M A N I T O B A F.A.S.NEWS FETALlALCOHOLlSYNDROME Spring 2003 A Publication of the Coalition on Alcohol and Pregnancy

Manitoba Addiction Awareness Week Awards: New Screening for Round Table on FAS Honoured Prenatal Alcohol Use

In January, 2003, Health Congratulations to the Norway House modified the BabyFirst Screening form Round Table on Fetal Alcohol Syn- to collect more relevant data on the drome on receiving the Manitoba Ad- prevalence of alcohol use during preg- dictions Awareness Week 2002 Provin- nancy. As part of the initial screen proc- cial Award of Distinction. The award ess, public health nurses now ask all was presented during the National Ad- women who deliver a baby in a Mani- dictions Awareness Week Kick-off in toba hospital about their use of alco- in November, 2002. hol during pregnancy.

This provincial award recognizes ex- If the mother indicates any use of al- ceptional work that demonstrates a cohol during pregnancy, further ques- high level of ongoing commitment, tions are asked to elicit information community involvement and support, about amounts and frequency. This and a positive, ongoing impact on both process gives all mothers an opportu- the community involved and the prov- nity to discuss their alcohol consump- ince overall. tion during pregnancy and any ques- tions or concerns that they may have. Each year the Manitoba Addictions Awareness Week (MAAW) committee The information collected through recognizes, through its "Awards of Dis- this screen will provide a picture of tinction," individuals and organiza- (Left to right) Walter Spence, Director of Minisewin Child Care Agency, annual incidence rates on alcohol use tions for their work in raising aware- Lia Braun, Special Services Consultant - Frontier School Division, John during pregnancy; incidence rates on ness around substance use/misuse, Borody, C.E.O., Addictions Foundation of Manitoba, Daisy Monias, Vice- gambling and other issues related to Principal, Jack River School - Frontier School Division, and Vic Thordarson, addictions. retired Superintendent of Frontier School Division. (cont'd on page 3)

The Norway House Round Table "In a recent poll of Norway House high Committee was chosen for playing an school students, 100% were aware of important role in raising awareness what FAS meant and how babies were 2003 Canada Northwest about the dangers of drinking alcohol, affected." taking drugs and smoking during FASD Conference pregnancy, both in the community of Committee members have conducted Norway House and in many other workshops locally and in other com- (Formerly called the Prairie Northern Pacific FAS Conference) places. munities for pregnant women, teach- ers, childcare workers and others. Convention Centre, November 19-21 In presenting the award, Addictions Foundation of Manitoba C.E.O. John The committee also encouraged and Borody noted that since its inception supported the FAS prevention "Our Communities...Our Strength" will provide a forum for community five years ago, the committee has partners to hear from experts in the field of FAS and community develop- achieved tremendous success. (cont'd on page 4) ment. The pre-conference day will provide half-day and full day workshops in focussed subject areas by invited experts.

The focus of the main conference will be to acquire skills in specific best W H A T ' S I N S I D E . . . practice prevention/intervention strategies that address the challenges of First Nations & Inuit Health Branch FAS/FAE Projects ...... 2 FAS; to disseminate information on FAS Community Mobilization Project for Adults ...... 2 the latest research regarding FAS; New Test Can Reveal Baby's Alcohol Exposure ...... 3 to learn about specific community $320 million for Early Child Development ...... 3 development models to support AMC Develops First Nations Response to FAS ...... 3 community efforts to address FAS; National Framework for Action of FAS/FAE ...... 3 and to strengthen regional networks. Update on Fetal Alcohol Family Association of Manitoba ...... 4 Metis Community Development Tool ...... 4 Submission guidelines for present- STOP FAS Program - Evaluation Highlights ...... 5 ers and information on conference FAS: The Birth Mother's Experience ...... 5 registration will be available at Caldwell to Chair Canada Northwest FASD Partnership ...... 5 www.fasconference.ca by May, 2003. Tying the FAS Knot ...... 5 Healthy Child Manitoba Helps to Fund CAP ...... 5 The Prairie Northern Pacific FAS Study looks at Supports for Reserve & Rural Families ...... 6 Partnership was recently renamed the Canada Northwest FASD Partnership. FAS in Adult Offender Populations ...... 6 It includes the governments of Alberta, British Columbia, Manitoba, Sleep Disorder Study Results ...... 7 Northwest Territories, Nunavut, Saskatchewan and Yukon. WCFS: Working with Families who Misuse Alcohol & Other Drugs ...... 7 FASD - Law Enforcement Training Spreads ...... 7 For more information on the 2003 conference, contact Linda Storoschuk at National Training for Community-Based Practitioners ...... 8 Planners Plus Inc. at 255-2244 or [email protected]. Addictions Foundation of Manitoba Library ...... 8 Come, Walk with Me: A Christian Response to FAS ...... 8 Manitoba Foster Family Network Conference ...... 8 Info at www.fasconference.ca by May 2003

1 First Nations & Inuit Health Branch Projects FAS Community Mobilization Project for Adults In fiscal year 2000-2001, the First Nations and Inuit Health Branch funded 10 FAS/FAE projects across Canada. The projects included training workshops, information and awareness sessions, the development of practical tools, FAS/FAE strategies and publications on the issue, and are briefly described below. In response to the "Think Tank on Adults living with FAS" presented by the Coalition on Alcohol & Alberta Treaty 8 Health Council, Kettle and Stony Point Health Services, Pregnancy in March, 2002, the FAS Community Mo- Edmonton, AB Forest, ON bilization Project was launched. This project featured awareness training on FAS/ This project provided capacity training for service FAE within community health centres or school set- providers to enable them to develop ongoing, sus- The four main focus areas of this project are to: tings in 23 First Nations within the Treaty 8 Alberta tainable action plans on FAS/FAE in their respec- territory. It provided the parents of FAS/FAE chil- tive First Nation communities. (1) Increase the dren with a sense of hope, understanding and in- Contact: Janet George at (519) 786-5647 or number of service spiration to continue with the challenging job of [email protected] options available raising an FAS/FAE child without feeling isolated. to adults living It also enabled the communities to develop their Mamaweswen, The North Shore Tribal with FASD by as- own prevention models conducive to their cultural Council, Cutler, ON sisting those eli- and traditional values. gible for existing This FAS/FAE capacity building and prevention government serv- Contact: Joyce Cardinal at (780) 444-9366 or project consisted of a five-day workshop and included ices to access [email protected]. frontline prevention workers using a train-the- those services and trainer approach to prepare the workers on how to to assist in the Anishinaabe Mino Ayaawin Inc., Interlake develop and deliver community awareness activities. creation of serv- Reserves Tribal Council Health, Winnipeg, MB A series of one-day workshops were also held with ices that will ad- This FAS/FAE Prevention/Community Mobilization educational, health and social work professionals. dress the gaps as Project provided training and mobilization of key Contact: Betty McCullough at (250) 949-8732. identified by the frontline workers on FAS/FAE prevention, support- ing strong community relations between seven First Musgamagw Tsawutaineuk Tribal Council, Think Tank. Nation communities in Manitoba. It was able to reach Alert Bay, BC (2) Address the need for general coordination of the identified key target This project was intended to services for adults living with FASD in Manitoba. groups and a total of 54 com- inform and train community (3) Address the need for greater access to assess- munity workers participated in members and frontline work- ment and diagnosis for adults living with FASD. the three-day training session. ers about FAS/FAE and pro- (4) Participate actively in the FAS community. The development of a commu- vide a mechanism for network- nity work plan ensured a col- ing and information sharing The FAS Community Mobilization Project is cur- laborative and coordinated ap- between the four communi- rently funded by the Association for Community Liv- proach in addressing FAS/ ties, three of which are acces- ing-Manitoba, Manitoba Marathon Fund, Opportu- FAE. A steering committee was sible only by seaplane or boat. nity Fund, and Health Canada's Population Health developed from the training Participants identified and session to oversee the commu- worked with community mem- Fund. Additional government funding will be es- nity work plans and follow-up bers at risk, specifically women sential to increase the services that are available on decisions. ages 12 to 45, and raised com- through the project. Contact Daryl Cote at (204) 659- munity awareness of FAS/FAE 2094 or [email protected]. by holding culturally appropriate community workshops. FAS Community Battlefords Tribal Council Indian Health Serv- Contact: Fern Assinewe at (705) 865-2171 or ices Inc., North Battleford, SK [email protected]. Mobilization Project The intention of this project was to provide frontline Contact Graham Wyllie at 489-8435 workers with training in the use of storytelling to Pauktuutit Inuit Women's Association, or Brenda Bennett at 786-1607 sensitize and inform the community about FAS/FAE. Ottawa, ON In partnership with Indian Bands Battlefords and Pauktuutit's FAS/FAE Prevention/Community Mo- Area Child Development Program and Saskatchewan bilization project reached 53 Inuit communities Existing services being provided in a limited capac- Literacy Network, this special project was a two-day through resource materials distributed to commu- ity to reach these goals include intake, referral and workshop that involved storytelling/story writing and nity health or addiction workers and media cover- application to government services; access to assess- training of trainers. A total of five communities were age. It promoted healthy, alcohol-free pregnancies ment and diagnosis; access to community program- served. Besides increasing the knowledge achieved and encouraged discussion about FAS/FAE. The ming; housing assistance; funding for job support on the issue of FAS/FAE, the stories produced will project produced a culturally and linguistically ap- programs; support workers; and support to adoles- be used as resource material. propriate radio play called "Before I was Born," which cents transitioning to adult services. Contact: Janice Kennedy at (306) 937-6700 or aired on stations throughout the North. Youth were [email protected]. the target audience of the play and were involved in A sampling of current activities includes: meeting its production and in the direction, acting and film- Deh Cho Friendship Centre, Fort Simpson, NT ing of the complementary 26 minute video of the with individuals who are either formally diagnosed or where there are indications of being alcohol af- This project provided training workshops for same title. The video story is about a young preg- nant teenager and her journey through her preg- fected; a three month project with Family Services to healthcare workers, educators and community mem- provide assessment and support services for five in- bers on the causes, prevention and implications of nancy. The complete kit also includes a facilitators' dividuals; and through the Opportunity Fund, as- FAS/FAE. It was focussed on training and capacity viewing guide and a poster. Approximate cost of the sisting a number of individuals through community development for frontline workers in seven differ- kit is $50. programs to provide one-to-one support regarding ent communities of the NWT. Contact: Catherine Carry at (613) 238-3977 or job search and employment retention. Contact: Gerald Antoine at (867) 697-2577 or [email protected]. [email protected]. Taku River Tlingit First Nation, Atlin, BC First Nations Education Council, Wendake, QC This project was designed to create a support and Summary of Think Tank Goals This project provided training on FAS/FAE and respite network for FAS/FAE caregivers while rais- developed practical tools and methods for special ing awareness of FAS/FAE among potential moth- u Address criteria and eligibility for services. ers and community leaders, and encouraging the education teachers. It increased the awareness and u Address transition supports from expertise of frontline workers and promoted the development of a community mobilized social ac- development of resource material. tion justice plan on the issue. incarceration to community. Contact: Lise Kistabish at (418) 842-7672 or Contact: Ed Anderson at (250) 651-7755 or alternately, u Address transition from school to [email protected]. Linda McGill at [email protected]. community life. u Address housing and employment needs. u Address the need for alternatives to jail. u Address the need for greater support to families.

2 Screening for prenatal alcohol use $320 million for Early Childhood Development - (cont'd from page 1) First Nations & Other Aboriginal Children low dose drinking as well as binge drinking; infor- mation at a regional level to help plan and target On October 31, 2002, the Government of Canada on training for frontline workers. The training will prevention resources; and a baseline measure with announced a funding allocation of $320 million over assist these workers in supporting, identifying and which to compare and determine the impact of pre- the next five years for a strategy to improve and managing those at risk of FAS/FAE. Another objec- vention work. expand Early Childhood Development programs tive is the development of public education tools and services for First Nations and other Aboriginal and resources. "We hope to obtain solid statistics on the incidence children. of drinking during pregnancy in Manitoba. There With an additional $10 million in 2002-03 and $15 have not been any good studies in Canada so far to This investment will expand the Aboriginal Head million ongoing, the expanded FAS/FAE Initiative indicate prevalence. It's very exciting from a research Start Program for Aboriginal children living on and will include a stronger focus on First Nations chil- perspective," notes Jill Swaffer with Healthy Child off reserve, and will enhance and expand the First dren and families to increase efforts in raising aware- Manitoba. Nations and Inuit Child Care Program. The invest- ness of this important health issue and will assist in ment also enables the Federal Government to in- the prevention of FAS/FAE and in providing sup- For more information, contact Jill Swaffer at Healthy Child tensify its efforts to address FAS/FAE in First Na- ports for those affected. Manitoba at 945-8641. tions on reserve. Funds will also support a national survey on Aboriginal children and research at the Initiatives will be put in place to help mobilize com- community level. munity action and contribute to enhancing the qual- ity of life for affected individuals and families, in- New test can reveal baby's While conditions are improving, the general health cluding the improvement of family and parent sup- status of Canada's Aboriginal population ranks be- ports in federal community-based programs. alcohol exposure low the national average. Infant mortality rates are two to three times the national average and anecdo- Current efforts will be expanded to enhance pro- An article published on November 5, 2002, in the tal research suggests growing concerns with respect fessional training and to develop practical screen- Globe & Mail reported that a new test can reveal a to FAS/FAE and Sudden Infant Death ing tools for physicians and health care providers baby's alcohol exposure. Margaret Philp reported Syndrome (SIDS). working with First Nations children and families on that doctors at Toronto's Hospital for Sick Children reserve. have invented a test that is used on the first bowel Initial studies suggest that the rates of FAS/FAE in movements of newborns to look for chemical clues some Aboriginal communities may be significantly The expansion will also support the development that their mothers drank alcohol in pregnancy. higher than in non-Aboriginal populations. In the of new programming through demonstration 1999 Budget, the existing Canada Prenatal Nutri- projects in First Nations communities. Philp explained that the laboratory at Sick Kids' tion Program was expanded to support an increased Motherisk clinic analyzed the black, sticky meco- focus on FAS/FAE and to further improve the health Working collaboratively with other federal depart- nium that all newborn babies pass, a result of having of pregnant women at risk and their babies. ments, provincial/territorial governments, profes- digested amniotic fluid in the womb. They look for sional associations and non-governmental organiza- a chemical that forms when alcohol bonds with fatty The First Nations and Inuit component of the FAS/ tions, Health Canada will continue to play a key role acids. FAE Initiative ($1.7 million annually) has focussed in the overall strategy to prevent FAS/FAE.

Dr. Julia Klein, director of the Motherisk fetal toxi- cology laboratory, which developed the meconium test, described how it works: "Meconium is like a AMC Develops First Nations Response to FAS trash can. What the fetus experiences in utero accu- mulates there, and it stays there until the baby is born, so it's a very good medium for measuring what The Assembly of Manitoba Chiefs (AMC) FAS Work- Recognizing this, the committee is starting with a the fetus is exposed to." ing Group is working towards developing a First Na- community response. The intent is to heal a com- tions strategy in the area of FAS. This year's strategy munity first and then the children. Philp reported that only trace amounts of the chemi- is to increase education while next year's goal is in- cal are likely to be detected in the first bowel move- tended to include a number of strategic projects, This year, to meet their goal of increasing educa- ment of a baby born to a woman who sipped an occa- says committee member Kathy Jones of West Region tion, two on-reserve FAS conferences took place in sional glass of wine in pregnancy. But it will appear Child and Family Services. March, one in the north and one in the south. Kathy in abundance in the meconium of babies born to Jones was the contact person for the southern con- women who binged or drank regularly. Funding to develop the First Nations strategy is pro- ference and Freda Lepine was the contact for the vided by Health Canada through the First Nations and northern gathering. Peter Selby, a physician at St. Joseph's Health Cen- Inuit Health Branch as part of a national FAS strategy. tre in Toronto, which is using the testing for babies "What we tried to do at these conferences is give born to women enrolled in the hospital's program "The committee has been meeting for two years and is people ideas on how to do community-based inter- for alcoholic expectant mothers, cautioned that the really interested in developing a customized Manitoba ventions in the area of FAS," says Jones. test only indicates alcohol was consumed and does First Nations response and not try to fit someone else's not constitute a diagnosis of FAS. ideas into ours." says Jones who notes that the needs of A third FAS conference is planned that will focus on a First Nations community are very different. best practices in daycares in First Nation communi- ties. It will include funding for retrofitting First "There are no professional supports to speak of, few Nation daycares to support kids with FAS. National Framework for recreational opportunities, and no children's pro- grams. There is a combination of high levels of FAS Jones notes that the FAS working group is excited Action on FAS/FAE but also high levels of emotional difficulties, includ- about where they are and are looking forward to some ing high suicide rates." really innovative programs next year. On February 12, 2003, Health Canada held a consultation in Winnipeg regarding the devel- opment of a National Framework for Action on FAS/FAE. Approximately 40 organizations and Manitoba government departments were represented by the 41 participants. First Nations The purpose of the working session was to Education Resource Centre reflect on past experiences and chart out a 6th Floor 338 Broadway national framework for action that builds on Winnipeg, MB R3C 0T2 what has been accomplished to date. Phone: (204) 940-7020 The ultimate goal of the national framework is to develop a broad-based, collaborative effort to www.mfnerc.com prevent FAS/FAE, and to improve the quality of life of people and families affected by FAS/FAE across Canada. The framework document is to be launched in May 2003.

For more information, contact Lynn Foley at 983-8028.

3 Update on Fetal Alcohol Family Association Fetal Alcohol Syndrome: The Fetal Alcohol Family Association of Manitoba shops in communities across the province. For ex- A resource for professionals (FAFAM) is dedicated to providing advocacy, sup- ample, FAFAM president Deb Thordarson spoke to port and education to families caring for and pro- numerous families considering adoption through fessionals working with children and Winnipeg Child and Family Services adults prenatally exposed to alco- about the effects of prenatal expo- hol/drugs. sure to alcohol. FAFAM Executive Di- rector Leilani Buschau presented to Donations needed Winnipeg librarians about making library programs more inclusive. The Family Association is a charita- Two full-day workshops were held in ble, not-for-profit organization. St. Martin for foster parents working Should you wish to make a charita- for Anishinaabe Child and Family ble donation, a tax receipt will be is- Services and a half-day workshop was sued for all donations over five dollars. held in Eriksdale for foster families working for New Directions for Children, Youth and Families. After a meeting with Drew Caldwell, Minister of Fam- ily Services and Housing, regarding ongoing oper- On the request of the national Native Alcohol and ating funding for the Association, the Board of Di- Drug Addiction program in Little Saskatchewan First rectors is hopeful that additional dollars will be in- Nation, the Family Association made a presentation cluded in the next provincial budget. The Board to students from grades 7-12 during Alcohol and was particularly appreciative of the many letters of Drug Awareness Week on the prevention of FASD. support they received from families, agencies, In Winnipeg, students at the Arthur E. Wright School organizations and community groups whom heard a presentation on the effects of prenatal ex- the Association has served and partnered with over posure to alcohol. the last two years. Let's Find A Solution New FAFAM brochure being developed Parent Information Series: Saskatchewan Institute on Prevention of Handicaps Fostering Awareness and Strength Buschau notes they are working hard at developing Tel: (306) 655-2512 / Fax: (306) 2511 ways to let people in the community know what the [email protected] www.PreventionInstitute.sk.ca The FAFAM began its sixth Parent Information Se- Family Association can offer to families and profes- ries on March 3 at the Family Community Centre sionals. One method is a new FAFAM brochure that will soon be available. (100-475 Sargent Ave). The series runs until April Manitoba Addictions Awareness Week 28 and is titled "Fostering Awareness and Strength". Care for the Caregivers: Parent Support Group (cont'd from page 1) Topics and speakers in the series include: "What is Fetal Alcohol Spectrum Disorder" with Leilani In partnership with the Interagency FAS Program, curriculum document, "Making the Right Choices," Buschau (Executive Director, FAFAM); "Talk to the the Family Association offers the "Care for the published by the Frontier School Division. In addi- Doc" with Dr. Sally Longstaff (Clinic for Alcohol and Caregiver" project—a closed support group for par- tion, the committee has been involved in the devel- Drug Exposed Children); "Adolescence or FAS" ents of children who have been prenatally exposed opment of a diagnostic protocol in collaboration with with Susan Opie (Interagency FAS Program); "Ahh, to alcohol. Norway House Hospital and the Northern Medical How Come You Don't Listen? Managing Behaviours" Unit. At the time of the award presentation, the pro- with Lisa Hurl and Karen Johnston (FAS Outreach The parent support group meets weekly to celebrate tocol had resulted in the diagnosis of 27 children. Team); "IEPs and Team Meetings - Where do Par- accomplishments and discuss issues of concern. Top- ents Fit?" with Deb Thordarson (FAFAM); and "What ics for discussion are decided in collaboration with In addition to the awards, the Manitoba Addictions is the Behaviour Commu- group participants. Awareness Week (MAAW) committee is involved in nicating" with Anita several other activities to raise awareness. Posaluko and Dan Fetal Alcohol Family Association The group meets Neault. of Manitoba Wednesday evenings "Manitoba really from 5:30 to 7:30 p.m. at is a leader in this Community workshops Annual General Meeting the Family Community area, undertaking & presentations May 21, 2003 Centre (100-475 Sargent the awards pro- Ave). For more informa- gram, funding Over the past fall, the tion this or on any FAFAM community initia- Call the Family Association at tives and develop- Family Association deliv- (204) 786-1847 for details. programs, contact Leilani ered numerous work- Buschau at 786-1847. ing and distribut- ing MAAW Re- source Kits each year," notes committee member Sheila Duprey and Metis Community Development FAS Tool AFM librarian. The kit, available in English and French, goes out to This past year, Family Resource Centre coming out and asking others for resources," ex- all schools in the province as well as various commu- partnered with the Manitoba Metis Federation plains Terralyn McKee, Executive Director of The nity groups, such as Girl Guides, 4H, church groups, (MMF) to prepare and deliver a community de- Pas Family Resource Centre. and selected work places. This year, around 2,000 kits velopment tool to representatives from the 23 were produced, 1800 in English and 250 in French. Metis communities in the NOR-MAN region. The training tool is currently under revision with a consultant, Caroline Chartrand, who has done "They were gone in a flash," says Duprey. "We ended Funded through the Health Canada Rural and extensive work with Manitoba Metis organizations. up having the RCMP photocopy another 90 English Remote Innovations Fund, the project involved a kits and there are only about 10 left of the French "train-the-trainer" approach. Each community was The goal, says McKee, is to produce a tool that can version." invited to send two representatives to a three-day be used in other communities and provinces to training workshop. address FAS in a respectful and empowering man- Included in the resource kit distributed annually is ner. The final version should be available by Sep- a Fast Facts sheet on FAS plus learning activities for Representatives took away a presentation package tember, 2003. students appropriate for kindergarten through that could be shown in their community using secondary school. either overhead slides or a Powerpoint version. Another avenue to support community develop- ment and FAS awareness activities is the submis- The MAAW resource kit is updated each year with Also included in the package were two types of sion of an electronic version of the tool to a Health new statistics, topics and activities being added. The the "Baby Think It Over" dolls, one of which is an Canada web site. 2003/04 kit will be ready for distribution at the begin- FAS model, that they can use in their community, ning of September, 2003. Manitoba Addictions Aware- public health and school presentations. "The idea is that people could either download it ness Week runs this year from November 16-22. for free from the web site or they could purchase a "In this way we are leaving the expertise and train- hard copy for which they would pay the produc- To add your organization's name to the mailing list for the ing in the community so they don't have to keep tion cost," explains McKee. resource kit or for more information, contact Sheila Duprey at 944-6367.

4 STOP FAS Program FAS: The Birth Mother's Experience Caldwell to Chair Canada Northwest Evaluation Highlights (In her masters' thesis, Jessica Neville looked The fourth theme explored the toll at FAS from the birth mother's experience. taken on their emotional and physical FASD Partnership The STOP FAS Program is a para- She summarizes her study and results below.) well-being. All had accessed mental professional mentorship model of health support during their lives, pre- Manitoba's Minister of Family Serv- enhanced case management. The Research data was collected through dominantly to combat depression. Two ices and Housing, Drew Caldwell, mission of the program is to work two primary sources: interviews and revealed they, like their children, were is the 2002-03 chair of the Canada with high-risk mothers who use al- field notes. Given the blame and living with the effect of their mothers’ Northwest FASD Partnership, for- cohol and drugs heavily and who stigma often associated with being a alcohol use during pregnancy. One merly known as the Prairie North- are currently pregnant or have just birth mother, several women were re- had herself been diagnosed with FAE ern Pacific FAS Partnership. had a child, to avoid the birth of luctant to participate. Further, given and another was awaiting a diagnosis. other children affected by alcohol that many lived in situations that were The partnership is an ongoing col- and drug use. often chaotic, they were not always easy Discovery and reclamation also laboration of the four western prov- to locate, even once they had agreed emerged as an important theme. Sev- inces and three territories de- Each participant is assigned a men- to participate. eral spoke of the self-loathing that ac- signed to maximize the use of ex- tor who works intensively on a one- companied the way they had lived, and isting expertise and resources in to-one basis with her and her fam- Fortunately, with the assistance of the the impact their lifestyles had on their the development of joint strategies ily for up to three years. Interagency FAS Program in Winnipeg, children. They spoke extensively of and initiatives to address Fetal Al- and the FAS/E Support Network of BC, two how they came to make incredible cohol Spectrum Disorder (FASD). The typical client is approximately women from Winnipeg and six from changes in their lives, discovering not The Ministers' Committee is sup- 26 years old, has had four children, British Columbia ultimately agreed to only who they were as women, but re- ported by a multi-disciplinary steer- has lost three children to the child participate. They ranged in age from claiming their strength and dignity. ing committee of officials. welfare system, has not planned 22 to 45 years. The Ministers agreed to change the her pregnancies, has completed a Significance of the Study partnership's name to reference Grade 8 education, is in an abusive Interviews were the main method of Canada as the country of origin of relationship, began drinking early collecting data. The objective in meet- This study is significant for several rea- the partnership. They also agreed in youth, uses other substances in ing and working with the women was sons. First, it gives a voice to the to use the more current, accurate addition to alcohol, was raised in a to generate information of benefit to women, who in their self-described and inclusive term of FASD in all family with addiction issues, moves each participant, and to the commu- experience, have been without it. partnership business. frequently or is homeless, and has nity at large. They had felt silenced by the guilt and shame associated with being both al- a history of trouble with the law. Another significant change Minis- cohol dependent and birth mothers Main themes of findings ters agreed to was altering the fre- of children affected by alcohol. Many After completing three years in the quency of partnership conferences of the women also believed that they STOP FAS program: Several main themes emerged and symposia from annual to bi-an- were not represented in either the lit- through the interviews. The first, bro- nual events, with the partnership- u 84% of the clients are no longer erature or the media in portrayals of ken trust, describes experiences of sponsored conference occurring in at risk of having a child with FAS; birth mothers of children with FAS or abandonment and disappointment the years opposite to British Colum- they have stopped using alco- FAE. For many of them, participating during the participants’ lives. Partici- bia's bi-annual FAS conference. The hol or drugs, or are using birth in this study was their first experience pants spoke of abuse as children, of Ministers also approved expanding control speaking “publicly” about their often-painful relationships with par- the focus of symposia to target a ents, and of patterns of difficulty sub- experiences. u 65% have completed an addic- range of professional designations tions treatment program sequently experienced in relation- with an interest in education and Second, it provides a frame of refer- ships with men. professional development opportu- 49% have stopped using alco- ence for those who are currently work- u nities around FAS. Previously, the hol; of those more than half have ing, and those planning on working, Each participant described having symposia have been directed prima- abstained for 6 months or more with mothers and children who have been repeatedly failed by the system, rily at physicians and allied health a failure that had continued into the been identified as high-risk. Partici- 49% use birth control professionals. u lives of their children. The women pants were able to identify what serv- u 28% have completed an educa- explored their own difficult ices and interventions would have Other partnership-sponsored events tional/training program experiences with various systems as made a difference for them and their include: the FASD Symposium children. They further described the children. This study may assist in iden- Inuuqatigiianiq (Community Kin- 63% of children are living with u obstacles they had encountered while tifying which services and approaches ship), March 21-24, 2003, in Iqaluit, their own families trying to obtain a diagnosis for their are effective and which are not. Nunavut; the Medical Education Sym- u 100% of the target children are children and the ensuing struggle that posium, September 27-29, 2003, in fully immunized followed diagnosis, stemming largely Finally, FAS and FAE are issues attract- Burns Lake, B.C.; and the next major from the lack of supports available for ing increased attention by research- FASD conference, Our Communities their children. ers, the media and policy makers alike. ...Our Strength, November 19-21, As previously mentioned, the litera- 2003, in Winnipeg. Experiences with alcohol, the third ture that speaks to the experiences of Healthy Child Manitoba theme, involved participants’ relation- birth mothers is limited, particularly Ministers also agreed to explore ships with alcohol and drugs, about that from a qualitative perspective. sponsoring FASD activities and ini- Helps to Fund CAP which they spoke emotionally. Most This study adds to the growing body of tiatives beyond conferences and literature that seeks to provide greater symposia, which could potentially The Healthy Child Committee of had had early experiences with alco- depth to what is presently known about include such initiatives as a national Cabinet approved $7,500 in hol and in many cases, immediate ad- diction. They described their histo- birth mothers of children with FAS and forum, the publication of a docu- funding to help support the ries with treatment and what had FAE, offering insight into the life ex- ment, or a project selected through a continued activities of the worked for them in creating lives with- periences of these women. (Contact Request for Proposals. Coalition on Alcohol and out alcohol. Jessica Neville at [email protected]) Pregnancy (CAP) in 2003.

As noted by Minister Tim Sale, Chair of Healthy Child: "We know Bonnie Buxton and husband Brian Tying the FAS Knot "The circle symbolizes the womb, a ba- that addressing Fetal Alcohol Philcox of FASWorld are founding co- by's head, the human brain, the earth. Syndrome cannot come from ordinators of International FAS Day And we, a planet-size network of peo- government action alone; it along with Teresa Kellerman in ple who care about people living with requires a collaborative effort Tucson, Arizona. FAS, are the knot that will make them between government and its whole. If women did not drink in preg- community partners. I would like One of the symbols created by Buxton nancy, FAS would be eliminated. Our to take this opportunity to and Philcox to mark International FAS long-range goal is to rename this small commend CAP for providing a Day (September 9) is the "FAS Knot." piece of cord 'The FAS Not!' " forum for this partnership and In their words, this piece of knitted cord was designed in memory of Abel playing an integral role in Step-by-step photos showing how to Dorris, 1968-1991, whose brief and make the FAS Knot can be found at: supporting those whose lives are poignant life resulted in the affected by a fetal alcohol syndrome www.fasworld.com/symbol.ihtml groundbreaking 1989 book about FAS, disorder (FASD)." "The Broken Cord," written by his fa- To contact Brian Philcox at FASWorld, ther, Michael Dorris, 1945-1997. call (416) 264-8000.

5 Study Looks at Supports for Rural & Reserve Families FAS in Adult Offender Drawing from her work with West Region Child and emotional relationship had a harder time maintain- Family Services, Kathy Jones recently defended her ing a family." Populations PhD thesis, which looked at the kind of supports individuals from rural and reserve families need to Jones found that the families did not mind the The following is excerpted from a paper titled "The support their children affected by FAS. child's difficulty with emotional reciprocity, but the Challenge of FAS in Adult Offender Populations" co- child had a much harder time at school, with friends authored by Fred Boland (Addictions Research Cen- "As a child welfare agency we know that 70% of chil- or in a recreational setting. tre, Correctional Service of Canada), Dr. Ab Chudley dren with FAS are in care and that children with FAS (University of Manitoba), and Brian Grant (Addic- are the most transient," says Jones. "And we know "I would argue that not being able to join in an emo- tions Research Centre, Correctional Services of Canada), that children in long-term foster home placements tional way with people is the damage of FAS, not a which appeared in the September 2002 issue of Forum are healthier, emotionally and physically. So I was bonding issue," she notes, who adds that as some- on Corrections Research (Vol. 14, No. 3). looking at what we at the agency can do to ensure one who has worked in this area for a long time, she children stay there." had always assumed that it was about bonding when Offenders suffering from Fetal Alcohol Syn- a child could not show emotional reciprocity. Now drome (FAS) and its related disorders present For example, the Streissguth study on secondary she believes that is a physical disability. a significant challenge within correctional set- disabilities concluded that children who stay in the tings. The behavioural and learning character- same home for 72% of their life are healthier. Jones hopes that research will be done to look at this istics associated with these disorders make it subset of children to determine whether it is about difficult for affected individuals to function ef- "The Manitoba FAS study showed that 20% of chil- bonding or another facet of FAS. fectively in the aggressive and often uncertain dren with FAS had more than 5 foster home place- environment of a prison. The presence of af- ments in their childhood. The question was what Based on the results of her study, West Region CFS fected individuals creates issues for institutional did child welfare need to put into the mix to make will work to look more carefully at children who have staff, program deliverers, parole boards, and these foster homes more issues with emotional those involved in community supervision. How stable and more long- reciprocity to determine we address these issues is dependent on the term." whether they have number of affected individuals within the cor- In child welfare, we need to look really carefully enough services in place. rectional system. Unfortunately, to date, no study Jones interviewed eight at the model of support for children with FAS has been undertaken to estimate the inci- families representing 22 because they are at the highest risk in the system "Instead of saying we're dence/prevalence of affected individuals children from rural and for multiple placements and at highest risk going to help teach this within the offender population. reserve areas in West Re- for never returning to their families. child how to feel emo- gion. She found that the tions, we might have to Collecting incidence/prevalence data is not a issues were not around realize that certain chil- simple task. No screening instrument with known supporting the family dren can't," says Jones, reliability and validity is currently available. but around creating what Jones calls a circle or noting that the real need is to develop a network of network of support for each child. support for every child and particularly for the chil- Since one of the key principles of good correc- dren who have problems with emotional reciprocity. tional planning and intervention is the assess- "I found that foster families were very able to sup- ment of offender criminogenic needs and risk port their children as long as they were the princi- "In child welfare, we need to look really carefully at levels, it is important to identify this sub-popu- pal means of support. It was community demands the model of support for children with FAS because lation so their needs can be addressed. that were crumbling the families. The moment the they are at the highest risk in the system for multi- children went to school or to recreational activities ple placements and at highest risk for never return- Diagnosing FAS/FAE: The challenge where there were no supports, things started to fall ing to their families." with adults apart." Jones also believes that we need to think carefully There are many difficulties diagnosing adults. Jones found families were able to make astounding about where child welfare fits into the FAS field. Official records from pregnancy, early child- accommodations for their children and were good hood and school are often unavailable, and older case managers of the children in the home. The "Child welfare has not been active at the table. We records may not be complete. Memory related problems for the family arose with outside systems have all the children but we've never talked about a to prenatal alcohol use may be inaccurate and that had problems with the children. different way of dealing with children with FAS. self and collateral information may be limited There needs to be a focus on how child welfare needs or unavailable. Facial structures change with age In her research, Jones also looked at resiliency of to work differently." and the characteristic features may be lost. Most research on developing diagnostic criteria have the children in the study, specifically what was go- The role of foster fathers ing on with children that was making their outcome been based on children and there are few more successful. Jones was intrigued to see the amount of work being experts available who are experienced in adult done by foster fathers. She found their role was quite diagnosis. She found that children who were able to show emo- different and yet there is very little research in this tion were actually healthier as teenagers. Those who area. As such, she plans to look next at the role of seemed to be the most unhealthy in their teenage foster fathering. FASD: a definition years were described as children who could not make Fetal Alcohol Syndrome (FAS) and related emotional connections. "The foster fathers really were the parent who sup- disorders, such as Fetal Alcohol Effects (FAE), ported the mother and child," she says. "They did a are conditions now commonly referred to by "This was very interesting because as a system we ton of work maintaining the mother and child con- the non-diagnostic umbrella term Fetal tend to lump all children with FAS into the same nection and giving emotional and physical respite Alcohol Spectrum Disorders (FASD), where pot, thinking that all children with FAS need cer- to mom. We don't often see foster fathers as an im- prenatal exposure to alcohol is an important tain things. What this might suggest is that a par- portant component of the support program so I'm factor in problems an individual exhibits ticular subset of children with FAS are at a higher particularly interested in looking more carefully at throughout development. risk. The subset of children who have difficulty with where fathers fit into the picture.

Theoretically, one way to identify offenders with FASD is to do a full diagnostic assessment on all incoming offenders. However, this would be pro- Trying Differently hibitively expensive and neither the expert per- sonnel nor financial resources could possibly be found. The alternative is to develop a reliable and A Guide for Daily Living and Working with FAS valid screening tool that would identify the much and Other Brain Differences e 2nd Edition smaller subgroup at "high risk" for FASD who could then be sent for a diagnostic assessment. Produced by Fetal Alcohol Syndrome Society Yukon, 2002 Edited by Debbie Trudeau The authors have initiated a research project to develop a potential screening instrument that To contact FASSY: could be used with adult offenders. It is antici- Box 31396, Whitehorse, Yukon Y1A 6K8 pated that final planning for the project will be Phone: (867) 393-4948 / Fax: (867) 393-4950 completed in the fall of 2002 with data collec- Email: [email protected] tion to commence as soon as possible.

6 Sleep Disorders Winnipeg CFS: Working with Families who Misuse Study Results Alcohol and Other Drugs in Child Welfare

Anecdotes from parents and other Winnipeg Child and Family Services The training content was based on the Representatives from the major addic- caregivers of children affected by FAS (WCFS) recently offered training to harm reduction model, stages of tions programs in Winnipeg partici- describing a variety of sleep problems its 500 social workers around working change model, and the use of motiva- pated in a panel session, including has been confirmed and quantified in with families who are experiencing tional interviewing techniques. Moti- Tamarack Rehabilitation, Native Ad- a study by Dr. Ana Hanlon-Dearman at problems with substance abuse. vational interviewing uses a set of tech- dictions Council, Behavioural Health Children's Hospital. niques and tools that a worker can ap- Foundation, Main Street Project, Ad- The training evolved from two factors: ply depending on what stage of dictions Foundation of Manitoba, Lau- "Parents frequently tell us their child agreement by frontline staff that sub- change the family is at. rel Centre, Salvation Army, and sleeps terribly, that they may chew on stance abuse training geared specifi- Nor'west Co-op Mentor Program. their bed clothes or bang their heads," cally toward child welfare/protection "Many clients are not at a stage where says Dr. Hanlon-Dearman. "We have was needed and secondly, the results they're ready to address the substance These and other agencies were invited heard that these kids are wakeful, that of a study completed by Valerie Bimm abuse issues. The training offers tech- to put up display booths. Examples of they're up often, restless, moving." and Kim Thomas, project coordinators niques that can be used in discussion other agencies included Alcoholics with Quality Assurance and Research with clients that can potentially moti- Anonymous, Narcotics Anonymous, The parents would ask her if the sleep and Planning at WCFS. vate them toward taking action to Health Sciences Centre detox pro- problems were connected with FAS or address their substance misuse," gram, and Union Gospel Mission. if it was something else. This became "The study looked at families who re- explains Bimm. the focus of the research. turn to the agency for service to gain a Additional individuals from five key better understanding of the factors A two-day training session focussing outside addictions agencies also at- that contribute to this phenomenon," specifically on substance using moth- tended the training, allowing the ad- explains Bimm. ers and their families was offered to dictions workers and social workers to all WCFS social workers. Two separate intermingle and share ideas. In the study they discovered that sub- sessions were held, one in January and stance abuse was one of the most sig- the other in February, with approxi- In addition to this training, WCFS is nificant drivers for families who re- mately 140 workers attending each. developing an initiative to provide en- turned to the agency in a relatively hanced service to families who present short time. Since this is not unique to The training built on the existing substance abuse issues at intake. The Winnipeg, they started to explore what counselling and support skills of Addictions Foundation of Manitoba is other agencies are doing across North WCFS workers, and promoted discus- helping intake workers with more in- America. sion and action on policies and prac- tense, specialized training to provide tices that support workers can use in this service. "We learned that agencies are collabo- responding to the needs of mothers rating with addictions treatment pro- with substance use problems. "This continues our collaborative ap- grams in a more integrated way than proach with outside addictions agen- in the past." The keynote speaker was Nancy Poole, cies," notes Bimm. "We are all trying to a provincial research consultant on help the same families so it makes sense While it is standard practice to refer women and substance use issues with that we work together in our efforts to The objective of the study was to quan- individuals to an outside source for the Aurora Centre, a provincial wom- do so." titatively describe the sleep character- addictions treatment, they realized en's alcohol and drug treatment pro- istics of children with FASD and quali- there were additional ways in which gram based at B.C. Women's Hospital For more information, contact Valerie Bimm tatively describe the effects of sleep they could collaborate. in Vancouver. at 944-2041 or [email protected]. disruption on the affected child and family. The results could then be used to develop appropriate sleep manage- COALITION ON ment strategies for these children. FASD - Law Enforcement Training Spreads ALCOHOL AND Families were recruited to the study PREGNANCY (CAP) through the Clinic for Drug and Alco- The FASD training program developed for police officers by Constable Annette Laporte of "D" Division, RCMP, and Terralyn McKee, Executive Director of The hol Affected Children. Dr. Hanlon- CAP represents over 160 organi- Dearman looked for families who had Pas Family Resource Centre, is spreading across the country and across borders. zations interested in FAS/FAE is- a child affected by prenatal exposure sues in Manitoba. Six focus areas to alcohol and a second child around Over 80 Western Canada court workers were presented with an overview of the the same age who was not affected. The program last March, organized by Sandra Delaronde with the Department of include: Family Support, Educa- non-affected child acted as the con- Justice. This led to a two-day workshop being presented to more than 50 partici- tion (including early years), Serv- trol in the study. pants of the Aboriginal Federation of Court Workers in Ontario in June, 2002. ice Co-ordination/Development, Justice, Research, Communication "By including the second, non-af- In September, 2002, Laporte and McKee presented at the World Forum on and Information Dissemination. Drugs held in Montreal and co-hosted by the Canadian Centre on Substance fected child of roughly the same age Special task forces are formed Abuse. The purpose of the Forum was to engage addictions professionals and in the same household, we could say around specific issues. CAP's those affected by drug use. Participants represented a wide range of interests, these parents are doing the same thing members represent a diverse cross- for both kids so it's not about the including public policy, social services, academia, the justice system, law en- forcement, community services, education, and health. section of individuals, groups and parenting, it's intrinsic to the child." communities throughout Mani- toba. We bring together the needs In the quantitative part of the study, "There was a mix of people from around the world in our session. A doctor from of parents (including birth, adop- both children wore a watch-like mo- a large research hospital in Toronto really applauded the fact there was finally tion detector called an Actigraph that something in place where there had been a gaping hole," says McKee. tive and foster) and professionals. could be worn on the wrist or ankle. It picked up restlessness and movement Laporte and McKee followed up in October with another presentation at an Manitoba F.A.S. News in sleep, and identified how long it FAS conference held in Hamilton, Ontario. is published by the Coalition on takes the child to fall asleep, what time Alcohol and Pregnancy (CAP). they get up in the morning and how Most recently, in January, 2003, they presented to the Winnipeg City Police Newsletter Editor: many times they get up in the night. Department along with invited Manitoba judges. Beth McKechnie: (204) 339-0247 "They were an exceptionally receptive crowd. My understanding is that two of This information was correlated with CAP Correspondence & Mailing List: a sleep log kept by the parents, who the officers will be working internally to implement a program around FAS." Dale Kendel, c/o Association for would record when they believed the Community Living – Manitoba child fell asleep and woke up. The Judge Giesbrecht was one of the judges who attended the training session. He 210-500 Portage Ave, Winnipeg, parents also filled out a questionnaire sits on a national committee for the Judges' Association of Canada, which looks Manitoba R3C 3X1 describing the child's sleep habits. at professional development for judges. McKee is excited that the committee is considering adopting the Manitoba-initiated training program with a few addi- (204) 786-1607 (Fax) 789-9850 tions around alternate sentencing options and more case law. McKee and Laporte The qualitative segment of the study CAP receives funding support from followed in which most of the parents have submitted a proposal to present nationally to judges in September, 2003. Healthy Child Manitoba. (continued on page 8) For more information, call Terralyn McKee at (204) 623-4841.

7 T R A I N I N G F A S / F A E R E S O U R C E S C O N F E R E N C E S

National training for commu- Addictions Foundation of Manitoba Library Manitoba Foster Family nity-based practitioners work- Network Conference ing in prenatal and early child- The William Potoroka Memorial Recent additions to the library hood settings Library at AFM (1031 Portage Ave, Tel: include: This gathering is a time for foster par- 944-6233) contains a large collection ents from across Manitoba to get to- Taking advantage of knowledge of FAS/FAE materials. Library FETAL ALCOHOL SPECTRUM gether and learn from guest speakers and each other. The keynote speaker gained through several years of work membership is free and resources can Letters to our children, letters from our will be Karen Emilson, author of Where with CAPC/CPNP agencies on this be shipped anywhere in the province. children: living with Fetal Alcohol Children Run and When Memories Remain. topic, the Canadian Centre on Sub- Syndrome and alcohol related effects. stance Abuse (CCSA) and Breaking To receive a bibliography listing the Joining Karen will be the subjects of the Cycle have partnered and assem- wide range of print and video titles Corp. Author: Alberta Association for her books – David and Dennis bled a team to develop and present a available through AFM Library on: Community Living Pischke. Recording artist "Shingoose" two-day workshop. Day 1 will focus on t Fetal Alcohol Spectrum Disorder - (Curtis Johnnie) is the closing speaker working effectively with women who Parenting, Caregiving and FETAL ALCOHOL SPECTRUM and will perform his address. have substance use issues to prevent Educational Strategies DISORDER–DIRECTORIES FAS, and Day 2 will address ways to ef- t Prevention of Substance Abuse Directory of FAS/FAE information and April 25-26, 2003 fectively support a child affected by During Pregnancy support services in Canada (2002) prenatal alcohol exposure. Friday, April 25: 9 a.m.-4 p.m. Please contact the Library at 944-6279 Corp. Author: Canadian Centre on plus wine & cheese from 4-6 p.m. Intended participants: CAPC/CPNP/ or [email protected]. Substance Abuse Saturday, April 26: 9 a.m.-3 p.m. AHS workers and others who work with pregnant women, mothers and young Canad Inn, Fort Garry children in a community agency set- (1824 Pembina Hwy) ting who've received previous aware- Winnipeg, Manitoba ness and education on this issue. Come, Walk with Me A Christian response to fetal alcohol-related disabilities For more information on conference When: The team is available to con- sessions and registration, contact: duct 8 sessions during the months of The Mennonite Central Committee (MCC) has produced an informational Manitoba Foster Family Network June and September through Decem- brochure that briefly explains fetal alcohol-related disabilities, describes symp- Tel: (204) 940-1280 ber of 2003. toms and secondary disabilities, and provides ideas on how a church commu- Toll-free: 1-866-458-5650 nity can respond and support the family. Subject to interest and scheduling, the team aims to conduct at least one work- Suggestions for how a church community can FASWorld is an international alliance shop in each Health Canada region. respond include: of parents and professionals who do They will set up and work at a venue Be a loving, caring and appreciate commu- not want to see any more children, arranged by a host team. The host team l nity for all people and their abilities and teenagers and will secure a minimum of 20 partici- contributions. adults struggle pants and receive registration fees, Work at prevention. with birth de- arrange for an appropriate venue, and l Respond to individuals who live with the fects caused breaks and lunch. l disability. when their mothers drank Registration fee: for the two-day work- Copies of the brochure are available from: alcohol in preg- shop is $100, payable to CCSA, 75 nancy. For more Albert St., Ottawa, ON, K1P 5E7. Mennonite Central Committee information, visit www.fasworld.com. 134 Plaza Drive, Winnipeg, MB, R3T 5K9 To join the FASDay list, subscribe to Contact: Gary Roberts at the Canadian Tel: (204) 261-6387 Toll-free 1-888-6337 [email protected]. Centre on Substance Abuse at (613) Online at: www.mcc.org/canada/health/ 235-4048 or [email protected]. Brochure cover photo by Bruce Ritchie resources.html

Sleep study results cont'd... Notably, both children were able to recruiting as many study participants wear the sleep watch for basically the as desired. participated in an in-depth interview same amount of time and in total, the discussing sleep habits, how they amount of time that the children Perhaps not surprisingly, parents who coped with the sleep patterns, and spent in bed was comparable. were very scheduled and routine ori- their recommendations to others. ented were found to be dealing with "This is of interest to parents because the sleep problems the best. When the data was compared, Dr. they may have the sense that the Hanlon-Dearman found the differ- amount of sleep that a child affected They prepared for sleep and set firm ences that were significant were the by alcohol needs is less, but the study limits, such as putting a child to bed amount of wake episodes as well as the didn't show that," says Dr. Hanlon- with the expectation they would sleep number of sleep episodes, reflecting Dearman. "This tells us that these kids until morning. Although these chil- wakefulness or restlessness in their need their sleep but they're not able dren would wake during the night, they The Canadian Health Network is sleep. to get it, which is why they're tired weren't disruptive. a national, bilingual, Internet- during the day. They show being tired based health information service. FAS/FAE information can be "This tells us that these children are by being hyperactive." "Parenting and environment have an found under the topic area of up and down a lot. The number of impact on a child but I think there are Results from the sleep questionnaire some inherent differences related to Substance Use/Addictions. these episodes increased in children confirmed significantly more sleep being alcohol-affected. I hope that this who are alcohol-affected, which means concerns in the children affected by has been confirmed and that this will they are constantly awake and asleep alcohol—they were significantly more be helpful to parents who intuitively through the night. This was the strong- tired and more hyperactive during the recognize this. This study will be used est trend in the data." day. Dr. Hanlon-Dearman thinks these to do more research in this area." two are interrelated. They also saw trends indicating that Next steps for Dr. Hanlon-Dearman the sleep episodes of the children "The one thing that surprised us was will be to study more families, and to who are alcohol affected were some- not seeing a difference in the amount collaborate with colleagues to look at what shorter and the wake episodes of sleep in total. We may need larger medical treatment. were somewhat longer, but not quite numbers to show that." enough to reach significance. "Parents need to understand that the The challenge of including a non-af- kids are more wakeful and focus on "We were just coming close to it and it fected control child of roughly the setting routines and firm limit-setting. likely would have with more partici- same age in the same household But I also think we need to look at pants in the study," she notes. turned out to be a limiting factor in medical treatment," she notes.

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