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Fetal Alcohol Syndrome Among Aboriginal People in Canada: Review and Analysis of the Intergenerational Links to Residential Schools

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Fetal Alcohol Syndrome Among Aboriginal People in Canada: Review and Analysis of the Intergenerational Links to Residential Schools Fetal Alcohol Syndrome Among Aboriginal People in Canada: Review and Analysis of the Intergenerational Links to Residential Schools The Aboriginal Healing Foundation Research Series © 2003 Aboriginal Healing Foundation Published by: Aboriginal Healing Foundation 75 Albert Street, Suite 801, Ottawa, Ontario K1P 5E7 Phone: (613) 237-4441 Toll-free: (888) 725-8886 Fax: (613) 237-4442 E-mail: [email protected] Website: www.ahf.ca Design & Production: Aboriginal Healing Foundation Printed by: Anishinabe Printing (Kitigan-Zibi) ISBN 0-9732763-8-X Unauthorized use of the name “Aboriginal Healing Foundation” and of the Foundation’s logo is prohibited. Non-commercial reproduction of this document is, however, encouraged. Ce document est aussi disponible en français. Fetal Alcohol Syndrome Among Aboriginal People in Canada: Review and Analysis of the Intergenerational Links to Residential Schools Prepared for the Aboriginal Healing Foundation By Caroline L. Tait Aboriginal Mental Health Research Team National Network of Aboriginal Mental Health Research Cultural and Mental Health Research Unit Sir Mortimer B. Davis-Jewish General Hospital Montreal, Quebec 2003 This project was funded by the Aboriginal Healing Foundation (AHF) but the views expressed in this report are the personal views of the author(s). Table of Contents 2 Table of Contents Acknowledgements ----------------------------------------------------------------------------------------------- vii Definitions---------------------------------------------------------------------------------------------------------- ix Executive Summary ----------------------------------------------------------------------------------------------- xv 1. Defining the Scope of the Project ----------------------------------------------------------------------1 Introduction ---------------------------------------------------------------------------------------------------- 1 Objectives ------------------------------------------------------------------------------------------------------- 2 Methodology --------------------------------------------------------------------------------------------------- 3 Best Practices’ -------------------------------------------------------------------------------------------------- 3 ‘Best Practices’ and Fetal Alcohol Syndrome --------------------------------------------------------- 4 ‘Best Practices’ and Traditional Knowledge ----------------------------------------------------------- 5 Chapter Descriptions ----------------------------------------------------------------------------------------- 6 2. What is Fetal Alcohol Syndrome? ----------------------------------------------------------------------- 7 Introduction ---------------------------------------------------------------------------------------------------- 7 The Evolution of a Diagnosis -------------------------------------------------------------------------------- 8 Diagnosing Fetal Alcohol Syndrome and Alcohol-Related Birth Effects in Canada -------------- 11 Conclusion --------------------------------------------------------------------------------------------------- 12 3. Alcohol Use Among Aboriginal Peoples in Canada ----------------------------------------------- 13 Introduction -------------------------------------------------------------------------------------------------- 13 Levels and Patterns of Drinking: Alcohol Epidemiology Studies------------------------------------- 15 Aboriginal Women and Alcohol Use----------------------------------------------------------------- 17 Explanations for Contemporary Alcohol Abuse Patterns Among Aboriginal People-------------- 18 Biology -------------------------------------------------------------------------------------------------------- 19 The ‘Drunken Indian’ Stereotype -------------------------------------------------------------------- 23 Alcohol Dependency as ‘Disease’ or ‘Dysfunction’ ----------------------------------------------------- 24 Psychological Distress --------------------------------------------------------------------------------------- 29 Cultural and Historical Explanations of Alcohol Abuse Among Aboriginal Groups -------------- 30 Characteristics of Traditional Indigenous Cultures ------------------------------------------------ 30 Learned Behaviour -------------------------------------------------------------------------------------- 31 Alcohol in Contemporary Aboriginal Communities ---------------------------------------------- 32 Political and Economic Factors ---------------------------------------------------------------------------- 34 Conclusion --------------------------------------------------------------------------------------------------- 37 4. Child Abuse ----------------------------------------------------------------------------------------------- 39 Introduction -------------------------------------------------------------------------------------------------- 39 Child Physical Abuse and Neglect ------------------------------------------------------------------------ 39 Child Sexual Abuse ------------------------------------------------------------------------------------------ 41 Child Sexual Abuse Studies Among Aboriginal Groups ------------------------------------------ 42 Child Sexual Abuse and Alcohol Dependency/Abuse Studies ----------------------------------- 45 Pregnancy, Substance Abuse and Sexual/Physical Abuse------------------------------------------ 50 Institutional Child Abuse ---------------------------------------------------------------------------------- 52 Concluson ---------------------------------------------------------------------------------------------------- 54 i Table of Contents 5. Residential Schools -------------------------------------------------------------------------------------- 57 Introduction -------------------------------------------------------------------------------------------------- 57 Situating Residential Schools in Historical Context---------------------------------------------------- 57 Traditional Indigenous Education -------------------------------------------------------------------- 61 Gender Differences ------------------------------------------------------------------------------------- 61 Reasons for Enrollment -------------------------------------------------------------------------------- 62 Daily Operations and Life at Residential Schools ------------------------------------------------------ 63 Discipline, Control and Punishment ---------------------------------------------------------------- 65 Sexual Abuse and Residential Schooling ------------------------------------------------------------ 67 Resistance and Survival -------------------------------------------------------------------------------- 70 Parents and Communities ----------------------------------------------------------------------------- 71 Assault on Aboriginal Identity and Cultures-------------------------------------------------------- 73 Conclusion --------------------------------------------------------------------------------------------------- 74 6. Contemporary Health and Social Issues Linked to the Residential School System --------- 77 Introduction -------------------------------------------------------------------------------------------------- 77 General Poor Health ---------------------------------------------------------------------------------------- 78 Mental Health Problems------------------------------------------------------------------------------------ 81 Child Welfare, Parenting and Family Dysfunction ----------------------------------------------------- 85 Violence ------------------------------------------------------------------------------------------------------- 88 Crime and Incarceration------------------------------------------------------------------------------------ 89 Education ----------------------------------------------------------------------------------------------------- 90 Conclusion --------------------------------------------------------------------------------------------------- 92 7. Fetal Alcohol Syndrome and Alcohol-Related Birth Effects: Epidemiology Review -------- 93 Introduction -------------------------------------------------------------------------------------------------- 93 Canada -------------------------------------------------------------------------------------------------------- 94 Studies Among American Indians------------------------------------------------------------------------ 109 The United States ------------------------------------------------------------------------------------------ 114 Other Countries -------------------------------------------------------------------------------------------- 115 International Review Articles ----------------------------------------------------------------------------- 118 Conclusion -------------------------------------------------------------------------------------------------- 119 8. Risk and Protective Factors for Women ----------------------------------------------------------- 121 Introduction ------------------------------------------------------------------------------------------------- 121 The Controversy Over Defining ‘Risk’ and ‘Risk Behaviour’---------------------------------------- 122 Assessing Risk ------------------------------------------------------------------------------------------ 123 Threshold Levels ---------------------------------------------------------------------------------- 123 Averaging -------------------------------------------------------------------------------------------
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