...all the primary adults the home were intoxicated The Division of Youth and Family Services took Eddie into custody and a Ester family was found He was immediately hospitalized because at three weeks, Eddie had not yet opened his eyes. Local doctors and his new Ester parents were concerned that Eddie might be blind

Alaska has one of the highest documented incidences of Fetal Alcohol Syndrome (FAS) in the United States. Over 20,000 Alaskan women of childbearing age have acknowledged that they are heavy drinkers (DHSS, 1997). Incidence rates are reported as 1.4 per 1000 live births, about four times the national average (State of Alaska, 2001, p. 1). Yet what does it mean to Eddie to be one small part of these statistics? Can he receive in his small, remote northern community the diagnosis and services he needs? If so, how does it happen?

In this article we will (1) review the diagnostic descriptions of FAS, (2) outline the needs of a person with FAS across a life span, (3) discuss how these needs are met in rural Alaska in the hope that this experience will benefit other remote communities, and (4) describe what Alaska and other remote communities still need to help people like Eddie.

Defining FAS

Eddie's new family provided foster care to several children who had been prenatally exposed to alcohol-one of them was Christopher. Eddie's foster mother, Marilyn, had learned from "wisdom of practice" with her other children that Eddie would need specialized care and extensive support services to help him grow into a healthy, self-confident individual. As a baby Eddie would lie & his crib with his arms drawn underneath him. He was rigid, highly sensitive to noise and disliked soft touch.

There is no biochemical test to determine if a child has FAS. Eddie displayed many of the characteristics of this disorder at birth and it was known that his mother had consistently abused alcohol during her pregnancy. This can cause problems, because 'Alcohol is a neurobehavioral teratogen, an agent that can cause defects in the structure and function of the developing central nervous system in humans" (Olson, Morse, and Huffine, 1998, p. 262). FAS is characterized by (1) pre- and post-natal growth deficiencies that place a child below the tenth percentile for height or weight or both, (2) a distinct pattern of facial features, and (3) evidence of central nervous system (CNS) damage.

Prenatal alcohol exposure does not always result in a child having FAS. Some children have partial manifestations of the disorder, usually CNS damage. These individuals are described as having Fetal Alcohol Effects (FAE) or an alcohol-related neurodevelopmental disorder (ARND). FAE is not a less severe form of FAS. Quite the contrary, children with FAE often experience worse problems in school and as adults because many people do not perceive them as having brain damage since they lack outward signs of a syndrome (Streissguth, 1997a).

The central nervous system (CNS) dysfunction associated with prenatal alcohol exposure can cause learning deficiencies (i.e., lower IQ scores), auditory, verbal, and spatial memory difficulties, problems in visual-spatial skills, hyperactivity, attention deficit problems, motors delays, problems with organization, and speed of information processing (Olson, Morse & Huffine, 1998; Streissguth, 1997a). While children with FAE often have a variety of these CNS difficulties, their problems are less likely to be recognized, and they tend to receive less help and support.

FAS/FAE is considered an equal opportunity disorder. Wherever women drink heavily, children with FAS are born. The likelihood of a woman who persists in a chronic drinking pattern...

NOTE: All illustrations and photos have been removed from this article.



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