FORT LAUDERDALE, Fla. — The warnings are bold on alcohol labels: if you are pregnant, consuming alcohol could cause serious health problems for your baby.
But pregnant women have been consuming alcohol for centuries. So how serious are those resulting health problems?
This week, experts told a Broward jury that confessed Parkland shooter Nikolas Cruz suffered severe brain damage as a result of his biological mother’s alcohol abuse. Brenda Woodard was known to abuse beer, wine and crack cocaine during pregnancy, multiple people testified. The experts said Cruz’s behaviors were consistent with fetal alcohol syndrome, one of the conditions that fall under the umbrella of fetal alcohol spectrum disorders, or FASDs.
If this syndrome spawned a killer, how common is it and what are the signs?
Question: Do the disorders create criminals?
Answer: These disorders are more common than most people realize but often go undiagnosed and untreated. The result tends to be problems at school — and with the law.
The disorders are surprisingly common, occurring in up to 1 in every 20 children, said Tom Robinson, CEO of FASD United. “That’s more significant than autism and it’s quite alarming,” he said.
FASDs are caused by someone being exposed to alcohol before birth. According to the Centers for Disease Control and Prevention, alcohol in the mother’s blood passes to the baby through the umbilical cord. With certain disorders, it only takes more than two alcoholic drinks in one sitting for the fetus to be affected.
“Of all the substances of abuse — including cocaine, heroin, (nicotine, and marijuana) — alcohol produces by far the most serious neurobehavioral effects in the fetus,” according to a 1996 report to Congress.
The effects vary but can cause delayed development, behavioral problems, learning disabilities, issues with motor skills, impulse control and socializing. Many children with the disorders have difficulty in school and getting along with others. They often end up suspended or expelled.
Researchers have seen a connection between FASD and run-ins with the law. A study published in the Journal of Mental Health and Clinical Psychology says “individuals with FASD are believed to be overrepresented in correctional settings.”
Q: Is FASD misunderstood?
A: Experts say because educators and medical professionals are unaware of FASDs and how the brain functions for someone who has an FASD, children are not treated for it properly or are misdiagnosed, which can lead to all kinds of bad outcomes.
Dr. Kenneth Lyons Jones, an expert who testified this week at the Parkland shooter trial, was among the first to give the disorder a name and has produced videos explaining that medical professionals have been slow to accept FASD as a real health problem. “There’s an incredible lack of awareness of this disorder,” Jones said in one of the videos. He is chief of the Division of Dysmorphology/Teratology at the Department of Pediatrics at the University of California, San Diego.
Under the umbrella of FASDs, there are several different conditions with different severities. Some children have more than one of the conditions. Experts who testified said Cruz has an alcohol-related neurodevelopmental disorder, which causes problems with behavior, learning and impulse control.
Diagnosing FASDs can be hard because there is no medical test, like a blood test, the U.S. Centers for Disease Control and Prevention says on its website
“Some children have facial features and growth deficits — physical markers — but many don’t,” said Tamra Cajo, director of the Florida Center for Early Childhood’s Fetal Alcohol Spectrum Disorder Clinic, which evaluates children and provides families with support. “It’s an invisible disability.”
Cajo said because FASDs are underdiagnosed, many individuals with this condition are seen by schools as problem students who are hyperactive, socially inept, impulsive and use poor judgment. “They see a child who is causing problems, getting suspended, having issues and no one has an understanding of the brain-based challenges the child is dealing with,” she said. “Schools often want to say they are bad people and simply put them somewhere else when this is so much more complex.”
Q: What needs to happen?
A: While there is no cure, the CDC says research shows that early intervention and treatment can help, especially if a child is diagnosed before age 6, lives in a stable home environment and gets special education.
The national organization, FASD United, released a statement when the Cruz sentencing trial began to let the public know that not all individuals with these disorders are involved in crimes.
“Each individual with an FASD is unique and Nikolas Cruz does not represent the FASD community, which is filled with many successful, inspirational people who have a positive impact on our society, especially when they are supported and understood.”
Robinson told the South Florida Sun Sentinel: “There is no research that shows having a FASD is a causal condition for violent crimes.”
Some people with FASD graduate from technical schools, live independently, work and are kind and caring, according to a report by the Pennsylvania Department of Human Services. But as many spend time in a juvenile detention center, have substance-use issues and need some type of dependent living arrangement.
FASD United is advocating in Congress for more funding for research and services for persons with FASD and their caregivers. “Recognition of the disability — with appropriate supports and services — can prevent secondary disabilities such as dropping out of school, getting into trouble with the law and alcohol and drug use,” FASD United said in its proposed legislation.
In its appeal to Congress, FASD United says families in every state, and especially in the child welfare system, struggle to find people who are equipped to diagnose and address FASD-related disabilities.
Cajo’s center in Sarasota, Florida Center for Early Childhood, helps those families and is opening more satellite offices.
“By no means, if you drink during pregnancy will you have a child who has issues and is going to become the Parkland shooter,” she said. “But as a caregiver, you need to understand your child’s brain so he gets the right support and you have the right expectations.”
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