History of my clinical involvement with FASD

1. 1964 - Graduated M.B. Ch.B., Liverpool University, England.
1965 -1971 Surgical Training, - Liverpool England and Edmonton,
Alberta. F.R.C.S. (C )
1971 - 1997 General Surgeon in Private Practice
1998 - 1999 Fellow (Observer privileges) Department of Psychiatry,
London Health Sciences Center, London, Ontario.
1998 - Interpersonal Therapy Training , Clarke Institute, Toronto 1998
- Working with Emotions, Dr. Les Greenberg, The International
Academy of Cognitive Therapy, Toronto
1998 - Cognitive Therapy Training - Toronto.
1999 - Emotional Focused Couples Therapy Training Program - York
University, Toronto.
2002 - February - Workshop - Assessing Psychopathy with the Hare
Psychopathy Checklist - Revised. Dr. Robert Hare, Dr. Adell Forth.
2012 Book - published “The Emotional Origins of Anger”.
FASD
Training in the diagnosis of FASD, 2002 - September - FAS DPN
(Fetal Alcohol Spectrum Diagnostic Prevention Network)
Multidisciplinary Clinical Training, University of Washington, Seattle,
U.S.A.
Member FASWorld, Toronto
Founding Member of, and Medical FASD Consultant to, FASD
Hamilton Support Group- a registered society dedicated to helping
those who have FASD and the families who support them.
[ no longer involved ]
Founding member of the St. Michael’s Hospital FASD Support Group
Consultant to the FASD Diagnostic Clinic, St. Michael’s Hospital,
Toronto.
Founding member of the Hamilton FASD Community Task Force- no
longer involved.
Previously Professional Advisor to FASAWARE UK. a registered
organization, dedicated to the education and increasing awareness of
FASD, in the U.K.
Member of the FASD- Study Group of the Research Society on
Alcoholism [ no longer involved ]
Founding member of the FASD Ontario Stakeholders, now titled
FASD ONE- FASD Ontario Network of Expertise.
[ no longer involved ]

2. I have made presentations on FASD on numerous occasions in
Ontario. Also in B.C., England, Wales and N. Ireland.
Recognized as an expert witness for FASD by the Superior Court of
Justice of Ontario and the Ontario Court of Appeal.
FASD referrals were from social agencies, justice system, diagnostic
clinics, schools, as well as self referrals [ see further note ]
My practice was confined to individuals who have fasd and the
families who support them.
I saw those with FASD and their families at the CAS offices in
Burlington and Barrie, Trellis Mental Health- Guelph and the
Aboriginal Health Centres in Hamilton and Brantford.
[ see further note ]
For diagnosis I obtained a detailed history and made clinical
observations, over five - six sessions.
I examine all documents, especially psychometric assessments. If
there was a confirmed history of prenatal alcohol exposure, with
correct psychometric results and a clinical history in keeping with the
diagnosis then I refered to one of the FASD diagnostic clinics in
Toronto.
In the process of obtaining the history I explained the disabilities of
FASD e.g. concrete thinking and perseveration.
The most significant factor that helps those with fasd is the
understanding of their disabilities by their caregivers. Knowing about
FASD is not the same as understanding it.
When necessary, for example when a history of prenatal exposure
could not be obtained, I wrote a detailed report with opinions and
recommendations.
If the individual with fasd or their families wish I continued to see them
to deal with ongoing issues of education and the law etc.
Note
We have a son diagnoses FASD.
In March, 2011 I reluctantly closed all my offices.
General Practice, Pediatrics and Psychiatry are the medical groups
exposed to FASD. However there is no training and little
understanding of FASD by the medial profession.
Yet it is to those trained in these areas of medicine to whom opinions
are sought about FASD.

3. Although I have had training and significant experience in FASD I am
not a pediatrician or psychiatrist. For this reason I have always
referred the client to one of the major diagnostic clinics in Toronto,
such as St. Michael’s.
The following are a few statistics from the Hamilton and Brantford
clinics that illustrate what I experienced over the years.
The following statistics are from my sessions in Hamilton and
Brantford- Hamilton one day a week September, 2004 to September,
2010. and Brantford- 2009 to September, 2010
All clients were diagnosed FASD or referred for assessment of FASD.
Total number 184 -aboriginal 82 [ 6 on reservation ] = 44.5% of total -
non aboriginal 102
Gender -male 105, female 79
Age - 0 to 14yrs= 93, 15yrs to 18yrs= 29, 19yrs to= 30yrs 38, 31yrs to
50yrs= 24
CAS involvement, in the present or past, 114 = 62% of total -
Adopted -80,Incare -62,Withfamily-84
Comorbid diagnoses from the DSM - 119 = 65%
Origin of referral - Self referral - 53 = 29%, De dwa da dehs nye>s -
33 = 18%, CASs - 36 = 20%, Physicians - 20 = 11%, St. Michael’s
FASD Clinic - 6 = 3.3%, Living Rock - 5, Six Nations - 2, Contact
Hamilton - 2,
The rest were from 19 other agencies and organizations
Observations and Conclusions
The numbers are an underestimate of those effected in society.
It has been a dynamic process. Increasing awareness of FASD and
of my services has resulted in increasing referrals.
Self referral is the greatest, reflecting the lack of response by
professionals etc to the needs of the families and individuals.
The involvement of the CAS is significant and reflects the disruptive
nature of FASD.
The 65% comorbidity is an underestimation, reflecting the difficulty
that those with FASD have in accessing psychiatric treatment, and
the young age of some of the patients. [the accepted comorbidity rate
is 94% ]
The extensive referral base shows how FASD affects all aspects of
society.
Barry Stanley March, 2012.