2448 Hamilton Road
Bright's Grove, Ontario,
Canada N0N 1C0
Phone: (519) 869-8026
you drink, baby drinks too.
FASlink around the world.
CCSA - Canadian Database of FASD Resources
NOFAS - National & State FASD Resource Directory
ignore the facts does not change the facts.
with disabilities are always in "survival mode".
- we cannot tell or teach them what to think - but have to work
at "how to think"
you tell a child something a thousand times and he still does
not understand, it is not the child who is a slow learner. To
be an effective teacher, you have to always be open to learning.
is always done by amateurs. By the time we get to be reasonably
competent we are no longer fertile.
tend to transfer many of their own neuroses and emotional baggage
to their kids. Kids with FASD simply emphasize many of the "normal"
child raising concerns as well as add a bunch of others.
If you are going
to train a puppy, first you have to train the trainer, and deal
with the trainer's issues. If you have a stressed-out parent you
will have a very stressed out child. One of the greatest gifts we
can give to our children is being calm, particularly under stress.
gift is that of unending patience. Without patience, you will
drive both your child and yourself nuts.
important gift is an off-the-wall sense of humour. Our kids can
find humour in the neatest places. The best way to defuse a confrontation
is with humour. You may be able to escalate a power struggle to
where you can "win" and get immediate compliance, but
everyone loses in a power struggle.
battles carefully. Don't set yourself up to be permanently "tuned
submission to WHO survey on health problems related to alcohol
Alcohol Spectrum Disorders (FASD), Fetal Alcohol Syndrome
(FAS), Fetal Alcohol Effects (FAE), Partial Fetal Alcohol
Syndrome (pFAS), Alcohol Related Neurodevelopmental Disorders
(ARND), Static Encephalopathy Alcohol Exposed (SEAE) and Alcohol
Related Birth Defects (ARBD) are all names for a spectrum
of disorders caused when a pregnant woman consumes alcohol.
100% preventable. If you are pregnant or plan to become pregnant,
don't drink any beverage alcohol. There is no known safe level.
is funded through voluntary donations.
We depend on you for being able to continue our services.
FASlink serves more than 400,000 people annually through this
website and the Discussion Forum.
The FASlink Archives provide access to more than 130,000 documents
on FASD related issues.
the FASlink Collection - more than 200 MB of information
in a downloadable file.
FASlink Collection is an extensive compilation of key articles
about FASD. It is available for download as a Thank You for
a donation of $20.00 or more to FASlink. Click on the image
above or click here to donate.
it quacks like a duck ....
by Bruce Ritchie
fresh view of the epidemiology and a major change
in the estimation of the prevalence of FASD.
incidence of FASD exceeds 10% of our children.
FASD is the full spectrum of disorders caused by prenatal
exposure to alcohol as listed above. The incidence
of FAS (with the classic facial features) is about
1%. Facial features are determined around the third
week of pregnancy, so if the mother was not drinking
at that time, the facial features can be quite normal,
but the neurological damage can be as severe.
Statistics Canada's "Canadian Community Health
Survey" and their Birth and Population statistics
for the concurrent period, It is likely that 37%
of babies have been exposed to multiple episodes of
binge drinking (5+ drinks per session) during pregnancy.
An additional 42% have been multiply
exposed to 1 to 4 drinks per session during pregnancy.
alcohol exposure has been linked to more than 60 disease
conditions, birth defects and disabilities. Damage
is a diverse continuum from mild intellectual and
behavioural issues to profound disabilities or premature
death. Prenatal alcohol damage varies due to volume
ingested, timing during pregnancy, peak blood alcohol
levels, genetics and environmental factors.
Ethanol interacts with more than 1000 different
genes and cell events, including cell signalling,
transport and proliferation. Alcohol supresses serotonin
production. Serotonin suppression causes loss of neurons
and glia, inducing excessive cell death during normal
programmed death (apoptosis) or triggering apoptosis
at inappropriate times leading to smaller or abnormal
brain structures with fewer connections between brain
cells, leading to fewer cells for dopamine production,
leading to problems with addiction, memory, attention
and problem solving, and more pronounced conditions
such as schizophrenia.
20% of Canadian school age children
are receiving special education services, most for
conditions of types known to be caused by prenatal
is a diverse continuum, issues range from almost imperceptible
to profound. It is somewhere in the middle that the
issues attract the attention of parents, educators,
medical and social work professionals, and eventually
the justice system. Most of the issues that attract
sufficient attention are behavioural and performance
is probable that 10% to 15% of children are significantly
enough affected by prenatal alcohol exposure to require
special education. As they become adults,
FASD does not disappear but the issues of youth translate
into ongoing problems in family relationships, employment,
mental health and justice conflicts. The cost to the
individuals affected, their families and society are
enormous and as a society, we cannot afford to ignore
ignore the facts does not change the facts.
Video Presentation to the Legislative
Assembly of Ontario, Standing Committee on Social Policy,
Bill 118, Accessibility for Ontarians with Disabilities
Disabilities - An individual’s place, and
success, in society is almost entirely determined by neurological
functioning. A child with a brain injury is unable to meet
the expectations of parents, family, peers, school, and
career and can endure a lifetime of failures. The largest
cause of brain injury in children is prenatal exposure to
alcohol. Often the neurological damage goes undiagnosed,
but not unpunished.
are strategies that can work to help the child with FASD
compensate for some difficulties. Early diagnosis and intensive
intervention and tutoring can do wonders, but the need for
a supportive structure is permanent.
to Fetal Alcohol Spectrum Disorders (PDF) Document prepared
for the above presentation.
PowerPoint FASD Presentation provides an overview of
FASD. 8 MB download.
intoxicated is defined as a Blood Alcohol Level of .08%.
A 100 lb (45 kg) female consuming 5 standard
drinks will reach a BAL of .25% - three times
the legal limit. BAL reduces .01% per hour.
50% of pregnancies are unplanned. "If you drink, don't
have sex. If you have sex, don't drink. Prevent Fetal Alcohol
Spectrum Disorders (FASD)”
girls are 2 to 3 months pregnant before they find out and
the baby may well have been to many parties before the pregnancy
link shows on Windows Media Player an ultrasound
recording of a fetus responding to alcohol. Original
damage to the fetus occurs over a wide and diverse
continuum. Damage varies due to volume ingested, timing during
pregnancy, peak blood alcohol levels, genetics and environmental
is not a threshold condition. It is a diverse continuum ranging
from mild intellectual and behavioural issues to the extreme
that often leads to profound disabilities or premature death.
the mild end, damage may be the loss of some intellectual
functioning (IQ), visual problems and higher than normal pain
tolerance. At the severe end, damage may be severe loss of
intellectual potential, severe vision problems, dyslexia,
serious maxilo-facial deformities, dental abnormalities, heart
defects, immune system malfunctioning, behavioral problems,
attention deficit disorders, hyper-activity, extreme impulsiveness,
poor judgment, little or no retained memory, deafness, little
or no capacity for moral judgment or interpersonal empathy,
sociopathic behaviour, epilepsy, tremors, cerebral palsy,
renal failure, heart failure, death.
ask my child to fly
ask my child to fly,
for he has not wings.
ask my child to see the glint on the eagle's beak,
for his vision has been diminished.
ask my child to remain calm amid the din,
for her ability to screen out the noises has been taken away.
ask my child to be careful with "strangers",
for he is affectionate with everyone and prey for the unscrupulous.
ask my child to "settle down",
for the clock which works for you and I, does not exist for
ask my child to not play with the toys of others,
for he has no concept of property.
ask my child to remember you tomorrow,
although you met today.
ask my child to heal your wounds,
for her hands cannot hold a scalpel or sutures.
ask my child to meet the challenges set by society,
for you have denied her the tools.
ask my child to forgive you for standing idly by,
while he was in trouble in his mother's womb,
Bruce Ritchie, President/Moderator
Who are we? FASlink Fetal Alcohol Disorders Society
is a Canadian federally incorporated non-profit organization.
Our roots go back to 1991 as the Fetal Alcohol Support
Network, formed by a group of parents who were struggling
with the lack of professional knowledge and supports in
the FASD field. FASlink online began as a FASD discussion
forum in 1995, founded by Val Surbey. In 1999 FASlink
was merged with the FASN website under the direction of
Bruce Ritchie and the combined name became FASlink Fetal
Alcohol Disorders Society. FASlink's website contains
more than 130,000 searchable FASD related documents and
serves more than 400,000 visitors annually. The FASlink
Discussion Forum, with more than 725 members, compiles
the papers and discussions into the FASlink
Archives. Our membership is worldwide but most are
in Canada and the USA, from the most remote locations
to urban centers. You can join
the FASlink Discussions.(.....more)
FASD News Items
Family Caregivers Unite!
with host Dr. Gordon Atherley and guests
adults, Mental Health and the Justice System
Aired September 27, 2011
Allard, who entered politics as a Manitoba Liberal, is
a City of Winnipeg police officer with 24 years of service.
Bruce Ritchie is Moderator & CEO of FASlink Fetal
Alcohol Disorders Society, and single father of a son
who was diagnosed with fetal alcohol syndrome as an infant.
They describe young adults who get into trouble with the
justice system. They discuss the challenges mental health
conditions bring to young adults. They explain the problems
with mental functioning that cause the young adults to
get into trouble. They share views about the ways in which
the police and the justice system deal with young adults
with mental health challenges. They say how serious the
social consequences are, and discuss the ways in which
the existing systems affect the social consequences. They
talk about the help that’s needed by the young adults
and the police. They say what they believe needs to be
done to address the consequences, reduce the harm, and
to bring about prevention.
about the advice that’s given to family caregivers
Dave Travland and Bruce Ritchie
Originally broadcast August 10, 2010.
Caregivers and Fetal Alcohol Spectrum Disorder
Teresa Kellerman and Bruce Ritchie
Originally broadcast April 13, 2010.
and Academic Achievement
diagnosis and intensive, appropriate intervention can make
an enormous difference in the prognosis for children with
are some thoughts about my journey with David over the 21
years since his birth. More.....
Faces of Hidden Fetal Alcohol Spectrum Disorders (FASD)
Great FASD Horseback Ride Across Canada
The Great FASD
Horseback Ride Across Canada 2007 trekked from
Halifax, NS to Victoria, BC and covered some 22,000 km
round trip over 4 months. There were many organized public
and private events and hundreds of teaching moments on
the trek. more
Sprenger and Bruce Ritchie received
the St. Michael's Hospital "Award for Pioneer
Work in the Area of Fetal Alcohol Spectrum Disorders".
Mary Cunningham, Ernie Parsons MPP, Margaret
Sprenger, Bruce Ritchie
Michael's Hospital, Fetal Alcohol Spectrum Disorder
Clinic is pleased to support the work of FASlink. St. Michael's
FASD Clinic views FASlink as an essential service for our
clients. We are fortunate to partner with FASlink in our
attempt to improve the lives of individuals and their families
with FASD. Dr. Brenda Stade, St. Michael's FASD Clinic"
St. Michael's Hospital is a teaching hospital affiliated
with The University of Toronto.
FASD Diagnostic Clinic - Booking Office: (416) 867-3655
Break a raw egg (without breaking the yolk) into a
clear glass. Add a 1 ounce shot glass of alcohol.
With a swizzle stick, gently stir some of the alcohol
into the egg white. Watch the effects on the egg white.
White streaks will form in the clear portion. Alcohol
literally cooks the cells. “Here is your baby's
brain on alcohol”
is no safe level of alcohol consumption during pregnancy.
Fetal Alcohol Spectrum Disorders are 100% preventable. If
you are pregnant or planning on becoming pregnant, don't
drink any alcohol at all.
prenatal alcohol consumption even
at low levels is adversely related to child behavior.
The effect was observed at average exposure levels as low
as 1 drink per week.
brief exposures to small amounts of alcohol may kill brain
cells in a developing fetus. A study carried out by John
Olney, M.D., at the Washington School of Medicine in
St. Louis showed that just two drinks consumed during pregnancy
may be enough to kill some developing brain cells, leading
to permanent brain damage.
Canadian Paediatric Society states: "Fetal alcohol
syndrome (FAS) is a common yet under-recognized condition
resulting from maternal consumption of alcohol during pregnancy.
While preventable, FAS is also disabling." "Health
care providers play an important role in identifying babies
or children with FAS. They should become familiar with the
screening tools that are available to diagnose the condition
in children at various ages." “FAS diagnostic
and treatment services require a multidisciplinary approach,
involving physicians, psychologists, early childhood educators,
teachers, social service professionals, family therapists,
nurses and community support circles.”
do it right, because I can’t.
I will find success, watch me.
not feel a thing when it hurts, because I can’t.
I will see tomorrow as a new, bright day.
see what I did as wrong, because I can’t.
I will stand up and make you see me as a confidant person.
ask again, because I can’t.
I will not be ashamed to try over and over again.
say yes when what I mean is no, because I can’t.
I will shout from the rooftops, “I’m normal”!
feel bad about myself, but I do.
I will look in that mirror and smile.
try to feel that I need to be perfect, but I do.
I will only do what I can.
say that I’m broken, but I am.
I will find the pieces and put them back together.
is your day, my day, their day.
Today we will change the world, shape it and recreate it
it fit in our lives.
We are different, but we will stand and together we will
Feel free to be you, them, and me.
ideas for effective interventions to reduce health problems related
to prenatal alcohol consumption:
Teach physicians and other health professionals to screen, diagnose
treat FASD. Every pediatrician and GP should be able to credibly
diagnosis. Currently can cost the family $2,500, inhibiting
diagnosis and effective intervention in financially compromised
and deal with the continuum, not just the extremes of FASD.
Children without the full physical features of FAS can be more
compromised and at higher risk of secondary disabilities.
screen for alcohol use in all patients and give advice. Alcohol
dipstick testing should be automatic in a regular physical exam
test strips, such as N-Multistix, would also be used. Physicians
with maintaining the health of patients and as only about 20%
of adult patients
do not drink beverage alcohol and alcohol is implicated in more
different disease conditions, it is logical that it be part
of the screening
process, whether or not it is a legal drug.
medical issues of alcohol and all personal, family and societal
Folic acid should be added to all beverage alcohol. See Dr. Bushan
studies on blocking ethanol/methanol brain damage during gestation.
women at risk of having children with FASD and intervene.
Meconium testing for Fatty Acid Ethyl Esters should be mandatory
birth. It can detect and quantify alcohol consumed in the final
20 weeks of
gestation. Confirmed maternal use of alcohol during pregnancy
is critical for
future diagnosis of FASD in the child and MUST be part of the
record of the child. It is a human right for the child and takes
the ego of the parents.
Break the cycle. Properly fund addiction intervention and rehabilitation
programs. Treat the entire family to help prevent relapse. Intensive
social service supports for FASD and recovering alcoholics.
Poverty is a result of, and breeds, substance abuse. Deal with
The beverage alcohol industry pays less than 1% of the total damages
by their products. It is the only area of pubic injury in which
the source is
not forced to bear the cost. Increase taxes on beverage alcohol.
All tax revenue to be returned to support rehabilitation programs
victims of alcohol.
Remove all incentives for governments to promote beverage alcohol.
End all government supports for the beverage alcohol industry,
"wine and beer tourism".
End all alcohol advertising.
Alcohol must be served with food.
Require public access single use breathalyzers in all alcohol
so at a minimum patrons can test their BAL before driving.
Ban alcohol sales incentives, contests, games.
Ban "Happy Hour" discounted promotions. They encourage
Educate the public that addiction is a medical issue not a moral
Educate children from a very young age about dangers of alcohol.
Have youth design anti-alcohol programs targeting youth.
Better diagnostic tools for the full range of FASD damage.
True incidence and scaling of FASD damage.
Chemically turn-off addiction center in brain.
Acid in the Drinking Patient and the Expectant Mother"
by Dr. Bhushan Kapur.
in small amounts is present along with ethanol in beverage
alcohol. The body's natural enzymes preferentially metabolize
ethanol while methanol breaks down into highly neurotoxic
Formic Acid. Formic Acid is best
known in the venom of bee and ant stings.
of high levels of Folic
Acid was found to inhibit brain damage caused by the
use of Folic Acid during pregnancy has
been recommended for several years to prevent neural tube
defects. However, this study indicates that even higher
levels of Folic Acid can be very beneficial to the developing
baby, particularly where alcohol exposure is a factor. Since
1997, Folic Acid has been mandated as an additive to all
flour sold in Canada. The debate has begun on its required
addition to all beverage alcohol to help mitigate damage
caused to both infants and adults.
Screening for prenatal alcohol exposure.
is the first fecal excretion from the newborn baby. MecStatSM
EtOH is a test of the non-oxidative metabolites of Ethyl
Alcohol called Fatty Acid Ethyl Esters (FAEE’s). These
metabolites are the chemical combination for endogenous
fatty acids present in the blood of a fetus and Ethyl Alcohol.
These new compounds, which only form when the fetus is exposed
to Ethyl Alcohol, are deposited into the fetus’s meconium
and can then be detected and quantified from the newborn’s
meconium after delivery. The amount of the Fatty Acid Ethyl
Esters found in the meconium is representative of the amount
of Ethyl Alcohol the fetus was exposed to during the last
half of the pregnancy.
States Drug Testing Laboratories (USDTL) and its dba MecStat
Laboratories using the MecStat-ETOH meconium testing
for FAEE's have shown 15% to 18% of newborns have
been exposed to significant levels of alcohol in the final
20 weeks with 4% having been exposed to very high levels
of alcohol. This test has become the de facto standard
for laboratory diagnosis of fetal alcohol exposure and is
in routine use all over the United States and Canada. Courts
have held that MecStatSM EtOH tests meet both the Fry and
Daubert standards and the results are admissible in adversarial
confirmation study: "Neonatal Screening for
Prenatal Alcohol Exposure - The Grey Bruce Study"
by Joey Gareri, HBSc, MSc student was presented at the St.
Michael's Hospital 2005 FASD Conference. The FAEE
study, found a high level of exposure in 4% of newborns.
test for fetal alcohol exposure when there is no treatment
There are several reasons why diagnosis of alcohol exposure
is important. As with any disease, early diagnosis provides
for many more options and treatments than detection at an
a. Early diagnosis
of fetal alcohol syndrome (FAS) and fetal alcohol effect
(FAE) allow newborns to be identified and enrolled into
early intervention and treatment programs. New programs
are showing dramatic improvements in children identified
earlier in life.
of an alcohol affected child can allow help, intervention
and treatment to be offered to the mother, so that future
FAS and FAE children may be prevented.
c. When cocaine
and opiate exposed newborns were first detected, there was
no treatment. As programs, understanding and treatments
improve, diagnosis at a very early stage can only help the
outcome of the child, mother and family.
testing should be part of the standard testing protocol
for all newborns. "Results of meconium tests offer
a unique opportunity to record gestational exposure to ethanol.
Missing this opportunity can leave many children impaired
by alcohol at risk of being undiagnosed: evidence of maternal
drinking is a prerequisite for diagnosis of fetal alcohol
spectrum disorder in cases where pathognomonic facial features
are not apparent."
child has the right to honest diagnostic information that
has not been corrupted by ego, social stigma or threats
by the medical profession's insurance agencies.
may not see FASD when they look at my son's face,
but I see it. I see it in the way his eyes flash
in anger when he is frustrated and I see it in the
tears that pour down his face when he is trying
so hard to understand his math problems. I see it
in his blank stare when he shuts down after working
so hard in school all day, a place that has labeled
him as lazy and defiant, and I see it in his silly
smile when he is being impulsive or inappropriately
friendly with strangers.
is also visible on my face and on the faces of other
moms and dads...it is spelled out in worry lines.
For some it is in the tears that flow in overwhelming
grief. These are the facial features of FASD that
do not appear on the FAS diagrams. FASD is often
called the invisible disability, but I see it everywhere
I look...and it doesn't go away just because I close
Fletcher, Adoptive Mom to 2 children with FAS and
advocate/trainer at MOFAS, the Minnesota Organization
on Fetal Alcohol Syndrome
represents the largest environmental cause of behavioral
teratogenesis yet discovered and, perhaps, the largest
single environmental cause that will ever be discovered."
-Riley, E. P., and Vorhees, C. V. (1986). Handbook
of Behavioral Teratology. Plenum Press, New York,
all the substances of abuse, including heroin, cocaine,
and marijuana, alcohol produces by far the most serious
neurobehavioral effects in the fetus." -Institute
of Medicine 1996 Report to Congress
should not be judged as a problem of will power, misconduct,
or any other unscientific diagnosis. The problem must
be accepted for what it is - a biopsychosocial disease
with a strong genetic influence, obvious signs and
symptoms, a natural progression and a fatal outcome
if not treated". Thomas R. Hobbs PhD MD - Physician's
News Digest of Feb. 1998
Health Organization's "WHO
Global Status Report on Alcohol 2004 - Health effects
and global burden of disease" states, "Alcohol
use is related to wide range of physical, mental and
social harms. Most health professionals agree that
alcohol affects practically every organ in the human
body. Alcohol consumption was linked to more than
60 disease conditions. In the developed countries,
9.2% of all the disease burden is attributable to
alcohol, only exceeded by the burden attributable
to tobacco and blood pressure."
security, succession planning
One of the greatest concerns for parents of children with
any disabilities is "What happens after I die?"
"Who will look after my disabled adult child for
his/her lifetime?" "How can I preserve my few
remaining assets so my child can benefit and governments
won't relegate them to abject poverty or life on the streets?"
in Ontario, ODSP is not available until the disabled individual's
assets drop below $5,000 and then the maximum ODSP payment
is $12,480 per year. That is reduced by 24% if the disabled
individual lives with a family member. So if there are
any family assets inherited, they have to be completely
used up before the disabled individual is entitled to
any government support, far below the poverty line. This,
of course, is very distressing to the parents who have
spent a lifetime trying to protect their child.
place tremendous emotional pressure on our families. Disabilities
mean high needs dependents and often mean one parent must
drop out of the work force, perhaps losing $30,000 to
$60,000 or more annually from the family resources.
also cause enormous stress on marriages and lead to marital
breakdown and single parenthood with its attendant heightened
emotional and financial stresses. In Ontario 85% of support
orders are in default. If you can't support one household
on the available income, how can you support two? Disabilities
often mean complete destruction of the family finances,
no retirement pension, stress-related / distress-related
physical and mental illnesses of the caregiver and the
When the parents
are going through excessive stress, that can reflect back
on the child and amplify the child's problems. For example,
it can be highly stressful to have to battle bureaucrats
to obtain the services to which your child is entitled.
It is even a struggle to find out what services are available.
They tend to be well kept secrets.