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Friday, August 09, 2024

 NOT JUST FASD

Children can inherit early aging symptoms from parents who abuse alcohol, researchers find


These accelerated aging effects include high cholesterol, heart problems, arthritis, and early onset dementia.

Peer-Reviewed Publication

Texas A&M University

Dr. Michael Golding and colleagues 

image: 

Dr. Michael Golding and colleagues

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Credit: Texas A&M University School of Veterinary Medicine and Biomedical Sciences



Researchers at the Texas A&M School of Veterinary Medicine and Biomedical Sciences (VMBS) have discovered that parents who struggle with alcohol use disorders can pass along symptoms of early aging to their children, affecting them well into adulthood. 

These accelerated aging effects — including high cholesterol, heart problems, arthritis, and early onset dementia — can be passed down from either mom or dad individually, but they become worse when both parents have an issue with alcohol abuse, especially in male offspring.

“Scientists have wondered what causes children who grow up in homes where there is alcohol abuse to be more susceptible to becoming sick,” said Dr. Michael Golding, a professor in VMBS’ Department of Veterinary Physiology and Pharmacology. “For example, we know that these children have behavioral problems that make it difficult to cope with stress and might lead to conflict with school systems or law enforcement.” 

But what scientists didn’t know was the cause behind the early aging and disease susceptibility — was it stress or something inherited from these children’s parents?

“Now we know that they’re inheriting dysfunction in their mitochondria as a result of their parents’ substance abuse,” Golding said. “The dysfunction causes these individuals to show early signs of age-related disease when they’re still considered young, usually in their 40s.”

With this new understanding, Golding hopes that doctors can work with patients to improve their mitochondrial health — and possibly delay the inherited dysfunction as they age — using methods like exercise and increasing intake of certain vitamins. 

Alcohol And Aging

As adults get older, they develop a biological condition called senescence, which is when cells slow down and stop dividing, limiting the body’s ability to replace deteriorating cells.

“Senescence is a key marker of aging, especially in the brain, where it leads to cognitive dysfunction and memory problems,” Golding said. “Scientists have known for a long time that heavy alcohol use can cause early onset of senescence in adults.”

Using a mouse model, research by Golding and his team revealed that senescence also happens to be one of the early-aging symptoms that offspring can inherit from parents who daily drink alcohol to the legal limit or more. 

“We also see fat increase in the liver, which creates scar tissue,” Golding said. “It’s especially common in male offspring. In fact, if both parents have an issue with alcohol abuse, it can have a compounded effect on male offspring, making them even more likely to get liver disease.”

Parental Drinking And Child Health

Golding’s lab focuses on the biological relationship between parental alcohol use and child development. His lab recently uncovered that fathers — not just mothers — can contribute to children developing Fetal Alcohol Syndrome, or FAS. As a result, he also continues to advocate for parents reducing their alcohol consumption prior to conception.

“There are all sorts of problems that children can develop right after they’re born because of FAS,” Golding said. “But what we haven’t understood well until now is how parental drinking habits might go on to affect these children into adulthood and influence their ‘healthspan’ — the number of years someone is healthy without chronic and debilitating disease. 

“Both the birth defects that come with FAS — like abnormal facial features, low birth weight and/or height, and attention and hyperactivity issues — and the stress from living with them create unique challenges. So do any environmental issues that these children may grow up with, including adoption and the foster system,” he said. “But now, we understand that there’s yet another component — early aging — that is inherited directly from one or both parents.”

Understanding Multi-Generational Health

This latest discovery also suggests that parents can pass along the benefits of healthy living to their children. According to Golding, healthy lifestyle choices also compound generationally, making efforts to reverse aging — through things like diet and exercise — beneficial for generations to come. 

“Parental health pre-conception — both parents’ overall health before pregnancy — is critical for the health of offspring,” he explained. “The more you can do as a prospective parent to get into a healthy mindset and a healthy lifestyle, the more significant effects you’ll have on the health of your kid both right at birth and even into their 20s and 40s.”

By Courtney Price, Texas A&M University School of Veterinary Medicine and Biomedical Sciences

###

Wednesday, October 04, 2023

First experimental study to propose a therapy to correct memory deficit caused by disorders in the fetal alcohol spectrum



Research conducted in a mouse model identifies the neurobiological mechanism responsible for alterations in the memory of young individuals exposed to alcohol during pregnancy and lactation. This study proposes a therapy that can reverse the deficit


Peer-Reviewed Publication

UNIVERSITAT POMPEU FABRA - BARCELONA

Authors of the research 

IMAGE: FROM LEFT TO RIGHT: INÉS GALLEGO, ANTONI PASTOR, ALBA GARCIA-BAOS, OLGA VALVERDE AND RAFAEL DE LA TORRE. CREDIT: UPF. view more 

CREDIT: UPF




A research team of the Department of Medicine and Life Sciences (MELIS) at Pompeu Fabra University (UPF) involving the Hospital del Mar Research Institute has for the first time, in mice, identified and validated the neurobiological mechanism and therapy to correct memory deficit in individuals with fetal alcohol spectrum disorders (FASD). These results pave the way for studying whether the mechanism is the same in humans, which would enable improving the diagnosis and treatment of affected individuals. 

Fetal Alcohol Spectrum Disorder (FASD) includes a number of conditions suffered by infants who have been exposed to alcohol during pregnancy. The effects of FASD range from craniofacial morphological malformations or growth problems, in the most severe cases, to hyperactivity, emotional and motivational difficulties or defects in learning and memory, in the mildest cases. 

“In children of normal appearance, FASD is underdiagnosed and is often mistaken for hyperactivity or ADD”, explains Rafael de la Torre, coordinator of the Integrated Pharmacology and Systems Neuroscience Research Group at the Hospital del Mar Research Institute. “Since there is no diagnosis, there is no treatment, and symptomatic therapy is given to alleviate hyperactivity or other disorders such as anxiety”. 

The results of the study published in the journal Molecular Psychiatryhave allowed the researchers to observe that “exposure to alcohol need not be chronic for FASD to occur. Sporadic consumption ending in intoxication - getting drunk- is enough to observe alterations in memory, in mice”, explains Olga Valverde, study coordinator and director of the Research Group in Behavioural Neurobiology at the MELIS-UPF. 

The study shows that mice born to mothers that have consumed alcohol sporadically during pregnancy and lactation have a memory deficit that persists into adulthood. One of the reasons for this deficit is that alcohol affects the function of the endocannabinoid system, reducing the expression of the PPAR-𝛄 receptor. 

“The endocannabinoid system is greatly involved in learning and memory processes”, de la Torre explains. “That is why it is especially relevant that this decrease occurs during infancy, when the mice, male and female, are of learning age”. However, the reduction in PPAR-𝛄 does not occur throughout the brain. It is limited to the hippocampal astrocytes -cells that support neurons controlling functions such as their metabolism or the inflammation to which they are subjected- of the hippocampus.

After confirming the neurobiological mechanism by three different routes, the study also proposes an effective treatment with the drug pioglitazone, commonly used to control sugar and which stimulates PPAR receptors. According to the first author of the study, Alba Garcia-Baos, “manages to alleviate the cognitive memory deficits of individuals with FASD in infancy”. 

 

Optimism regarding studies in humans

The results of this study pave the way for studying the effects of other cognitive impairments caused by alcohol exposure during pregnancy. “In this work we have only studied alterations in memory, but there may be emotional, motivational or behavioural alterations related to FASD”, points out Valverde, who is also a full professor of Psychobiology at UPF. 

Although this study has been conducted in mice, the researcher is optimistic about confirming that this mechanism is replicated in humans “because we are two species of mammals that share many similarities”. In addition, if confirmed, “it would be relatively simple to carry out a study to validate whether the therapy we propose works in humans, since there are drugs that have similar effects to the ones we have used that are approved for use in children”.

Monday, September 19, 2022

RIGHT TO LIFE END DEATH PENALTY
Psychologist: School shooter suffered fetal alcohol damage




Marjory Stoneman Douglas High School shooter Nikolas Cruz, right, sits with Assistant Public Defender Nawal Bashimam at the defense table during the penalty phase of his trial at the Broward County Courthouse in Fort Lauderdale, Fla., Monday, Sept. 12, 2022. Cruz pleaded guilty to murdering 17 students and staff members in 2018 at Parkland's high school. 
The trial is only to determine if the 23-year-old is sentenced to death or life without parole.
 (Amy Beth Bennett/South Florida Sun-Sentinel via AP, Pool)More

TERRY SPENCER
Mon, September 12, 2022 

FORT LAUDERDALE, Fla. (AP) — Attorneys for Florida school shooter Nikolas Cruz began building their argument Monday that his birth mother's alcohol abuse left him with severe behavioral problems that eventually led to his 2018 murder of 17 people at Parkland's Marjory Stoneman Douglas High School.

Paul Connor, a Seattle-area neuropsychologist, said medical records and testimony by prior witnesses show that Brenda Woodard drank and used cocaine throughout much of her pregnancy before Cruz's birth in 1998. Woodard, a Fort Lauderdale prostitute, gave up the baby immediately after to his adoptive parents, Lynda and Roger Cruz. Woodard died last year.

Connor, testifying by Zoom, told jurors that people with fetal alcohol spectrum disorder show at a young age problems with motor skills, impulse control, socializing and paying attention — problems previous defense testimony showed Cruz had.

Cruz's preschool teachers testified he couldn't run without falling or use utensils. He was diagnosed with attention deficit hyperactivity disorder as a young child and teachers testified that he was extremely anxious and had trouble making friends.

At 5, tests showed Cruz had impairments in 10 intellectual categories including memory, reasoning, language and impulsivity, Connor said. Court records and earlier testimony showed he would have frequent outbursts in class and at home. By middle school, he was making threats.

Connor said he measured Cruz's IQ at 83, which he said matches the slightly below average intelligence many people with fetal alcohol issues often score. He said IQ tests conducted throughout Cruz's life found similar results, including one done recently by a prosecution expert.

Under cross-examination by lead prosecutor Mike Satz, Connor conceded he is not board certified in his field but said such certification is voluntary and only a state license is required to practice. He also conceded that he almost always testifies on behalf of the defense in fetal alcohol cases, not prosecutors. He will continue testifying Tuesday.

Cruz, 23, pleaded guilty in October to murdering 14 students and three staff members and wounding 17 others as he stalked a three-story classroom building with an AR-15-style semiautomatic rifle on Valentine's Day 2018. His trial is only to decide whether the former Stoneman Douglas student is sentenced to death or life without parole. For the seven-man, five-woman jury to impose a death sentence, the vote must be unanimous.

Satz finished his primary case last month. He played security videos of the shooting and showed the rifle Cruz used. Teachers and students testified about watching others die. He showed graphic autopsy and crime scene photos and took jurors to the fenced-off building, which remains blood-stained and bullet-pocked. Parents and spouses gave tearful and angry statements about their loss.

In an attempt to counter that, assistant public defender Melisa McNeill and her team have made Cruz’s history their case’s centerpiece, hoping at least one juror will vote for life.

After the defense concludes its case in the coming weeks, the prosecution will present a rebuttal case before the jury's deliberations begin.


Prosecutors push expert witness to concede testimony was incomplete picture of Stoneman Douglas shooter


David Fleshler and Rafael Olmeda, South Florida Sun Sentinel
Tue, September 13, 2022

FORT LAUDERDALE, Fla. — Parkland shooter Nikolas Cruz showed no lack of mental competence as he planned and carried out his attack on Marjory Stoneman Douglas High School, a Broward prosecutor said Tuesday.

Assistant State Attorney Mike Satz reviewed the gunman’s actions while cross-examining neurologist Paul Connor, who testified Monday that Cruz lacked the ability to quickly shift the focus of his attention and had trouble solving problems and using his working memory.

Defense lawyers are portraying Cruz as the neurologically damaged victim of his mother’s heavy drinking, part of their bid to persuade jurors to spare him from the death penalty.

But in cross-examination Tuesday, Satz got Connor to concede that many of Cruz’s neurological test scores were in the normal range. Those scores were not discussed during Connor’s direct testimony Monday.

Satz took aim at a graph prepared by Connor headed “Neuropsychological testing of Nikolas Cruz Deficits in nine of 11 domains assessed.” Under questioning from Satz, Connor acknowledged that the chart only contained results of a fraction of the tests he administered and that many of those tests contained average scores, in contrast to the below-average scores highlighted in his chart.

“Did you ask the defendant about the 17 murders committed by the defendant at Marjory Stoneman Douglas High School on Feb. 14, 2018?”

”I did not,” Connor responded.

“You saw how purposeful his actions were?” Satz asked.

”I watched the video,” Connor said. “I was not doing it to interpret it.”

”Did you see how goal-directed it was?” Satz asked. “So you can’t say whether he appeared on the video to be goal-directed and dedicated to his task?“

”I have no opinion on that,” Connor said.

Kenneth Lyons Jones, a pediatrician and one of the first two doctors in the country to identify fetal alcohol syndrome as a medical condition, was brought in Tuesday to testify with even more precision about Cruz’s ailments. He said Cruz does not have the syndrome, which has very specific characteristics, but Cruz does suffer from a related condition called alcohol related neurodevelopmental disorder.

Both fall under what Jones identified as fetal alcohol spectrum disorder. People suffering from ARND tend to be incapable of planning and organizing their thoughts, Jones said during cross examination. “I think that he lost control of himself, without any question,” he said.

But his testimony gave Satz an opening to remind the jury of just how much planning went into the Stoneman Douglas mass shooting.

Satz brought up the series of internet searches Cruz conducted prior to the massacre, again attempting to indicate a capacity for planning that would contradict the experts’ assessment of Cruz’s mental capacity. The searches included information about the mass shootings at Columbine and in Las Vegas and Aurora, Colorado.

Jones said he was unaware of any of those searches.

Jurors will later be asked to weigh the conflicting testimony about Cruz’s mental health issues to determine whether the death penalty is an appropriate punishment for the 17 murders he committed. The defense is raising fetal alcohol spectrum disorder as a possible mitigating factor the jury can consider in choosing a life sentence instead of condemning Cruz to die.

Testimony is scheduled to resume Wednesday morning.


Thursday, March 10, 2022

NZ

Government Must Act In Response To Heart-breaking, Compelling Evidence On FASD

Statement on behalf of Roopuu Apaarangi Waipiro

Alcohol harm reduction experts are calling on the Government to urgently act on recommendations from nine witnesses who have detailed the multiple, serious and systemic failures by successive Governments to address the unequal harms to Māori from the lifelong disability of Fetal Alcohol Spectrum Disorder (FASD).

The witnesses will be heard by the Waitangi Tribunal on Monday and Tuesday, in support of a claim (WAI2624) submitted by Raawiri (David) Ratuu (Ngaati te Ata Waiohua, Waikato-Tainui, Ngaati Maniapoto) of Kookiri ki Taamakimakaurau Trust and member of The Health Coalition Aotearoa’s Roopuu Apaarangi Waipiro, Alcohol Expert Panel.

First, caregivers will describe the devastating, life-changing and on-going challenges and distress they face raising their loved ones with FASD, often with little to no Government support. Clinical practitioners and researchers will then present compelling evidence on the Crown’s breaches of Te Tiriti o Waitangi by failing to respond to the serious harm of FASD. This includes failures to measure the prevalence of FASD as well as providing specific and adequate funding for diagnosis and wrap-around disability support services for individuals and whānau.

Fellow Health Coalition Aotearoa Panel member and clinical neuropsychologist, Dr Valerie McGinn, is one of the witnesses presenting evidence next week. She says "the evidence to be presented will be upsetting to many - the implications of alcohol exposure in pregnancy have devastating, intergenerational effects. With an estimated one-half of all pregnancies being exposed to alcohol, as many as 1800 or more babies are born with FASD in our country each year. The damage to the brain from prenatal alcohol exposure leads to outcomes such as low educational achievement, mental health and substance abuse issues, early contact with the justice system, benefit dependence and premature death - including through suicide. With the right funding and support, these outcomes can be greatly reduced and persons with FASD and their whānau can thrive. FASD must be recognised as a stand-alone disability, eligible for disability support services. Other countries are leading the way, and Aotearoa New Zealand must follow suit."

"The Waitangi Tribunal claim and witnesses present clear solutions for change. Proper regulation of alcohol is also imperative to reduce the number of babies born with FASD each year. Weak regulation has resulted in the oversaturation of alcohol outlets across many communities, low alcohol prices, and sophisticated advertising to target young people and those of child-bearing age" says Panel member Dr Nicki Jackson.

"The persistent lack of regulation of alcohol has enormous, lifelong consequences. Our pro-drinking environment drives inequities in alcohol use and harm, including the lifelong disability of FASD. We, as the Health Coalition Aotearoa Alcohol Expert Panel, urge the Government to implement effective regulation of our most harmful drug. They have a duty to create healthy environments that support alcohol-free pregnancies. We want every child to have the opportunity to reach their full potential", ends Dr Nicki Jackson.

© Scoop Media

SEE https://plawiuk.blogspot.com/2006/12/alcoholism-is-colonialism.html

Sunday, February 06, 2022

 Saskatchewan

Gladue reports can reduce sentences for the most marginalized, but many don't know it's their right

Team in Sask. is making reports more accessible to those

 who stand to benefit most

Thanks to his Gladue report, Blaine Hotomanie is now serving a reduced six month sentence in jail after being found guilty of impaired driving. He's seen here in Carry the Kettle Nakoda Nation, Sask., in early January, before he started his sentence (Richard Agecoutay/CBC News)

Blaine Hotomanie's Gladue report did more than reduce the time he'll spend behind bars.

"It changed my life, the way I look at things," he said. "I've got a big family and I want to show my grandchildren not to drink and drive. I talk to them about it."

Gladue reports present circumstances of a self-identified Indigenous accused's life for a judge to consider while deciding on a sentence. These can include personal and community histories, and traumas such as colonialism and its ongoing impacts.

Even though Gladue reports are a right for every Indigenous person who appears in court — thanks to two court decisions from 1999 and 2012 — not everyone is aware of their right to them, or has access to Gladue report writers. Saskatchewan in particular ranks near the bottom of the country for the use of Gladue reports, according to data from the Aboriginal Legal Society, which intervened in the landmark 1999 court case.

Gladue reports are time-consuming and resource-intensive, but in late 2020 the Integrated Justice Program (IJP), which is funded by Public Safety Canada, created a team of legal experts and people who study and work with people with fetal alcohol spectrum disorder (FASD), entirely focused on writing the reports for Saskatchewan trials.

WATCH| What are Gladue reports?

What are Gladue reports?

9 hours ago
Duration2:51
Gladue reports explain an Indigenous person’s history, their families history and their community's history to the courts to take the individual’s unique circumstances and challenges into consideration. 2:51

Advocates say the writing team is allowing more people to get the Gladue reports they are entitled to.

Michelle Stewart and Robyn Pitawanakwat, members of the Integrated Justice Program, seen here working on laptops at the University of Regina, are part of a team that writes Gladue reports for people with fetal alcohol spectrum disorder. (Bryan Eneas/CBC)

Hotomanie, 57, from Carry the Kettle Nakoda Nation — roughly 80 kilometres east of Regina —  had at one point been facing 18 months for impaired driving last spring. After his Gladue report, which presented factors including his FASD, Hotomanie's sentence was reduced to six months.

Over the course of three days of three-hour interviews for his Gladue report, Hotomanie shared the pains he faced growing up. He experienced a lot of violence as a child in a home where both his parents drank. He lost loved ones — particularly his parents — and was in the residential school system.

It wasn't until his interviews with the IJP that Hotomanie learned how these traumas impacted him.

Now, with a large support network consisting of his wife, his six children, 25 grandchildren, friends and leaders in Carry the Kettle, he's more worried about his future than his sentence.

"I've got all that stuff out and I'm doing better. I've got a job. I've never had a job for a long time," he said.

"I'm kinda hoping that I can save my job, but time will tell."

Representing the most marginalized

The IJP was launched in 2019. It is a joint initiative run by the Fetal Alcohol Spectrum Disorder Network and File Hills Tribal Council. The program focuses on comprehensive support for Indigenous people with FASD in Saskatchewan. 

IJP launched the team focused on writing in-depth Gladue reports in fall 2020.

Hotomanie said he didn't know what a Gladue report was until he met Michelle Stewart and Robyn Pitawanakwat from the IJP.

Stewart, an expert on FASD, is the IJP's project lead and Gladue project coordinator, while Pitawanakwat is the program's coordinator, runs the organization's frontline services and conducts Gladue interviews.

"These are often the most marginalized people within the justice system," Pitawanakwat said.

"We work with them because their disability [FASD] isn't understood, and their disability often makes them more vulnerable to charges, where someone else who presents differently would probably not be charged."

Stewart, an associate professor at the University of Regina, said the initial goal was to work directly with people with FASD to ensure their complex needs were being met.

"Our goal is to expand that circle of support for them, because we're talking about individuals that experience compounding forms of marginalization and alienation," Stewart said. 

Stewart and Pitawanakwat said their work — building relationships to learn about someone's traumas, personal and familial history, taking the time to understand those subjects, then preparing the reports — is an effort toward reconciliation within Saskatchewan's justice system.

Pitawanakwat, the Integrated Justice Program's lead interviewer, seen here at the University of Regina, said those involved feel supported in what they do and those who've participated felt the process was good for them. (Bryan Eneas/CBC )

The Truth and Reconciliation Commission's 34th call to action calls on governments, "to make changes to the criminal justice system to improve outcomes for offenders with Fetal Alcohol Spectrum Disorder (FASD)."

Pitawanakwat said IJP writers provide courts with important context. Many of the interviewees have been separated from their families and peers, Pitawanakwat said.

"One of the strongest ways that we can push back against colonialism is to bring families back together; to bring people home and keep them home whenever possible," Pitawanakwat said.

Hotomanie's report did just that, allowing him to stay in Carry the Kettle a bit longer before he was incarcerated. He will also be able to reconnect with his family sooner, due to the reduction in his sentence the judge granted after reading the report.

Program's work greatly needed

The IJP team has completed more than 30 Gladue or pre-sentencing reports in Saskatchewan as of January 2022, Stewart and Pitawanakwat said.

Gladue reports can take weeks to months to complete, due to resource constraints within the justice system. The IJP's team-based approach has dramatically reduced turnaround times in Saskatchewan, where the need for the program is great. 

The province ranks near the bottom when it comes to using Gladue reports in court, said Jonathan Rudin, the program director for Aboriginal Legal Services.

Jonathan Rudin, Aboriginal Legal Service's program director, said most Gladue reports completed in Saskatchewan are privately funded. He's seen here speaking at a lectern at Lakehead University. (Amy Hadley/CBC)

"In most parts of Canada where there are Gladue reports, the provincial government in particular, or the provincial legal aid plan, steps up with funding," Rudin said. 

"In Saskatchewan the provincial government does not seem inclined to provide that funding at all."

Data provided by the Ministry of Justice showed that the provincial government paid a combined $78,080 for 24 Gladue reports over the past five years. That data doesn't include reports by independent agencies like the IJP.

In the 2019-2020 reporting year — the last time the province covered the costs for Gladue reports — the government paid for two reports. In the 2018-2019 reporting year it paid for 10, the most in the five years of data provided.

In the 2020-2021 reporting year, it paid for none.

Rudin said that, aside from IJP reports, the few cases where Gladue reports were completed in the province were primarily privately funded. In just a few instances, courts were asked to provide the money or ordered the government to provide the money.

Government support needed, expert says

Jane Dickson, who trained Stewart in Gladue writing and is currently a professor of law at Carleton University, said there shouldn't need to be independent agencies doing Gladue reports, as the Supreme Court of Canada has ruled every Indigenous person should be granted one.

"If government stepped up and adequately funded Gladue we wouldn't need to find these creative solutions to secure funding," Dickson said. 

She said in Saskatchewan and many other parts of Canada, courts take it upon themselves to decide whether or not they have the right amount of information to determine someone's fate. 

Stewart, left, the Integrated Justice Program's lead, seen here at the University of Regina, said a variety of different people participate in the practicum program offered through the IJP, which in turn spreads the knowledge and style of Gladue writing the team offers. (Bryan Eneas/CBC)

In Saskatchewan, the Ministry of Justice said courts were committed to using "relevant Gladue information" in pre-sentencing reports completed by community corrections staff like parole officers.

"Community corrections has made a concerted effort to heighten awareness of Gladue factors and provide Gladue information in pre-sentence reports," the ministry's statement said.

Dickson said legal professionals would rather see full Gladue reports like those being done by the IJP, but there is too much demand. She's working with organizations across Canada on a team-based approach like what the IJP is doing in Regina.

"The model is absolutely generalizable across the country," Dickson said.

A success, so far

Pitawanakwat said while some of the reports the IJP did were more beneficial than others, the program was successful so far because the people involved feel supported in their work.

Most importantly, Pitawanakwat said the clients involved in the program seemed to feel the process was good for them and judges seem to be recognizing the reports are well researched and well written.

Hotomanie says he was a bit nervous about his six month sentence, though he was mostly more worried about being able to return to his job in Carry the Kettle when he comes home. (Richard Agecoutay / CBC News)

Hotomanie said he felt comfortable during the interview process. When things got tough and he became emotional, the group pressed pause and agreed to continue the next day when he felt better. 

He also felt as though he got to know Pitawanakwat and Stewart through the process as much as they got to know him.

The final report made him feel understood by the courts in a way the justice system never had.

"I wasn't just a person who was getting caught for impaired [driving], I felt good about myself," Hotomanie said.

"It made a difference in me and my life." 

ABOUT THE AUTHOR

Bryan Eneas

Reporter

Bryan Eneas is a journalist from the Penticton Indian Band currently based in Regina, Saskatchewan. Before joining CBC, he reported in central and northern Saskatchewan. Send news tips to Bryan.Eneas@cbc.ca.

Saturday, March 07, 2020

New approach to FASD in N.W.T. focuses on accommodation, not behaviour
CBC March 6, 2020

A new wave of thinking on how to work with those who live with Fetal Alcohol Spectrum Disorder (FASD) has arrived in the Northwest Territories.

It aims to recognize FASD as a brain-based physical disability, with symptoms or effects expressed through undesired behaviour. But instead of a focus on correcting the behaviour, this "brain-based" approach is focused on accommodating the disability before the bad behaviour happens.

A three-day workshop in Yellowknife this week presented the approach to more than 150 parents, and front-line social, mental health, and justice workers in the N.W.T.

"Until recently … FASD has been understood as a condition," said Nathalie Brassard, the FASD consultant and facilitator with FASCETS Canada West who led the workshop.

"We knew what caused it, but we didn't really know quite what to do for the individuals…. We focused on … behaviours, not realizing that behaviours are only a sign for the root cause, which is a brain that functions differently."

It's estimated by the Centre for Addiction and Mental Health (CAMH) that one out of every 13 women who consume alcohol during pregnancy will deliver a child with FASD — a disorder with a range of mental, physical and behavioural effects that result from neurochemical and structural brain damage in the mother's womb. It can interfere with a person's ability to successfully function in daily life.

In Canada, the CAMH estimates that eight out of every 1,000 children have FASD, although rates are generally acknowledged to be higher in special populations, such as the child welfare system or the justice system. According to the Northwest Territories Health and Social Services Authority, there are no statistics on the prevalence of FASD in the territory, but between one and four per cent of the Canadian population is affected by the disorder.

A paradigm shift

Brassard described the change in focus — from behaviour correction to disability accommodation — as a paradigm shift.


Kate Kyle/CBC

"The importance is to realize who we have in front of us — to ask ourselves, who is this person? What do they need? How do they function or function differently? What's hard for them?" Brassard said.

"By providing accommodation and support, those behaviours that we've been focusing on reduce on their own, and diminish and disappear."

But accommodation will vary from person to person, said Shawna Pound, the territory's adult FASD program co-ordinator with the Northwest Territories Health and Social Services Authority. The trick is to identify what a person needs in order to overcome undesired behaviour, and then to put mechanisms in place to account for those needs.

As an example, she describes a person with FASD who is chronically late for work. That person may, through disability, lack the capacity to understand what is going wrong every day. For the rest of us, it might be obvious that the person needs to set alarms as reminders to get to work on time. What may be unique about the person with FASD is the inability to make that judgment call, to recognize there is a problem, and to set an alarm.

"They need someone to set the reminders up in their phone, or maybe they need a phone call," Pound said. "It'll look different for everybody."

Pound said that the three-day workshop this week qualified participants for formal facilitator training in the method. She said a few people have shown interest in the year-long training process, and her department would like to see the approach expand in the North.


SEE