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Old 10-31-2008, 10:27 PM   #1
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FASD- How do we find out for sure?

At our parent teacher conference last week, the teacher stated she believes our newly adopted son may have been exposed to alcohol and drugs while in the womb. She stated he has several behaviors and wonders if the aspergers diagnosis is incorrect and its really Fetal Alcohol Spectrum Disorder. We know his birthmom was an addict and he has 2 bio half sibs who were addicted at birth. Can someone direct me to books, links, etc that might be helpful in understanding this issue? Also does anyone know how to find out 100% if this is the issue, is it even possible? Asking the birthmom is impossible as she refuses to acknowledge she even gave birth to my son. I just want to make sure they arent just adding another diagnosis to his long list already without making sure its really necessary. Thanks In Advance
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Old 11-01-2008, 02:52 AM   #2
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You also might want to check out a rad specialist, there is a GREAT yahoo group called radfasd kids. Many of those kids were misdiagnosedwith spectrum disorders. Good luck.

I think but dont quote me that the gray matter in the brain is malformed, causing the brain to appear like swiss cheese.
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Old 11-01-2008, 04:10 AM   #3
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I remember reading about FASD long long ago. So I googled to find out if I was remembering. I was right.

The easiest clue is facial deformaties. The bridge of the nose is flattened and might look a bit like a splayed African American nose but it doesn't and is also broader between the eyes. Native Americans have the highest rate of FASD. It is not uncommon for FASD children, like other disorders, to be misdiagnosed. Read the info below for more information. The article I read long ago mentioned that the person had trouble with the concept of time and that they also had emotional problems like poor social skills and being emotionally cold/distant.

from http://pubs.niaaa.nih.gov/publications/aa63/aa63.htm
Another image and bulletin.

a picture showing what to look for.

Government information

This is a machine used to test for said deformities.

She blogs about her adopted son and how she was told that his mom did not drink while pregnant.

An article on a 31 year old man with FASD
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Old 11-01-2008, 05:43 AM   #4
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With birth mother history, FASD is definitely something that needs to be evaluated. One thing to remember is that the diagnosis of ASD and FASD are not mutually exclusive. There are many levels of FASD so a definitive diagnosis in many cases is not possible (just as in ASD/Aspergers).

ASD/Aspergers generally have some level of innate social skill deficit so that is a good 1st indicator of if the ASD/Aspergers diagnosis has some validity. Also any cognitive losses due to FASD (or any other reason) can cause an individual who otherwise just exhibit some of the spectrum characteristics of Autism genetics to approach or meet the clinical definitional of ASD or Aspergers.

If you have any information about the genetic father or his family that might be a good place to look for spectrum characteristics which might give you a clue as to the validity of the Aspergers diagnosis, while less likely if available you might also look at the genetic maternal side also.

In the end there are no 100% answers on either diagnosis, but on the good side therapies for Aspergers should be effective for FASD also.

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Old 11-01-2008, 11:56 AM   #5
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Currently my son's diagnosis is PDD-NOS, RAD, ADHD, PTSD, Anxiety, Sensory Integration Dysfunction, Night Terrors, Severe Abuse/Neglect, possible FASD. I think I got them all, sadly it seems every week they are adding new possible diagnosises. His teachers and therapist have absolutely no problem slapping labels on him right and left.

As far as the birth father, he murdered a man in a bar fight (all I really know about him) and is serving a life sentence. His family has a history of child abuse but no known drug or alcohol issues. He has no facial deformities, though his head is slightly larger than other children his age (we notice this with ball caps, firemen hats, etc but it isnt a noticable difference)

From what I have read about each disorder, he could fit just about any of the diagnosis listed or all of them. I think his most serious are the RAD and PTSD, though his therapist and teacher believe he is firmly attached to us. I think he is for the most part, but I truly believe he lives in constant fear that someday we will throw him away like the other adults in his life or harm him in some way. He still tests us (though not regularly) and is fearful when we leave.

Thank you all who have answered me, I greatly appreciate your insight and support
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Old 11-01-2008, 02:26 PM   #6
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Most of the “diagnosis” you listed are maladaptive co-morbid issues of Aspergers, not distinct primary diagnosis’, with his history and potential cognitive issues they become much more acute. The reason I ask about the genetic parents is that it is very likely that there would also be significant spectrum characteristics and/or co-morbid manifestations that would help confirm the Aspergers diagnosis. The head size thing is reasonably common for Aspergers children. The PTSD history makes the situation much harder until a “safe” environment can be established in which he feels secure, Although any situation which where he is not comfortable will bring up safety issues and the associated anxiety and co-morbidities.

Clinicians who use additional label without the caveat that they are secondary to the primary Aspergers diagnosis are just poorly educated, trained and experienced. PTSD and FASD would be separate distinct diagnosis but in practicality are intertwined in their manifestations with Aspergers.


Last edited by bookwormde; 11-01-2008 at 02:36 PM.
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Old 11-01-2008, 04:10 PM   #7
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I wouldn't consider a large head in and of itself to be a sign of FASD; my son had an unusual form of hydrocephalus and has a big head, too (Adult L hat at 6). Seperate to that, I don't understand how any teacher, no matter how good they are, is equipped to diagnose a child with ANY disorder. That would be the job of a doctor: neuropsychologist, dev. ped, pediatric psychiatrist, etc. Please don't think that I don't empathize or accept your kiddos challenges, etc. I just know how painful and confusing it is when everyone and their brother diagnoses your child (from a lot of experience.)
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Old 11-01-2008, 11:45 PM   #8
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A person I knew from church has helped cared for her cousin's daughter. The vegetable diagnosis slowly has expanded to retardation then a bit behind other kids. The child is normal looking except for the braces, walker and huge head, lol, but look at her Auntie and you see why as large heads run in the family. Beautiful child but that head just does not match her small body. She looks a lot like her Auntie, lol.

As for diagnosis, pshaw. First off is that kids have quirks so that a normal kid who is scared of something might be labelled as being abnormal. Children cannot effectively communicate so that they do not tell parents what is bugging them. A two year old may be avoiding an ugly doctor or is in a bad mood but the Slap-a-Label MD might label the kid ODD, SID, ADD, or something else.

As for FASD look at the kid's face. Are the eyes set wide apart, small eyes, a flat spot on the bridge of the nose? Not the head size but the face itself should look off. If you do not see those indicators then the kid could have something else like SID or autism. Bookworm is very skilled in autism and aspergers. You need to find medical people who will find the roots of the kid's problems and not just slap labels on the kid.

Welcome to the Twillight Zone where what is real and what is not real are really not real and real unless you believe they are not real and real then they are surreal and cereal. lol.

Hugs and good luck
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Old 03-07-2011, 02:20 PM   #9
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If you are questioning whether or not your child has FASD, the first thing you should do is find a good pediatrition - one that is qualified to make this kind of diagnosis. I've read a lot of responces about looking at facial features - [U]Many[U] children with FASD do not have facial features typically described for FAS. And others have only one or two of these features. There are also other things that can cause almost any symptom listed for FASD. FASD is an umbrella term used to describe the multitude of issues a child can have when the woman drinks while she is pregnant. FASD is known as the invisible disibility because most of the time you will not know by just looking at a child that they may have FASD. Find a legitimate specialist and work toward a diagnosis. Get a second and third opion if you do not feel comfortable with the first. Stiving for a correct diagnosis is a step towards understanding and care that can help a child be the best that they can be.
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Old 03-08-2011, 04:35 PM   #10
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Because that line is fuzzy on FASD from mild to not and you know birth Mom has issues.Talk with Dr. One of my former Foster kids had easy to tell classic FASD with a small head(All the facial tells low nose bridge, thin upper lip,flat long area between nose and lip,flatter mid face, etc), growth delays, mental retardation and hard nails.

In kids with milder I am not sure where the clear cut line would be so an evaluation would be needed.

With my Foster kids they often get labled with the kitchen sink(everything they can throw at them that they think might stick) that I like to spin in the posative light of folks trying to get them extra help.

I fight for evals for my Foster kids.

Sounds like you are doing a great job with him.
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Old 03-09-2011, 11:19 PM   #11
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They found link between autism and big heads but FASD heads are supposed to be smaller. From the adopted kids I know with problems is that dr's don't/won't diagnose fasd unless the mother admits it or that there are signs(such as a smooth area above the lip). Either way, most theropy and help at school won't change with a change in diagnoses.
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Old 03-10-2011, 10:07 AM   #12
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Since the teacher suggested that your child may have FASD, the school district is probably liable for paying for a doctor to either confirm or rule out the diagnosis. We were told to NEVER suggest a diagnosis--just say what we were seeing and tell the parent "There are some physical conditions that might cause these things. You may want to see your doctor to make sure everything is okay." If we even said to go see the doctor without the "may," the district was liable to pay for it! It was also suggested that we have another teacher or administrator present if we were going to discuss behaviors that could be the result of physical conditions.
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