
Medical Psychology Assessment Center
Semel Institute for Neuroscience and Human Behavior
Department of Psychiatry and Biobehavioral Sciences
David Geffen School of Medicine at UCLA