[Barksum]

We expected to get a diagnosis of FASD, which is why it was such a facer to get a dx of RAD.

The team that did the evaluation is called ECAT which stands for "Early Childhood Assessment Team" -- I think! LOL Something along those lines, anyway. DS was seen by a developmental pediatrician, speech/lang. specialist, audiologist, occupational therapist, and a psychiatrist. I had requested that he be screened for FASD. When I talked with the psychiatrist she said if it "...makes you feel better, call it fetal alcohol, but the result is the same", that is, brain damage resulting in attachment disorder. To her, whether the brain damage was due to PEA (prenatal ex. to alcohol) or neglect during the first year, what did it matter? She said in her experience foster/adoptive children that she sees fall roughly into two catagories: PTSD and RAD. I asked which was "better"; PTSD or RAD. She threw up her hands and said it didn't matter, they were equally injurious to children, and were serious long-term issues.

I mentioned the hoo-haw in the adoption community over attachment vs. fetal alcohol. She rolled her eyes around and said it was THE SAME THING. Whether biological in nature or environmental, what was the difference in the symptoms and how we treated them? Very little. That kind of threw me. She told me to lay out on paper the FASD symptoms and the RAD symptoms and to see how large the overlap was. Sure, there are some things that are different in application, but I imagine (am I being naive?!) that you could work well with a FASD child by implementing RAD parenting techniques, and that you could work well with a RAD child by implementing FASD parenting techniques. Yes, yes, you NEED to address the core of RAD with intensive and immediate therapy. (We are getting that rolling as I type.) BUT I really think that we will be able to encompass RAD and FASD as we go through treatments and therapies in the coming years.

I asked the psychiatrist if we could work with a fetal alcohol clinic and she said that they would be able to address many of his issues, but to be sure to have his attachment disorder addressed specifically as well. She also said that he had "poor sensory modulation" and "regulatory disorder". Her recommendations were 1) sensory integration therapy, which would address alot of the problematic behaviors, and 2) attachment therapy, which would address the foundational problems of anger and control.

She didn't discuss the learning aspect of things, which I believe the FASD arena will be able to help us with. I imagine (again, am I being naive??) that there will be overlaps in the various therapies and trainings. I'm beginning to think that RAD and FASD are the head and tail of one coin, in a large percentage of the cases. I was SO convinced that DS had/has FASD because he doesn't have the big, glaring issues that come with RAD. I'm still not "convinced" that he doesn't have FASD, but I envision that it will be addressed throughout life for him because I'm becoming so aware of it and reading, researching and aware.

Oh, as to evaluating FAE, the documentation we have it "too sketchy" to give a dx of FAE. I guess we'd need the bio mom to go in with us and say, "I drank 5 oz. of hard liquor every morning before breakfast, and 6 beers each evening for the last trimester" before we'd have adequate documentation, but who knows. DS doesn't have FAS, which we knew, and he does have attachment issues, which we also knew. So, an official dx of RAD is handy because it enables us to go out and get services. In the process of getting services we can gently prompt about FASD and see what we get.