Fetal alcohol syndrome rate in Alaska is declining

$29M GRANT: Stevens earmark for educational program given credit for downward trend.

February 19, 2010 

The state has documented a 32 percent drop in the rate of Alaska children born with fetal alcohol syndrome. A state health official is attributing the decline largely to programs started under a multi-year, $29 million grant former U.S. Sen. Ted Stevens obtained in a 2000 congressional earmark.

The state used the money for both prevention and treatment of fetal alcohol syndrome, which occurs if a mother drinks during pregnancy. The state launched a multi-media campaign to educate people, and set up teams around the state to work with fetal alcohol kids.

"It did turn the corner," Diane Casto, a manager in the state Division of Behavioral Health, said of the Stevens money. "What we know about prevention ... you need to get the message out strongly, consistently, over and over again. It gave a good kick-start."

Fetal alcohol syndrome results in mental retardation, delayed physical growth and distinct facial features such as small eyes. Some children do not develop the full syndrome, but suffer from one or more elements of it, and are said to have fetal alcohol spectrum disorders.

Children are diagnosed by age six. The findings the state published this week cover those born between 1996 and 2002, and diagnosed by 2008. During that time, the rate of FAS births dropped from about 20 per 10,000 births in Alaska to 13.5. The trendline shows a steady decline through the years.

The actual number of children born with fetal alcohol syndrome was 20 in 1996, and 13 in 2002, said Janine Schoellhorn, a state epidemiologist.

Many more children were born from 1996 to 2002 and reported to have the alcohol spectrum disorders -- an average of 180 per year, said Schoellhorn. However, in the most recent year studied, that declined to 130, she said.

Even changing the outcome for one child makes a difference, Casto said. The lifetime care for a person with fetal alcohol syndrome is estimated at $4 million, she said. "If we prevent one birth, we reduce the cost for our service delivery system, for developmental disability care."

The decline in the rate of fetal alcohol births was all due to a reduction in cases among Alaska Natives, Schoellhorn's report says. The rate of non-Native FAS births did not drop.

It's not clear why that's the case, she said.

Casto said she believes Alaska Native health organizations have strongly emphasized screening and intervention for pregnant women and women of child-bearing age.

"They have recognized it as a huge problem. They are making an active and forceful effort to intervene."

When spending the federal money, the state tried to build programs that could be sustained after the grant ended in 2006, Casto said.

In some measure, it achieved that, she said.

One goal was to change attitudes toward drinking during pregnancy by educating women, their friends and family, alcohol servers and medical providers about the threat of FAS. The state produced public service announcements, newspaper, radio and TV ads that some communities are still using, she said.

And attitudes have changed.

"At that time there were a lot of women who really didn't know it was not OK to drink during pregnancy," she said.

There were also some doctors would tell pregnant women it was OK to drink in moderation, she said.

But each person is affected differently by alcohol, and where some fetuses might not be harmed, others could, Casto said. "My belief and the belief of the state of Alaska is, why would you take a chance?"

Another goal with the federal grant was to establish diagnostic teams with members who could do psychology, speech, language and motor skills tests, for example, she said.

Ten such teams still exist around the state, including in Anchorage, Juneau, and the Bethel region, she said. They are supported by new annual state funding of nearly $600,000. There were more teams started under the grant, but the ones that folded never really took hold, Casto said.

The state administration is hoping to get an additional $500,000 for substance abuse treatment for pregnant women in the budget currently under debate in Juneau, Casto said.

Meantime, the state will continue to check the trend for fetal alcohol syndrome rates every year, said Schoellhorn.

Find Rosemary Shinohara online at adn.com/contact/rshinohara or call her at 257-4340.

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