Monthly Archives: February 2018

Register now for the March 21, 2018, Fetal Alcohol Spectrum Disorder (FASD) Webcast

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Join us for this free webcast entitled: Let’s Get Real: the FASD Prevention Conversation Adolescent Project.

“The FASD Prevention Conversation: A Shared Responsibility,” is a province wide initiative funded by the FASD Cross-Ministry Committee. The project focuses on the power of relationships by fostering brief, non-judgmental conversations to inspire change related to alcohol use during pregnancy.

The FASD Prevention Conversation originally targeted adults and was well received in Alberta communities. The Adolescent Project is bringing the key messaging to young people.

Debbie and Megan will:

  • Provide a brief overview of the intent, content and proposed delivery of “Let’s Get Real” strategies to reach youth and young adults with prevention messaging.
  • Detail new resources available for teachers, youth group leaders, and others who mentor young people and want to provide positive FASD prevention messaging.
  • Explain how local network facilitators can provide mentors with training and materials adaptable to make the program appropriate for a variety of age groups, developmental stages and settings.

This webinar will be of interest to persons directly affected by FASD and anyone else supporting persons with FASD.

AGENDA:
Date: Wednesday, March 21, 2018
Time: 9:00 a.m. – 10:00 a.m. MST
Speakers: Megan Tucker and Debbie Collins
Register Here
Format: Presenters with PowerPoint Presentation
Cost: FREE! Please share with your networks
Q&A: You can pose questions to the speakers through the live chat functionality. Remember, the live webcasts are interactive and we encourage you to participate in the question and answer portions by typing questions for speakers in the chat window, which is located below the main video panel on the webcast page.

SPEAKER BIOS
Debbie Collins currently facilitates “The FASD Prevention Conversation” in the Lakeland Network. She also trains mentors/advocates through The Parent and Child Assistance Program (PCAP). Debbie is a mother and a grandmother of loved ones with FASD and is passionate about prevention.

Megan Tucker is the training coordinator at the Lakeland Centre for FASD as well as a prevention conversation facilitator for the Lakeland Metis Network. Megan has been involved with the Network for almost 10 years.

Previous webcasts are available on the CSS Learning Series Website.

THE FASD LEARNING SERIES:
The FASD Learning Series helps individuals, caregivers, front-line workers and professionals learn more about FASD, and how to support persons with FASD. The educational sessions cover a broad range of topics and are accessible to all Albertans.

Alberta’s FASD 10-Year Strategic Plan outlines the government’s commitment to provide awareness and prevention of FASD, as well as assessment, diagnosis, and support for individuals with FASD and their caregivers. All services and activities are built on a foundation of stakeholder engagement.

Resource: Make a Difference, Talk To Your Child About Alcohol

Did you know…

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With so many drugs available to young people these days, you may wonder, “Why develop a booklet about helping kids avoid alcohol?” Alcohol is a drug, as surely as cocaine and marijuana are. It’s also illegal to drink under the age of 21 (18 or 19 in Canada).

This guide is geared to parents and guardians of young people ages 10 to 14. Keep in mind that the suggestions on the following pages are just that—suggestions. Trust your instincts. Choose ideas you are comfortable with, and use your own style in carrying out the approaches you find useful. Your child looks to you for guidance and support in making life decisions—including the decision not to use alcohol.

“But my child isn’t drinking yet,” you may think. “Isn’t it a little early to be concerned about drinking?” Not at all. This is the age when some children begin experimenting with alcohol. Even if your child is not yet drinking alcohol, he or she may be receiving pressure to drink. Act now. Keeping quiet about how you feel about your child’s alcohol use may give him or her the impression that alcohol use is OK for kids.

It’s not easy. As children approach adolescence, friends exert a lot of influence. Fitting in is a chief priority for teens, and parents often feel shoved aside. Kids will listen, however. Study after study shows that even during the teen years, parents have enormous influence on their children’s behavior. The bottom line is that most young teens don’t yet drink. And parents’ disapproval of youthful alcohol use is the key reason children choose not to drink. So make no mistake: You can make a difference.

 

 

 

 

Discredited Motherisk hair-testing program harmed vulnerable families: report

A review of nearly 1,300 child welfare cases spanning 25 years has found that a now-discredited hair analysis program in Toronto that tested for drug and alcohol use caused extensive – and potentially irreversible – harm to vulnerable families across Ontario.

An independent commission tasked with examining the Motherisk hair-testing program said Monday the child welfare system’s reliance on the analysis was “manifestly unfair and harmful” even when it did not substantially affect the outcome of cases.

The commission led by retired provincial court judge Judith Beaman said the tests were used to determine parents’ credibility and investigate suspicions of substance use. The results were given excessive weight by the organizations and the courts, Beaman said.

“The testing was imposed on parents and other caregivers who were among the poorest and most vulnerable members of our society. There was scant regard for due process or their rights to privacy and bodily integrity,” she said in a news conference.

“Most of the parents who were tested were powerless to resist. They told us they submitted to the testing under duress, in fear of losing custody of or access to their children. In some of the cases we reviewed, parents were told explicitly that this would be the consequence if they did not submit to testing.”

The tests had a significant impact on the outcome of 56 cases and seven of those families have obtained legal remedies, with four cases involving children being returned to their parents’ care, Beaman said.

But for many families, the damage cannot be undone, she said, noting the courts may decide it is not in a child’s best interest to go through another upheaval.

“The decisions we make in child protection are often devastating and irrevocable,” she said. “That is why it is critical that only reliable evidence and a fair process be used in the service of making those decisions.”

The commission was convened two years ago after another report found the Motherisk program run by Toronto’s Hospital for Sick Children fell short of international forensic standards for use in child protection and criminal proceedings, and said the lab “frequently misinterpreted” test results.

Children’s aid societies were directed in 2015 to stop using the Motherisk tests and the hospital shut down the program after apologizing for the issues.

But the tests had already been used in thousands of child-protection and criminal cases, and the program came under scrutiny after an appeal court decision highlighted differing expert opinions about a particular hair-testing method previously used by Motherisk.

“The discovery that unreliable test results were used as part of expert evidence in child protection proceedings for so many years undermines the public’s confidence in the fairness of our justice system, particularly with respect to how it treats vulnerable people,” Beaman said in the report.

Children’s aid societies and courts often drew negative inferences about parents who didn’t submit to testing or who disputed the results, she said. The tests were often used as a proxy for assessing parenting and the results were regularly admitted into evidence without the usual checks and balances, she said.

Beaman raised similar concerns about urine tests she said are currently being used to screen for alcohol and drug use in child protection cases.

The Motherisk saga has shown that child protection and court systems must be more careful in how they use expert evidence, and that more supports are needed for families and communities, particularly Indigenous and racialized communities, she said.

The commissioner issued 32 recommendations, including changes to legislation on the use of expert evidence, more education for judges, more funding for band representatives in First Nations, the creation of family-inclusive substance abuse treatment programs and measures to address racism in the child welfare system.

She also recommended extending free counselling services to the affected families for three years on top of the two they have already been offered.

The provincial government has accepted the recommendations and promised to continue the counselling, as well as form a taskforce on the issue, with a progress update due in a year.

“What we’re seeing today is a long legacy of the way the system has been built. There’s been some systemic issues that have been at play and, I believe, systemic racism at play when we talk about communities like Indigenous communities and the black community,” said Michael Coteau, Ontario’s minister of children and youth services.

The minister said the province has already taken steps to address many of the issues by passing new child welfare legislation last year that puts children at the centre of decision-making about their care.

Asked about the use of drug tests in child welfare cases, Coteau said there is no standard process at the moment but agencies must make sure to consider a variety of factors.

The review looked at cases between 1990 and 2015 involving Motherisk and in which children were permanently removed from their families.

Retrieved from https://www.theglobeandmail.com/news/national/discredited-motherisk-hair-testing-program-harmed-vulnerable-families-report/article38111582/?_cldee=bGlzYS5yb2dvemluc2t5QGNzc2FsYmVydGEuY2E%3d&recipientid=contact-fb04ede4f1d1e6118105480fcfeaa931-1479263f7d2b424696223698da91d3b9&esid=88b8c4b1-c61b-e811-813d-480fcff4b171

Alcohol among biggest risk factors of early-onset dementia: Canadian study

Chronic heavy drinking is the most important and biggest preventable risk factor for every type of dementia, especially early-onset dementia, a new Canadian study has found.

The observational study by Centre for Addiction and Mental Health (CAMH) looked at 57,000 cases of early-onset dementia (before the age of 65). What they found was the 57 per cent of these cases were related to chronic heavy drinking.

“What was the most surprising was the level of association between heavy alcohol use and all types of dementia,” says study co-author Dr. Jurgen Rehm. “Before our study … alcohol was not even listed among the most important risk factors for dementia. We know this was wrong, but that it turned out to be the most important risk factor for all kinds of dementia in controlled analyses [and] it was surprising.”

According to the World Health Organization (WHO), chronic heavy drinking includes consuming more than 60 grams of pure alcohol on average per day for men (averaging out to four to five Canadian standard drinks) and 40 grams for women (about three standard drinks).

The study looked specifically at the effect of alcohol-use disorders, and included people who had been diagnosed with mental and behavioural disorders or chronic disease that were linked to chronic alcohol drinking.

While researchers weren’t able to determine why alcohol was the top risk factor, they were able to identify two major pathways as to why that may be.

“Heavy drinking is linked to structural and functional changes in the brain which can be identified via imaging,” Rehm explains. “These changes actually start already at moderate drinking, but there is a dose-response relationship, and heavy drinking is much more important for worsening cognitive functioning.”

Rehm says there are also indirect ways how alcohol impacts on dementia through other risk factors. For example, alcohol use increases the risk for hypertension, and it leads to liver damage, among other things.

Rehm and his team also found that there was a gender divide in the results. While the majority of dementia patients were women, almost two-third of all early-onset dementia patients were men (about 65 per cent).

According to the findings, alcohol use disorders were also associated with all other independent risk factors for dementia onset. They include tobacco smoking, high blood pressure, diabetes, lower education, depression and hearing loss – all of which are identified as “modifiable risk factors.”

“Dementia is one of the quickest increasing and most disabling disease clusters currently, and very important for public health,” Rehm says. “Many efforts are being started now to look into potential ways of prevention, and reduction of alcohol consumption is now a promising way to reduce incidence of dementia, or to postpone the onset.”

Non-modifiable risk factors for dementia include age, a family history and genetics and other medical conditions like Parkinson’s disease, multiple sclerosis, chronic kidney disease and HIV, the Alzheimer’s Society of Canada says.

As of 2016, it is estimated that about 564,000 Canadians live with dementia, and about 25,000 new cases are diagnosed every year. By 2031, that number is expected to jump to 937,000 – an increase of 66 per cent, the Alzheimer Society of Canada reports.

Retrieved from https://globalnews.ca/news/4038341/alcohol-risk-factor-in-dementia-study/

In The News: Montana Prosecutor’s Crackdown on Pregnant Women Who Use Drugs Could Harm Women’s Health

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Last month, a Montana prosecutor made a major move to criminalize pregnant women. Big Horn County Attorney Gerald “Jay” Harris announced he would issue civil restraining orders against pregnant women who use drugs or alcohol. Under these court orders, pregnant women can be monitored for such conduct by law enforcement. If they are found in violation of the orders, they can be sentenced to jail time.

“In the event there are provable violations of any such protective court orders, the State will further prosecute on a contempt basis and seek incarceration in order to incapacitate the drug or alcohol-addicted expecting mother,” Harris stated in a January 11 press release.

Harris also called on the public to be his eyes and ears. “In furtherance of this crackdown policy, the County Attorney’s Office is asking the public to report any known instances of pregnant females using drugs or alcohol to the Big Horn County Sheriff’s Office,” the press release stated. “Reporters must be willing to testify in court.” He also asked pregnant women with addictions to report themselves to the Department of Health and Public Services and voluntarily enroll in substance abuse monitoring. In Montana, health care workers are also required to report suspicion of drug use by pregnant women.

But critics say his plan is likely to backfire. “I think this whole idea of policing pregnancy that Jay Harris is encouraging is very counterproductive and dangerous,” said Caitlin Borgmann, director of ACLU Montana, “if what we’re wanting to do is help these women have healthy pregnancies.”

Harris is not the the first Montana county attorney to attempt to protect fetal rights. In 2014, a prosecutor in Ravalli County tried to charge a woman with criminal endangerment based on her drug use during pregnancy. The charges ended up being dismissed by the judge, who noted that a fetus is not protected from criminal endangerment under state law. That may be why Harris chose to utilize civil instead of criminal charges against women; he likely assumes he won’t run afoul of a Montana law that prohibits the type of “fetal assault” charges used in other states.

In response to Harris’s announcement, groups like ACLU Montana and the Coalition against Domestic Violence and Sexual Violence signed a letter calling the prosecutor’s move “counterproductive, paternalistic, and cruel … [as well as] illegal” and condemned the crackdown for building barriers to substance abuse treatment.

ACLU Montana and several other organizations also said they will sue Harris, arguing that his move to punish pregnant women would violate the dignity and due process statutes as well as the equal protection statutes of Montana’s constitution. It would also violate Montana’s Human Rights Act, they say, which prohibits discrimination based on sex and pregnancy status.

Laws designed to punish pregnant drug users can be found across the country. According to the Guttmacher Institute, “24 states and the District of Columbia consider substance use during pregnancy to be child abuse under civil child-welfare statutes, and three [Wisconsin, South Dakota, and Minnesota] consider it grounds for civil commitment.”

According to an Amnesty International report released last year, fetal assault laws enacted in 2014 in Tennessee and 2006 in Alabama disproportionately affected rural women and Black women. Arrests in Shelby County, Tennessee, a Black-majority county, comprised a quarter of all arrests under the fetal assault law in that state, despite Shelby County having one of the lowest rates of babies born exposed to opioids. In interviews Amnesty conducted with women charged under fetal assault laws in Tennessee and Alabama, low-income women told the organization they avoided obstetrical care because they were worried they might get drug tested. Furthermore, Amnesty reported high arrest rates in areas like East Tennessee where access to treatment centers and medical options for addiction are scarce.

The ACLU’s Borgmann says that DA Harris’s plan to pursue civil charges against pregnant women will similarly target minority communities and low-income residents generally.

“Attorney Jay Harris reached out specifically to the Crow and Northern Cheyenne reservation to ask them to help him implement this policy,” Borgmann told In Justice Today by phone. “So I think we do have to be concerned that this will disproportionately be targeting Native women in Montana.

“Low-income women tend to have more interactions with the government,” Borgmann continued. “For housing, for medical care, for other kids of social services — so their drug use is more likely to be caught. It doesn’t mean that they’re necessarily doing higher rates [of drug use], but it’s because of … their increased interactions with the government that they tend to be disproportionately targeted.”

Worse, in Montana there are few options for pregnant women with addictions. According to the Missoulian, only 7 percent of the state’s treatment centers have programs specifically for pregnant women or women who just gave birth. Addiction treatment providers say that after getting their Medicaid reimbursement funding cut in 2017, it’s difficult to meet the needs of addicted people in the state, especially pregnant women. And Big Horn County doesn’t have a residential treatment program specifically for pregnant women; the county offers only outpatient services for them, according to Lenette Kosovich-Edgerton, CEO of Rimrock, the largest treatment center in Montana.

In order to receive residential treatment services, a pregnant woman from mostly rural Big Horn County, population 13,343, would have to go to the largest city in the state: Billings, Montana, which is about 50 miles away. She would then likely be placed on a waiting list before she could be admitted into the center.

Borgmann of the Montana ACLU fears that Harris’s plan to crack down on pregnant women in a state where there is already a lack of treatment centers would likely lead to low-income women and rural women avoiding necessary health care services.

Both she and Kosovich-Edgerton say the best way to help pregnant women with substance abuse problems is not to criminalize them, but to provide more accessible and affordable treatment centers that are designed to treat them, and to encourage such women to seek treatment via education and public awareness campaigns. “It would basically be the opposite of what [Harris] is suggesting,” Borgmann said.

Retrieved from https://injusticetoday.com/montana-prosecutors-crackdown-on-pregnant-women-who-use-drugs-could-harm-women-s-health-7e81802a1105

A free online course from the AFWI: BRAIN STORY CERTIFICATION

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WHAT YOU’LL LEARN

Lifelong health is determined by more than just our genes: experiences at sensitive periods of development change the brain in ways that increase or decrease risk for later physical and mental illness, including addiction. That finding is the premise of the Brain Story, which puts scientific concepts into a narrative that is salient to both expert and non-expert audiences. The Brain Story synthesizes decades of research and reflects a body of knowledge that experts agree is useful for policy-makers and citizens to understand.

The Alberta Family Wellness Initiative (AFWI) has developed an online course to make Brain Story science available to professionals and the public. Brain Story Certification is designed for those seeking a deeper understanding of brain development and its consequences for lifelong health. The course is also designed for professionals seeking certification in a wide range of fields.

Have questions about the course or would like further details? Contact us.

THE COURSE

A free, in-depth course for anyone who wants to learn more about the science of brain development.
  • Videos of more than 30 leading experts in neurobiology and mental health
  • Certification in Brain Story science
  • 19 modules self-paced

Brain Story Certification is a course endorsed by our Curriculum Committee. For a detailed description of the course contents, download the course outline.


Brain Story Certification is open to anyone at no cost to the learner.

To register please visit: http://www.albertafamilywellness.org/training

Building the right mobile app for caregivers of children with FASD

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Mt. Hope Family Center research associate Christie Petrenko, left, and electrical and computer engineering research associate Cristiano Tapparello have won a $1.5 million grant from the National Institutes of Health to support their work to develop a mobile app to provide health information for self-directed and peer-to-peer interventions for parents and caregivers of children with fetal alcohol syndrome disorder. (University of Rochester photo / J. Adam Fenster)

After years of working with patients and researching fetal alcohol spectrum disorders (FASD), Christie Petrenko, a research associate at the University’s Mt. Hope Family Center, knew a mobile app might be just the tool she was missing in order to help families and caregivers of children with FASD. She wasn’t sure who might have the right technical expertise but knew fellow psychology researchers had forged connections with colleagues at the Hajim School of Engineering and Applied Sciences. Soon, she was introduced to Cristiano Tapparello, a research associate in the Department of Electrical and Computer Engineering. A team was born.

This past summer the newly-formed team were awarded a $1.5 million grant from the National Institutes of Health to develop an app that provides health information for self-directed and peer-to-peer interventions for parents and caregivers of children with FASD. The mobile health intervention will provide scientific, evidence-based content and peer-moderated support that’s easily accessible.

Earlier this month, the duo conducted initial focus group meetings with caregivers to show off their first prototypes and get input from those the app is designed to serve. Top of the list for parents: confidentiality, community, the ability to personalize information to their child, and, of course, ease of use.

Among other things, parents agreed with the researchers’ idea that the app should contain a caregiver forum to exchange ideas and local resources. The forum needs to feel safe and be moderated so that people can’t make inappropriate comments, they told the researchers. Also, focus group participants said they didn’t want to engage in endless scrolling on their screens to find the pertinent content.

To Petrenko and Tapparello this is vital feedback. Tapparello, who often uses his wife as a sounding board for his prototype apps, especially liked the parents’ feedback: “Getting a sense of how everything that I’m presenting with the design is perceived by different people is really helpful.”

The app is currently called “FMF Connect.” Its name is derived from the Families Moving Forward (FMF) Program, which was designed specially for children with FASD by co-investigator Heather Carmichael Olson, a clinical professor at the University of Washington and Seattle Childrens Research Institute. 

Petrenko, a recognized expert in the field, has conducted multiple studies that have resulted in a program of interventions for parents and other caregivers of children with the disorder. The multidisciplinary team now hopes the app will help reduce caregivers’ feelings of isolation while providing reliable, evidence-based health information.

“Many families have little to no access to the kinds of information and parenting strategies that are most helpful in managing the behavior of children with FASD,” she says. “They need support from others who understand their experiences.”

The building of the app is a constant back-and-forth process, says Tapparello. Trained as a computer engineer with a much more theoretical focus, app building was not originally part of Tapparello’s professional repertoire. Sometimes he tinkered with apps for his own phone. What started as a hobby slowly began to seep into his professional life. After successfully writing apps to help parents manage their child’s asthma, and to improve medication compliance in oncology patients, he says it’s “fun to try to fulfill what other people find useful.”

At this point, the core content is written and basic design structures are in place, confirms Petrenko. More focus groups throughout the US are planned—in Rochester, Washington D.C., Atlanta, Minneapolis and San Diego—to elicit a wide range of perspectives and feedback.

The team is devoting a lot of time to building an interface that looks good and feels intuitive to the user. That’s why they aren’t rushing things. The first two years are earmarked for systematic development to “build a really nice prototype that’s thoughtful, easy to use, and hits just the right mark,” says Petrenko. The app will have learning modules, a library of resources and articles, a peer-moderated family forum, a notebook function for saving comments and ideas, and a dashboard that shows progress through the various learning modules. The researchers are also considering adding a medication tracker function after parents in the focus groups specifically asked for it.

“Having easy access to peers who really understand both the joys and challenges of raising children with FASD can help reduce feelings of isolation and increase support,” says Petrenko. “Caregivers can brainstorm together and reinforce educational content on the app to help each other come up with strategies to try to manage specific behaviors displayed by their children.”

Awarded over five years, the grant includes a subcontract with Seattle Children’s Research Institute. The first two years will be spent focusing on the app development. Year three is earmarked for a feasibility trial with 30 families, and years four and five are scheduled for a large-scale test with 120 families in a randomized controlled trial.

Co-investigators include Wendi Heinzelman, dean of the Hajim School of Engineering & Applied Sciences; Zhiyao Duan, assistant professor in the Department of Electrical and Computer Engineering; Elizabeth Handley, research associate at Mt. Hope Family Center; Rebecca Van Dyke, a master’s student in computer engineering; project coordinator Jennifer Parr, a master’s student in mental health counseling at the Warner School of Education, and Heather Carmichael Olson with the Seattle Children’s Research Institute and the University of Washington.

Those interested in participating in FASD research trials can join a registry through CIFASD at www.nofas.org/cifasd/.

Retrieved from http://www.rochester.edu/newscenter/building-right-mobile-app-caregivers-children-fasd-294102/

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