A typical 18yo with FASD may have:

The expressive language of a 20 year old
The reading ability of a 16 year old
The living skills of an 11 year old
The money and time concept of an 8 year old
The social skills of a 7 year old
The comprehension and emotional maturity of a 6 year old

#FASD #BACCH

Individuals with FASD have strengths

They may be creative and have strong expressive language

This, combined with the usual lack of facial features, can mask true vulnerability

#FASD #BACCH

About 4% of children in the UK may have FASD

That's between 18-35,000 annually

#BACCH #FASD

Alcohol is such a small molecule it can permeate every part of the body, so comorbidities are common

50% of people with FASD have ADHD

41% of women in the UK drink alcohol while pregnant. That is the 4th highest rate in the world.

The reasons are multifactorial

#BACCH #FASD

Foetal Alcohol Spectrum Disorder is a common neurodevelopmental disorder caused by prenatal alcohol exposure (PAE)

It is frequently unrecognised

ADHD diagnosis may be the first starting point

Less than 10% have the classical facial features

#BACCH #FASD

Yesterday's programme in the quote post above.

First talk today: Dr David Junior Gilbert: The Impact of FASD Diagnosis on Justice Pathways

#BACCH

We're BACK for Day 2 of @commchildhealth.bsky.social #BACCH Annual Scientific Meeting in Cardiff/Caerdydd

Bore Dda y'all

End of the day!

Round two tomorrow

#bacch #ARFID @commchildhealth.bsky.social

Q. What is in your ARFID blood panel?
A. It'll be sent round!

Q. Do you have input from paeds gastro
A. No, but I'd like it!

Q. Do you think we're struggling to differentiate between ARFID and paeds feeding disorder
A. Yes!

#bacch #ARFID

Q. At what age can you confidently diagnose ARFID
A. Tricky question. Research evidence varies. Some situations may say 5-6, some 8yrs. 8-18 makes sense for their local service but they do have younger patients.

#BACCH #ARFID @commchildhealth.bsky.social

Overall learning:
It's a LONG TERM condition
Teamwork and collaboration is needed
Expectation setting is a priority from the start

#BACCH #ARFID @commchildhealth.bsky.social

For high risk:

They have an "ARFID panel" blood screen

A food diary is required

MEED guideline observations completed

#BACCH #ARFID @commchildhealth.bsky.social

ARFID now sits in the CYP Eating Disorder service

Physical monitoring now provided by this team

Moving towards a more workshop-based model

Age accepted moving towards 8-18

#BACCH #ARFID @commchildhealth.bsky.social

Parental expectations were really high
Difficulties of discharge monitoring
System was holding them accountable
Difficulties accessing business support
3 medical record IT systems
Estates - no base

RE-DESIGN INCOMING

#BACCH #ARFID

Other teams would refer to the pathway and discharge, so that reduced the ability of the team to make progress with referrals.

The pathway needed review. It closed to new referrals.

#BACCH #ARFID

The team found referrals grew but they could not progress patients through the pathway to discharge. The young people required long term input, so the very small team could not maintain the service

Some children had been experiencing feeding difficulties for many years. 50% were under 8

#bacch

Cornwall set up a new referral system for ARFID

Referral criteria were set high, MDT triage was HARD

Often no prior input from other services

MDT assessment and formulation, then attempted intervention (for 4-6 sessions) then aim for discharge to "other" services

#BACCH #ARFID

Electrolyte issues common

Cardiovascular, puberty and menstruation issues UNCOMMON (compared with other eating disorders)

#BACCH #ARFID

Physical impact:
Low weight common (but not universal)
Nutritional deficiencies common can lead to illness
Low bone mineral density

Most severe micronutrient deficiencies have been found in those of health weight or overweight

#bacch #ARFID

Difficulties:
Heterogenous group leading to lots of treatment approaches
At what age do you diagnose?
When do you start a service

Lots of children have restrictive intake, so if there IS a service it will fill up with non ARFID stuff

#bacch #ARFID