Adoption, the Unknown, and Fetal Alcohol Exposure

[WearyWoman]

Hi all,

As you may already know, we adopted both of our boys (the oldest at age 2 through foster care) and the youngest at birth through a private adoption. I can't shake the lingering fears I have about possible fetal alcohol exposure, especially for difficult child 2.

Our youngest (difficult child 2 - now 9) has more severe problems than our older boy (now 16). He demonstrates an extremely high activity level, difficulty in cooperating with requests and routines, and lags behind socially and developmentally. He also has apraxia of speech. His current diagnoses are ADHD and Pervasive Developmental Disorder (PDD) - not otherwise specified, as well as apraxia of speech. Daytime and nighttime pants wetting are regular, self-care skills are below normal, and there is an extremely low frustration tolerance too. Transitions can be really hard.

I do think the worst problems we have though, are his uncooperative behavior, argumentative nature, and frequent meltdowns. Most of the time, we all feel like we're walking on eggshells around him, worried about the next tantrum. Even telling him to pick up his Legos when he's done playing could cause an over-the-top rage. I have been hit, kicked, bitten, spit at, and had things thrown at me. Once a rage starts, it has to run its course, which can be as long as two hours. Consequences have little meaning, since he does not seem to draw on past experience in making decisions.

difficult child 2 does not perceive the difference between an adult and a child, and he is often extremely mean and rude to people. He shouts at his grandparents, brother, and the therapists who work with him. I know other parents of children with autism, and when I mention these behaviors, they raise their eyebrows, as their children don't seem to exhibit this type of disruption to the degree that we experience.

I recently read an article that explores the relationship between fetal alcohol exposure and autism. It seems that it could be an environmental trigger for it.

I believe difficult child 2 has very subtle facial characteristics of fetal alcohol syndrome, including slight epicanthal folds, wide-set eyes, a low nasal bridge, a flat facial midsection, and an underdeveloped jaw. When he was born, I remember thinking his ears looked a little different, but it's not noticeable really any more. He's not missing the groove in his upper lip, and his nose is not short, although it is upturned a bit. His growth has been normal. The facial characteristics are all extremely subtle.

His bio mom (age 21 at the time) told the adoption agency that she did not drink or use drugs during her pregnancy with him, with the exception of smoking cigarettes before realizing she was pregnant. She was still breastfeeding her first baby, who was only 3 months old at the time she became pregnant with difficult child 2. She didn't know she was pregnant until about 4 months along, and we have zero medical history on the bio father (nothing about race or ethnicity either). If she didn't know she was pregnant for so long, isn't it possible she drank in those early months and possibly felt to ashamed to tell the adoption agency?

Anyway, I've read about fetal alcohol exposure, and I'm extremely concerned that difficult child 2 may be affected. I'm devastated at the thought, as I know it means brain damage.

What should I do at this point? If he is affected, does that negate his Pervasive Developmental Disorder (PDD) diagnosis? Are there any resources anyone is aware of that could be beneficial? I worry a lot about difficult child 2's future and ability to function independently.

Thanks,

WW

 

[BusynMember]

I have an adopted son too who I thought had alcohol affects. He has low set ears and I thought he had some features too, but he's almost 17 and definitely only has autistic spectrum. Fetal Alcohol Syndrome (FAS)/Fetal Alcohol Effects (FAE) kids don't know or understand the difference between right and wrong. They also have "swiss cheese thinking" as in they may know the alphabet one day and forget it the next and need to keep asking the same questions over and over again. I would take him to a specialist who understands fetal alcohol syndrome and effects for a diagnosis. Even a neuropsychologist could be confused on that one. I took my son to a top specialist in the Chicago area and he didn't really know...lol. It is only as my son aged that we realize he doesn't have any symptoms of it in his behavior or learning processes. They tend not to have a conscience or understand rules. If your son understands right from wrong, I wouldn't worry.

You can not know if he will or won't function independently at this point. He's too young. I had hopes my son would be independent, but he's going to need some help, and that's ok. That could have happened even if he were my birth child. I still feel he will have a good life and he has really come far.

Most adoptive mothers cl aim they didn't do any drugs or drink while pregnant. Some mean it/some don't. If she didn't know she was pregnant for so long, anything is possible. Good luck and I'm sorry...I know how frustrating this all is.

 

[AnnieO]

WW,

As you can see from my signature Jett was diagnosis'd with Fetal Alcohol Syndrome (FAS). Aside from rages (which he doesn't seem to have... Those are the milieu of my Onyxx), you could be describing him. The physical characteristics, the forgetfulness, the inability to "get" directions, social and developmental issues, low self-care skills, and though his accidents have tapered, they still happen... And his first IEP was for speech only. Biomom was, from all accounts (and I realize these are biased as they come from husband, his family, and Onyxx) a "party animal".

I'm sending you lots of hugs. We are having one heck of a time finding a specialist who understands Fetal Alcohol Syndrome (FAS), and as a result nothing has been done. Insurance will cover most of it, but it's extremely frustrating not to be able to DO anything.

 

[BusynMember]

There actually isn't much you can do for Fetal Alcohol Syndrome (FAS) other than custodial care...if they truly have the syndrome independence doesn't happen because they have brain damage. You may also consider that Onyxx could have Fetal Alcohol Effects, which could be why she doesn't learn from her mistakes. If BM drank while pregnant with Jett, she likely drank during her pregnancy with Onyxx too. Fetal Alcohol Syndrome (FAS)/Fetal Alcohol Effects (FAE) kids tend to abuse drugs/alcohol, act out sexually, and not be able to learn from their mistakes. Many end up in jail, which is tragic, because unlike defiant kids, they really don't understand why they keep getting into trouble. It's sad...I know some Fetal Alcohol Syndrome (FAS)/Fetal Alcohol Effects (FAE) adults that were adopted...and the pain of their parents.

There are some good books on Fetal Alcohol Syndrome (FAS)/Fetal Alcohol Effects (FAE). One is Fantastic Anton Succeeds. I don't remember the author, but if you put the name into Amazon, it should come up. My favorite Fetal Alcohol Syndrome (FAS) book is The Broken Cord by Michael Dorris. He adopted three kids and they all had Fetal Alcohol Syndrome (FAS)/Fetal Alcohol Effects (FAE), although the book only focuses on the oldest child. It sort of goes into a lot of detail on his son's behaviors.

 

[WearyWoman]

Midwest - I have read SO much about this stuff, and it is very difficult to distinguish the characteristics between disorders with overlapping symptoms. It's like a complicated puzzle where the pieces seem to fit in more than one place. Bubby does seem to have comprehension of right vs. wrong, and I haven't noticed the "swiss cheese" thinking. BUT . . . on the other hand, when it comes to accepting responsibility and learning from past behavior . . . ughhh. If you've ever seen the movie Groundhog Day where the actor keeps getting up every morning only to find he has to do the same day all over again, that's kind of what it's like with our Bubby. We go through the same things over and over. Consequences, rewards, and visual schedules, and redirection, etc., etc., don't work well. It's really hard to help him that way. For example, he still fails to flush the toilet most of the time, even though we've been through it many times. He also throws a tantrum about using the bathroom when it's time to go. He will argue and argue and then wet his pants. He's 9 1/2. And, of course, these are minor issues compared to the big meltdowns. Thanks for the book recommendations. I think those will be very helpful.

Stepto2 - It does seem hard to find specialists in that field. I don't know even where to begin. It's unfortunate that more attention hasn't focused on Fetal Alcohol Syndrome (FAS)/Fetal Alcohol Effects (FAE), as is the case with autism spectrum disorders. I'm sure there are many, many people affected, children and adults, who are not receiving the proper support. I worry that there aren't any answers or help if permanent brain damage has resulted.

WW

 

[barneysmom]

Hey you WearyWoman,

If it was me I'd probably get your Bubby evaluation'ed anyway. Bubby is such a cute name. It's sad that his little brain has to be so burdened. And no wonder that you are (((((((Weary)))))

If I come upon anything interesting or unique on Fetal Alcohol Effects (FAE)/Fetal Alcohol Syndrome (FAS) in my reading, I'll be sure to let you know.

 

[BusynMember]

Fetal Alcohol Syndrome (FAS)/Fetal Alcohol Effects (FAE) is far more serious than a mental illness, which can be treated with medication. You need a real expert to tell Fetal Alcohol Syndrome (FAS)/Fetal Alcohol Effects (FAE) from other illnesses. However, there are some real telltale signs, such as "Swiss-Cheese Thinking." The person may know the alphabet one day and forget it the next. These kids are a lot like Alzheimer patients. They have brain damage. Kids with bipolar/autism/anything else don't have these characteristics. They may be forgetful, but not in such an obvious way where they CAN'T remember and CAN'T understand right from wrong. That's why they often end up in jail for the same offenses, not even sure how they got there. They need lifelong custodial care to make sure they don't do anything wrong. And it's not their fault when they do.

 

[Marguerite]

WW, the behaviour you describe, even the extreme degree of it, ALL of it is what we see or have seen in difficult child 3. And more. There is absolutely no way difficult child 3 has Fetal Alcohol Syndrome (FAS) whatsoever, since I know how much I drank both before pregnancy and during it - zero. I used to drink, bot never a vast amount and I didn't start drinking at all until late teens/ I was a uni student at 19 or older before I drank more than half a glass of anything. I did try to get drunk a couple of times and gave up because I just didn't like it and found it boring. At most I've only been a light drinker but after my liver began to misbehave (medication-related initially) I stopped all alcohol. For decades now. I do have maybe half a glass of champagne at Christmas.

So absolutely no way was I drinking any alcohol when pregnant with difficult child 3, not even before I knew. So no way could he be Fetal Alcohol Syndrome (FAS) or Fetal Alcohol Effects (FAE).

I do worry that especially with adopted children, we tend to cry, "Fetal Alcohol Syndrome (FAS)!" at the first concern. Yes, I know some mothers (especially those who don't care about what happens to a pregnancy they don't want) are likely to drink during pregnancy and lie about it. But I don't see those as the majority. A woman who is breastfeeding a 3 month old probably isn't drinking much if anything, because I found out very early when I had easy child, that if I had anything to drink, even half a glass of wine with dinner, my ability to cope went out the window and my already desperate need for sleep multiplied until I was useless.

We need to think broadly about the sort of people who put a baby up for adoption. And their reasons. Usually it's because the birth mother can't cope with raising the baby herself.

Why can't the birth mother cope? A range of reasons:

1) Too young, too inexperienced.

2) Unfit - a drinker, drug user, abusive or violent.

Why would someone be unfit or unable to cope?
They could be mentally unstable. Financially insecure or irresponsible.

My sister's first adopted child was 10 months old when he arrived. We were told that his birth mother was mentally retarded (that was the term then) and he had been raised by his grandmother, who could no longer cope. The birth mother was not on the scene. She'd had the baby and left him with her mother. But of course, birth mother and grandma were both illiterate, we were told, due to "not being the full quid".

As we watched the boy grow, it was soon apparent to us that there was no mental retardation there. He was in fact a very bright kid, he responded well in a lot of ways. He was a handful at times and a behaviour problem at times. He liked things the same, didn't like change. But when he started school the problems began, at about Grade 1. He was dyslexic. back in those days it wasn't recognised so well; I was studying child psychology at the time and recognised the problem, my sister then got him help very early. But despite the early help, my nephew had severe problems with dyslexia and there were no supports in place at school. In his early teens things got so bad tat he got onto drugs and ran away from home, ended up on the streets as a junkie with a criminal record.
He now has sons. Of those sons, two are doing OK. Another has dyslexia (but support is much better these days) and another has Asperger's.

We know a lot of these conditions have a hereditary component. When we look back at what we were told about my nephew's birth mother, i think it highly likely that her diagnosis of "mental retardation" was due to her being dyslexic. In her generation, we had IQ tests done on all school kids (I remember them being done on me) and schools used these a lot to set expectations for students. They were written tests, all students went to the school hall and sat these written IQ tests like we were sitting exams. Someone with dyslexia would have failed such a test and been labelled.

What I'm saying - there can be a lot of reasons for a child being put up for adoption. The sort of reasons can have a hereditary component - bipolar, Pervasive Developmental Disorder (PDD), addiction, ADHD. If the adopted child has problems, then first thing is to consider that a bio-parent who had these problems would, if untreated, be more likely to need to put the child up for adoption.

It's not necessarily alcohol. Probably far less likely that you might think.

Certainly, give Fetal Alcohol Syndrome (FAS) or Fetal Alcohol Effects (FAE) suitable consideration. But don't go desperately looking for it, because:

1) It is less likely, there are other more likely explanations; and

2) Other explanations are preferable because at least a child with autism can be helped, more than a child with Fetal Alcohol Syndrome (FAS).

Take the diagnosis that provides more support and more help. And more hope.

Seriously, what you described - the inability to treat adults and children any differently (what I refer to as APPARENT lack of respect) so he's often rude to people, shouting at therapists, grandparents etc (it's all connected); lags socially and developmentally (especially with toiletting); low frustration level; speech apraxia; likely to rage with minimal stimulus - oh yes, it is all familiar and all very much consistent with Pervasive Developmental Disorder (PDD). Every kid is different, I can compare difficult child 3 with other autistic kids we know and a number of them are far more docile. But then, that is when I see them in public, and now in their mid-teens, they have learnt how to be socially appropriate in public, most of the time. But one boy I can think of at 10 is a real problem, with all these issues. He's a ball of energy, drives everyone nuts and is verbally abusive much of the time. Extremely intolerant of anyone who can't instantly read his mind. I'm wondering if perhaps it is the brighter High-Functioning Autism (HFA) kids who are more of a handful, more of a worry.

I remember when getting difficult child 1 & difficult child 3 checked out for Fragile X. I looked it up, was convinced that I could see the physical features. The blood tests were done, came back negative. And when I looked for the physical features I had been so sure were there - I couldn't see them.

It is very much a case of "seek and ye shall find".

So by all means get him checked out, to allay your fears. But take it from me - bad as it is for you, and I know how bad it can get - your boy could have it all explained under the autism umbrella. Those parents who raise their eyebrows - they don't know how lucky they are. Or maybe their child isn't as high functioning as yours and mine.

Hang in there.

Marg

 

[WearyWoman]

Marg - Excellent thoughts, and I appreciate them more than you may know. I believe difficult child 2 will receive more help and assistance under the Pervasive Developmental Disorder (PDD)-not otherwise specified umbrella, and your point about higher functioning Autism Spectrum Disorders (ASD) kids being more of a handful is very real. I have heard others say that as well, and given that he barely meets the criteria, that is the case here. He can talk, make eye contact, does not stimulant, does not repeat things, is able to read and write, etc., etc. It's his understanding of the world that is very impaired - social - behavioral - and also the self-care and neurodevelopmental things.

Bubby's birthmom became pregnant against her will, and that was the main reason she placed him for adoption, as well as being a single mom to her first infant already. She was unaware of the pregnancy for some time - about four months.

Bubby has the epicanthal folds by his eyes (mild but unquestionably there), and that's probably the biggest physical sign. His eyes are also noticeably wide-set. My sister, a nurse, actually brought it up to me in the past, and I dismissed it. I do know that ethnicity can cause the epicanthal folds too, but his bio mom was caucasian, blonde, and blue-eyed. We have zero info on the bio dad, but it's probably safe to say he has darker features, as Bubby is dark-haired and has brown eyes. In light of the severe behavioral problems and these subtle physical signs, I can't help wondering about alcohol exposure. The fact that fetal alcohol symtpoms can overlap with autism symptoms doesn't make it any easier to distinguish. It scares me when he gets angry and hits us or throws/breaks things. He says he will kill us sometimes, he is so upset, and this could be over a minor issue, like picking up toys or just having to do something he doesn't want to do. He doesn't seem to have proper empathy. I have bruises, scars, and more broken things than could be counted. As he is growing, I find myself more afraid of the harm he could cause. Bubby just isn't able to regulate his emotions or behaviors very well. It's not always possible to prevent his meltdowns. When he's not off the deep end, he actually is quite loving, though. He also is very gentle and caring with animals and sensitive in many other ways.

I agree that it's easy to allow fear to color perception. I pray that he doesn't have fetal alcohol issues, as I believe that could be worse in many ways than anything else.

WW

 

[Marguerite]

It scares me when he gets angry and hits us or throws/breaks things. He says he will kill us sometimes, he is so upset, and this could be over a minor issue, like picking up toys or just having to do something he doesn't want to do. He doesn't seem to have proper empathy.

It does get scary. In some ways, difficult child 1 was more violent than difficult child 3. What we found was/is a problem, is when ADHD medications wear off and we get rebound - the violence is much worse then. difficult child! in his early teens tried to avoid taking his medications, he went through a phase of "there's nothing wrong with me" and tried to prove he didn't need medications and didn't have a problem with caffeine. Problem was, he couldn't see it. He would get violent and aggressive, truculent and abusive and not realise HE was the problem. To him, it was everyone else. One day (unmedicated and hopped up on cola) he got hassled by a kid on the train and smashed a glass drink bottle to attack the kid with. Thankfully the school principal dealt with it very appropriately in my view - by the time they were at the principal's office, both boys were friends again and had apologised to one another (I suspect difficult child 1 was medicated by then). The principal organised for difficult child 1 to do railway platform cleaning duty for a week, as punishment. Far more effective than a suspension would have been!

I finally said to him (when he was calm and medicated) that it couldn't be everyone else. Either something was a problem with one person, or everybody. And the odds of it being everybody was too remote. He just had to accept our word on this. The other thing you can do (we didn't, but it was due to lack of technology, not an issue these days) is videotape the raging and violence. Then play it back to him at the therapist or when he's calm and medicated. Not in any angry mood, just to say, "hey, buddy, we need to talk about this. Do you realise how upset this makes me?"

The thing is - these kids will get cranky, will get aggressive. The primary thing you should do when they're being aggressive is protect yourself, protect the kid, protect others. Forget about trying to communicate anything to the child at that time. You won't get any message through. If you read "The Curious Incident of the Dog in the Night-Time" by Mark Haddon (it's fiction, but brilliant) the main character there records all events in his life eidetically, except when he gets really upset. Then he has blocks of time where he can't remember what happened. And I do know there have been times when either of my boys was raging, and they can't properly recall what was happening. They do have partial recall, though. They can see events, but only like a DVD fast-forwarded. No sound, blurred images. So difficult child 1 remembered attacking easy child with a screwdriver but he couldn't remember why.

The best way to tech him control, is to teach self-control. And the best way to teach self-control is the explosive Child method. You put everything except immediate safety, in Basket B or C. If you have something in Basket B andhe's beginning to ramp up (learn the warning signs and respond quickly) then immediately, dump the issue in Basket C an focus on calming him. Go back to the issue as and when you feel he can handle it.

I know some people feel this is "letting them get away with it" but remember, these aren't your average kid. Also, as they draw close to rage but can pull back (this comes with frequency and practice) they learn that getting angry doesn't have to progress to violence. Over time, the child learns more self-control. They also learn very quickly, that you are trying to help them not rage. That is different to you trying to stop a rage, because when we try to stop a rage we're trying to say, "Stop! Don't throw that table!" That doesn't do a thing to stop it when the rage is imminent.
What we need to be saying is, "It's OK, take a deep breath. And another. Go outside for a few minutes, let's deal with this later."

Being unable to regulate his emotions or behaviours is very much a Pervasive Developmental Disorder (PDD) trait.

Another thing to remember - you can have varying degrees of severity of Pervasive Developmental Disorder (PDD), even while you can independently have varying degrees of high-function. For example, difficult child 3 is very high-functioning, he has an IQ measured in the mid 140s (although his score has varied wildly depending on when he was tested and by whom - I've learned to ignore school psychologist scores, they're the most widely disparate). And yet when you score his Pervasive Developmental Disorder (PDD), it scores "moderate", not "mild". Similarly, difficult child 1 now scores as mild, because he has adapted a great deal. Extremely pacifist, very law-abiding, upright and moral. Extremely loyal. But needing a lot of support to do some basic things. It would now take extreme provocation for him to physically attack anybody, although he does have outlets. He's joined a medieval warfare mob where they go out on weekends and bash each other with broadswords and shields while wearing chain mail. They have strict rules to follow which he sticks to tightly. He's learned self-control to an intense level because the violence he displayed 15 years ago scared him.

Since your difficult child's biomom doesn't know the father, is there a chance he could have some Asian heritage? It would explain the colouring and the epicanthic fold. From my understanding of Fetal Alcohol Syndrome (FAS), for the epicanthic fold to be due to alcohol, there would be other, far more obvious signs of Fetal Alcohol Syndrome (FAS); signs distinct from Pervasive Developmental Disorder (PDD).

http://en.wikipedia.org/wiki/Fetal_alcohol_syndrome

First - growth. How are his growth parameters? If his facial features are due to Fetal Alcohol Syndrome (FAS), then he would have the rest of the stuff too, in spades. Not mildly, not a little bit. The lot. Growth retardation is measurable.

Facial features - these are believed to occur between 10th & 20th weeks of gestation. By this time biomom knew she was pregnant, I believe. Maybe just after 10th week? Presence of facial features guarantees brain damage. Absence of distinctive facial features does not guarantee lack of brain damage. Distance between eyes DECREASES with increased alcohol damage. So wide-set eyes is actually NOT an indication, according to tis link.
What is the width of his upper lip? Bear in mind that in most people (those who haven't had plastic surgery), the upper lip is thinner than the lower, so don't let that worry you too much.

I would keep going here, but I've run out of time, I need to be on the road NOW, so I will post more later, if you need me too. Gotta run!

Marg

 

[BusynMember]

Marg, I can not speak for Australia. But I've adopted six kids really (two didn't work out). The #1 reason kids are put up for adoption are because the parent is immature and drug use is a major issue. So I think she SHOULD have it evaluated by an expert. Especially in light of the fact that he has dysmorphic features, it would be foolish not to take him to somebody who can diagnose him or rule it out or at least watch him. Autism Spectrum Disorders (ASD) is not a lot like Fetal Alcohol Syndrome (FAS)/Fetal Alcohol Effects (FAE). Really, it's not. While he could very well be on the spectrum or have a mood disorder (let's face it, this birth father has contributed 50% of his genes to this child and he's a sick puppy) it's best, when a child is adopted, to check out every possibility so that you can do the best you can for your particular child.

Likely, this child will continue to be complicated, especially since there is no history on birthfather or his family and that throws a big kink into diagnosing. I am sure that L. was misdiagnosed so much because every diagnostician he went to, including neuropsychs, had very little to go by. All we knew about BM was that she used drugs and that cocaine was in L's system when he was born. BUT...he dodged the Fetal Alcohol Syndrome (FAS)/Fetal Alcohol Effects (FAE) bullet. Autism is a common problem of drug exposed children too and it beats the beejaysus out of Fetal Alcohol Syndrome (FAS)/Fetal Alcohol Effects (FAE).

Early on we realized that L. couldn't have Fetal Alcohol Syndrome (FAS)/Fetal Alcohol Effects (FAE), even though he does have s ome dysmorphic features, which every professional noticed (thus giving him a complete genetics screening...another good idea!) It came back negative. L. just had too good a memory for Fetal Alcohol Syndrome (FAS)/Fetal Alcohol Effects (FAE).

It could be that this birthmother did everything right. But nobody knows. It's best to cover every base...watch and see.

 

[Marguerite]

Autism Spectrum Disorders (ASD) is not a lot like Fetal Alcohol Syndrome (FAS)/Fetal Alcohol Effects (FAE). Really, it's not.

That is what I was trying to explain. WHat WW is describing, sounds exactly like we have been dealing with in difficult child 3 (including the degree of it). And I know difficult child 3 cannot have Fetal Alcohol Syndrome (FAS).

But I do agree - if there is concern, get it checked out. But be careful of the "seek and ye shall find" phenomenon, where you go to see someone who is an expert in their field, and it turns out they're an expert because everyone they see gets the same diagnosis, rightly or wrongly.

So I would suggest finding someone who is familiar with Asperger's and also familiar with Fetal Alcohol Syndrome (FAS), to thoroughly evaluate. A neuropsychologist assessment with this in mind would hopefully confirm or refute. It would probably provide a lot of other useful information along the way.

One very important thing to never forget - whatever the problem, this kid (and others like him) is a combination of the underlying disorder, and the way it makes him feel emotionally (which is the environmental component). It is natural for a kid with either Pervasive Developmental Disorder (PDD) or Fetal Alcohol Syndrome (FAS) (or other disorders) to feel angry, frustrated and depressed at various times. Those emotions run really deep and to a suicidal extent at times. Understanding of what is wrong with them can help them feel better about themselves, especially when they realise it's not their fault. It doesn't mean they don't have a lot of work to put in, but knowing that there is help and they are underneath, good people - they do cope better emotionally after that. And once a kid begins to cope better emotionally, the raging eases up a bit.

So don't necessarily blame the disorder directly for the raging, but blame how the kid feels due to the problems the disorder causes in his life (and yours).

it's a subtle distinction but it can make a big difference.

Marg

 

[WearyWoman]

First - growth. How are his growth parameters? If his facial features are due to Fetal Alcohol Syndrome (FAS), then he would have the rest of the stuff too, in spades. Not mildly, not a little bit. The lot. Growth retardation is measurable.

Facial features - these are believed to occur between 10th & 20th weeks of gestation. By this time biomom knew she was pregnant, I believe. Maybe just after 10th week? Presence of facial features guarantees brain damage. Absence of distinctive facial features does not guarantee lack of brain damage. Distance between eyes DECREASES with increased alcohol damage. So wide-set eyes is actually NOT an indication, according to tis link.
What is the width of his upper lip? Bear in mind that in most people (those who haven't had plastic surgery), the upper lip is thinner than the lower, so don't let that worry you too much.

I would keep going here, but I've run out of time, I need to be on the road NOW, so I will post more later, if you need me too. Gotta run!

Marg

First, in answer to your questions, Bubby is in the 5th percentile for weight and the 25th percentile for height. He was a fairly small baby, weighing in at 6 pounds, full-term. His bio mom did not realize she was pregnant until into her fourth month, or around 17 weeks. It is true that Fetal Alcohol Syndrome (FAS) causes a shortened distance between the inside and outside corners of each eye alone, however, the distance between the two eyes appears wider. So, it's definitely true that Fetal Alcohol Syndrome (FAS) is related to wide-set eyes. Bubby doesn't have a smooth crease between his upper lip and nose, however, his upper lip is narrow, his nasal bridge is quite low, and his nose is slightly upturned. His facial midsection is flattened, and his ears are ever-so-slightly curled at the tops. Despite any of this, Bubby is extremely cute (everyone says so), and if one were not educated about these subtle things, it could easily be missed. I've looked at photos of Fetal Alcohol Syndrome (FAS) kids, and in many cases, until I read about the features, I would have had no idea anything was unusual about their appearance.

I didn't mean to imply that all autistic kids are alcohol affected. I recently read that autism is linked to fetal alcohol exposure in some cases; that autism is believed to have both genetic and environmental causes, complicating research and understanding of the condition.

Fetal Alcohol Syndrome (Fetal Alcohol Syndrome (FAS)) causes abnormal facial features, growth problems, and central nervous system problems. Many children prenatally exposed to alcohol do not meet all of the criteria for Fetal Alcohol Syndrome (FAS). The CDC is presently working on diagnostic criteria for alcohol-related neurodevelopmental disorder (ARND), to address other forms of alcohol impairment. People with ARND might have intellectual disabilities and problems with behavior and learning. They might do poorly in school and have difficulties with math, memory, attention, judgment, and poor impulse control. The damage caused by alcohol can be measured on a spectrum, and that is the approach the CDC is taking on this. So, a wide range of physical, developmental, behavioral, and neurological issues are possible. Every child is affected uniquely. Some babies exposed to a lot of alcohol do not demonstrate impairment, while those exposed only mildly may have severe problems. Alcohol causes brain damage in utero, and this is measureable on MRI.

Fetal Alcohol Syndrome (FAS) and autism spectrum disorders do share a lot of characteristics in common, including sensory sensitivities, difficulty with change and transition, struggles with generalizing skills, ADHD, difficulty with abstract concepts, speech problems, developmental delays, difficulty understanding social cues, trouble forming friendships, and the list goes on.

Complicating things further is the possibility that a child may have both Fetal Alcohol Syndrome (FAS) and an Autism Spectrum Disorders (ASD) at the same time. Here is a link to an article about these disorders and their overlaps:

I am not interested in the "seek and ye shall find" method you mentioned, quite the contrary. I much prefer to embrace the "seek the truth, and the truth will set you free" philosophy. Yet, I hope that Bubby is not suffering any fetal alcohol effects, as I think it would harbor a worse outlook than his present working diagnosis. I am well aware of the availability of a diagnosis through shopping around, but that is not objective, nor truth seeking. Neither is clinging to a current diagnosis when the discovery of evidence raises another possibility.

Marg, you have the benefit of absolute certainty that your children were not exposed to alcohol prenatally, an assurance many adoptive parents will never know.

But adoptive moms have intuitions about their children, just like any mom, and I can't shake the unsettled feeling I have right now. It would be easier to shut the door on this, and move on. Yet, if a truth lies behind the door, despite my discomfort with it, I want to know. I want to know so I have knowledge on my side in understanding Bubby's struggles. He deserves that.

WW

 

[Marguerite]

I didn't mean to imply that all autistic kids are alcohol affected.

I didn't read it that way at all. Of course there is going to be an overlap, because even autism diagnosis is inexact, and some kids will meet the criteria (which are after all a description; there is no specific brain functioning thingie we can specifically measure and say, "this means it is autism."

What I was trying to say, was that IF your son's facial features are due to Fetal Alcohol Syndrome (FAS), then he would have other indications of Fetal Alcohol Syndrome (FAS) too of the more severe kind. He would have the other damage.

The "seek and ye shall find" concerns of mine, are that if you go to the wrong people on this, they WILL find what they personally want to find. So make sure you choose people who will genuinely look impartially, and not just look with blinkers on. Otherwise you risk being misdirected.

One thing to watch for is splinter skills. You shouldn't see much with splinter skills, if this is Fetal Alcohol Syndrome (FAS). But if it's high-functioning autism, then you should even now be seeing some signs of splinter skills and high function areas. If you do, give him his head in these areas, encourage him and support him even if it seems a bit way out or "too good to be true". For example, difficult child 3 showed very early ability with music, reading and use of computer.

Another big difference will show up in mathematical ability - kids with Fetal Alcohol Syndrome (FAS) have trouble across the boards, including problems with mathematics. But with autism while it's not 100% that they are good at maths, it is more common than not, that they are at least capable mathematically compared to other subjects. Language delay and poor support (say, problems at school) can get in the way of this, but if he's struggling across the board academically, and can't improve even with one-to-one coaching, I would be more seriously considering Fetal Alcohol Syndrome (FAS) as a possibility.

I'm trying to give you some hope here, WW, even while you follow through and get it all thoroughly, independently evaluated. If possible, have hope. But certainly, check it out. Whatever is going on, you need to feel assured and have a sense of direction.

I am glad I know, in the case of my boys. However, despite knowing alcohol is not a factor, I have at times wondered about other medications I have been on. In both boys I was taking salbutamol to stop labour. I was on double the dose with difficult child 3. And with difficult child 3, I was given 3 grams of iron by i.v. (that's grams, not milligrams) overnight, a few weeks before he was born. I'm fairly certain it damaged my liver (further). They have since discontinued this method of treatment for anemia. Did it cause brain damage? Did the salbutamol cause it?

We always have questions. There will always be unknowns. It's just that with adoptions, there are a lot more unknowns.

Let us know how you get on. I really hope you get test results that can assure you, rightly, that it isn't Fetal Alcohol Syndrome (FAS). Or if it is, you are also given some strategies that you can use to help him. But if I were a betting person, my money would be on it NOT being Fetal Alcohol Syndrome (FAS). Only I don't bet.

Marg