People With Fetal Alcohol Spectrum Disorder Deserve More Access To Massachusetts Health Care Services

The Huffington Post: Wellness

By Nicholas Covino and Kelly Casey July 01, 2016

Fetal exposure to alcohol can lead to prenatal brain damage which can be reflected in a host of significantly impairing emotional, neurological, cognitive, learning and behavioral problems. In this way, people with Fetal Alcohol Spectrum Disorder (FASD) face many of the same challenges as those diagnosed with another brain-based disorder: Autism Spectrum Disorder (ASD). But in Massachusetts, persons with FASD don’t qualify for the same services as persons with ASD.

Children born with developmental disabilities can receive early intervention until age 3, special education in local public schools until they’re 22, and adult services from various state agencies for life, according to the Massachusetts Department of Developmental Services (DDS). To qualify as having such a disability, people must have both an IQ of 70 or below, and display significant impairments in functioning.

In response to the needs of persons with ASD, the legislature recently implemented exceptions to the law which effectively expanded the populations served by DDS to include ASD and some other developmental disabilities. Now, those with ASD and an IQ over 70 may be granted an exception from the IQ cutoff and obtain a wide variety of services from DDS if their symptoms significantly impair their functioning at home and in the community.

But people with FASD don’t qualify for any of the exceptions and so they are on their own.

That means individuals with FASD and an IQ score above 70 are not eligible for services even though they often have the same kinds of challenges as people with ASD, including significant problems with learning, reasoning, memory, impulsivity, social relationships, judgment and emotional regulation. These challenges often lead to academic and social difficulties in school, referrals for mental health services (which are commonly ill-equipped to address this neurologically-based condition), and police contacts. As with ASD, people with FASD have brain-based impairments that can prevent them from “living up” to their IQ and which substantially compromise their daily functioning.

Long story short, a diagnosis of ASD makes one “eligible” for vital services from the state, including those from DDS and the Department of Mental Health (DMH), but a diagnosis of FASD does not. Ironically, DMH takes the position that FASD is a developmental disability rather than a mental health condition and should therefore be the responsibility of DDS, but DDS does not recognize it as a developmental disorder eligible for services. Excluding the FASD population from DDS services makes it one of the more restrictive developmental services agencies in the country. Many individuals with FASD have functional limitations just as impairing as those experienced by people with ASD and some other developmental syndromes.

The failure to provide individuals with FASD with needed services means thousands of children and young adults with FASD in Massachusetts are failing. Youth with ASD need and deserve the supports they receive through DDS but so do those with FASD.

Without intervention and support, individuals with FASD are more likely to be involved with other state agencies later in life, at a substantial cost to the state. Multiple studies have shown that child welfare, juvenile justice facilities, adult prisons/jails and homeless shelters are filled with people with undiagnosed and untreated FASD. People who were prenatally exposed to alcohol through no fault of their own are no less deserving of our compassionate attention and life-saving services than those born with autism.

Yes, early identification and intervention for persons with FASD will save the state money by limiting their involvement with other costly state agencies later in life. But this is about more than fiscal responsibility. This is about the human cost of FASD for those suffering from this disorder, and their families. They deserve better.