Fetal Alcohol Syndrome Rate in Alaska Declines

A federally-funded treatment and prevention program is being credited with a 32-percent decline in fetal alcohol syndrome cases among Alaska's Native population. The $29-million program, which included a state-produced multimedia education campaign featuring public service announcements, newspaper, radio and TV ads, changed the path of the trend, said L. Diane Casto, Manager of Prevention and Early Intervention Services, Division of Behavioral Health, for the Alaska Department of Health and Social Services – a CADCA state member.

Fetal alcohol syndrome results in mental retardation, delayed physical growth and distinct facial features such as small eyes. Some children do not develop the full syndrome, but suffer from one or more elements of it. Children are usually diagnosed by age six. The findings the state published cover those born between 1996 and 2002, and diagnosed by 2008. During that time, the rate of FAS births among Native populations dropped from about 20 per 10,000 births in Alaska to 13.5. The evaluation shows a steady decline through the years. Also, fewer children were born with Fetal Alcohol Spectrum Disorders.

Fetal Alcohol Spectrum Disorders describes a continuum of permanent birth defects caused by maternal consumption of alcohol during pregnancy, which includes, but is not limited to, fetal alcohol syndrome.

State health officials attribute the decline largely to programs started under a five-year, grant former U.S. Sen. Ted Stevens obtained in a 2000 congressional earmark. The state used the federal money for both prevention and treatment of fetal alcohol syndrome, working their effective strategies into building service programs so even after the grant ended in 2006, services could be sustained. The state launched a multi-media campaign to educate people that some communities are still using, and set up a network of diagnostic teams with members who could do psychology, speech, language and motor skills tests who partnered with community coalitions around the state to work with children affected by the syndrome and to increase the number of reports to the Alaska Birth Defects Registry.

The FAS prevalence among non-Native children in Alaska did not drop. It's not clear why that is, however, Casto believes Alaska Native health organizations have strongly emphasized screening and intervention for pregnant women and women of child-bearing age.

Another goal of the grant program was to change attitudes toward drinking during pregnancy by educating women—many of whom were older and educated and considered themselves social drinkers—their friends and family, alcohol servers and medical providers about the threat of FAS. Casto believes her office’s state-wide training of clinicians and social workers using curricula developed by her office has helped increase diagnoses of the disability and increased substance use screening in primary care settings.

“Before, it might have been misdiagnosed as a learning disability or ADHD,” she said. “There’s been such misinformation out there. When we did our pre- knowledge, attitude, beliefs and behaviors survey, and asked clinicians: “Is it OK to occasionally drink alcohol during pregnancy? The people to answer that “yes” were usually the OBGYNS.”

Coalitions educate clinicians and pregnant women in ways that alcohol affects the brain and how it causes brain damage in an unborn child. They teach doctors and nurses how to develop intervention programs, too.

The social norm may be changing, Casto said, but the state still has a long way to go. The Alaska legislature recently dedicated $2 million to improve services for the disability. Casto concluded: “(FAS) is the only fully, 100 percent preventable, birth defect.”