Fetal alcohol syndrome related knowledge assessment and comparison in New Jersey health professional groups.

BACKGROUND There is a need to educate health professionals in regard to Fetal Alcohol Syndrome and Fetal Alcohol Spectrum Disorders across many health and allied health fields. OBJECTIVE Conduct evaluations of educational programs designed to assess knowledge, attitudes and beliefs in relation to Fetal Alcohol Spectrum Disorders (FASD) among health and allied health professionals in the northeastern United States. METHODS FASD related educational efforts were carried out and evaluated in New Jersey for various health-related professional groups over a four-month period using a common set of materials. Pre and post-test evaluation comprised 20 questions on FASD recognition, diagnosis, treatment, and prevention. Groups surveyed included nurses, social workers, counselors, therapists, clinicians and allied health professionals comprising physician assistants, dieticians, physical therapists, occupational therapists. RESULTS Results showed that a majority of health care professionals in New Jersey possess basic knowledge related to FASD and the effects of alcohol on a child in utero. They also had significant awareness of the importance of early diagnosis and the importance of reducing secondary disabilities. The study did however reveal areas for improvement in some professional groups. CONCLUSIONS FASD is the most important preventable cause of mental retardation. Health professionals attending workshops typically had a good basic understanding of FASD, though with some weaknesses specific to their discipline. Educational efforts in regard to FASD should be sensitive to the various health professionals engaged in preventing, diagnosing and treating FASD.

Infant behavior and development in relation to fetal movement and habituation.

Fetal movement and habituation were examined in relation to behavior and development in early infancy. 39 fetuses were evaluated between 28 and 37 weeks gestation. A vibrating stimulus was repeatedly applied to the maternal abdomen until the fetus habituated (i.e., ceased moving in response). Fetal movements were observed on an ultrasound monitor by 2 observers who recorded their observations onto a strip chart. Using a median split, fetuses were placed into high- or low-movement groups and fast- or slow-habituating groups. The groups were compared after birth on the Brazelton Neonatal Behavior Assessment Scale and the Bayley Scales of Infant Development. Preliminary evidence is presented that fetal rate of habituation predicts some aspects of infant behavior and development.

Fetal response decrement: true habituation?

Preliminary evidence suggests that fetal movement in response to vibrotactile stimulation "habituates" with repeated exposure. If demonstrated in fetuses, the habituation paradigm may be useful as a measure of fetal well-being or as a predictor of neonatal outcome. However, the ability of the fetal response decrement phenomenon to meet criteria for habituation which would distinguish it from simple receptor fatigue has not been evaluated. In this study, fetuses were exposed to two different frequencies of vibration applied to the maternal abdomen. Fetal movement was observed on an ultrasound monitor. An inverse relationship between the strength of the stimulus and rapidity of the response decrement was not observed. However, return of the response to presentation of a novel stimulus, response decrement to repetition of the second stimulus, and more rapid response decrement upon re-presentation of the original stimulus suggest that the fetal response decrement phenomenon is true habituation.

Teaching a parent to train a spouse in child management techniques.

This study analyzed several aspects of the training of a mother and father in child management techniques for use with their 6-year-old severely developmentally delayed son. The mother received clinic training in procedures for increasing her son's independent dressing skills; subsequently, she was asked to teach the same procedures to her husband with no assistance from the trainer. For both parents, procedures were introduced sequentially across two components of parent behavior in a multiple baseline design. Examinations were made of (a) the effectiveness of initial child management training on the mother's behaviors, (b) her ability to teach the same techniques to her husband independently, (c) the generalization of both parents' skills from the training setting (a dressing task) to two untrained activities (eating and toy use), and (d) the impact of training on the child's behavior. Results showed that the mother learned to implement the trained procedures and successfully communicated them to her husband, as evidenced by substantial positive changes in both parents' behaviors after being introduced to the child management skills. Both parents showed some generalization to the untrained activities, and their written comments following training indicated they understood the procedures. Clear-cut improvements were observed in the child's attending and independent performance of dressing and toy use skills concurrent with parent training. A 2-year follow-up report indicated that both parents retained their knowledge of skills taught, continued to use the procedures, and rated the training as very helpful in teaching the child self-help skills.