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FASD Research Review

Screening and Intervention Programs

Arkansas Department of Human Services-Division of Children and Family Services

Intervention Type

FASD Diagnosis and Intervention Subcontractors
(Juvenile Court)

Project Contact Information

Arkansas Department of Human Services-Division of Children and Family Services
Carol Rangel, FASD Project Director
DCFS-Foster Care Unit, P.O. Box 1437, Slot S565
Little Rock, AR 72203
Phone: 501-682-1573
Fax: 501-682-5272
E-mail: Carol.Rangel@arkansas.gov

Project Summary Statement

The Pulaski County Juvenile Court FASD project is a collaborative effort between the Arkansas Department of Human Services, Division of Children and Family Services (DCFS) and the Pulaski County Juvenile Court. The project provides screening and diagnosis for FASD to children in Pulaski County between the ages of 0-7 who are in the states custody. All children between the ages of 2 and 7 are screen for FASD within 60 days of entering into foster care in Pulaski County. If a child screens positive and has a sibling who is between the ages of 0-2 with confirmed alcohol exposure, we will also screen the younger sibling. If children are diagnosed through the project, early intervention services are provided.

The overall goal of the FASD initiative is to improve functioning and outcomes for children ages 0-7 adjudicated dependant, who are diagnosed with an FASD. The Division of Children and Family Services and the Pulaski County Juvenile Court share the common goal of keeping children safe and provide appropriate interventions and services to families.

The key partners involved in the success of the project are the Pulaski County Juvenile Court, the Arkansas Department of Human Services Division of Children and Family Services (DCFS), and the University of Arkansas Medical Sciences (UAMS) The Project for Adolescent and Child Evaluation (PACE) FASD diagnostic team, UAMS Partners for Inclusive Communities, Division of Child Care and Early Childhood Education, Arkansas Early Intervention program (Part C-working with children ages 0-3), State Department of Education Special Education, Arkansas Department of Education (Part B – working with children age 3-5), and the members of the FASD project task force.

In year 1 of the project we were able to integrate the screening and diagnosis process into our existing Pediatric and Adolescent Comprehensive Exam (PACE) which is a collaborative effort between the Division of Children and Family Services (DCFS) and the University of Arkansas for Medical Sciences (UAMS). The goal is to remedy barriers to the provision of health care services for children in foster care, particularly the receipt of multidisciplinary, comprehensive health evaluations. All children entering the foster care system receive a PACE evaluation within 30 to 60 days of entering into foster care.

In year one of the project, our target population were children ages 0-5 adjudicated dependant in Pulaski County. We soon realized that our state has a large number of newborn infants who come into the states custody because of a state law called Garretts’ Law. This law mandates that a report is made to the child abuse hotline if an infant or his/her mother test positive for illegal substances at birth. The DCFS system to respond to children entering foster care is set up to have children assessed for a PACE exam in a timely manner (within 60 days of entering foster care). Because of the high number of children identified by Garrett’s Law and our system, a large number children can be as young as 1 or 2 months at the time of their PACE evaluation.

Diagnosing children with a FASD at this young age proved to be very challenging. In cases where the child is too young to diagnose and FASD cannot be ruled out, the PACE FASD team will typically place the child into the positive monitor category. For children who are placed into a positive monitor category, not only will we monitor them closely, but we will also refer them to our local part C coordinator where they will receive further testing if needed along with their own part C case coordinator. If a child who is placed in positive monitor becomes symptomatic, he or she will be referred for an FASD diagnostic exam. As a result of what we learned in year 1 we decided to modify our target population in year 2 from children ages 0 to 5 in the states custody to children ages 2 to 7 in the states custody; children ages 0-2, with confirmed prenatal alcohol exposure who are siblings of children who are ages 2-7 and are screened positive by the project; and children ages 2-7 who came into custody prior to the start of the FASD initiative and have prenatal alcohol exposure, CNS abnormalities, developmental delays, and growth delays.

Once we implemented our target population changes, we began to see an increase in the number of children diagnosed with an FASD through the project. A key component to the project is the FASD task force. This group serves in an advisory capacity to the project to guide project planning, implementation, sustainability, and expansion of the Pulaski County Arkansas FASD project. The task force members are highly invested in the project and participate in professional development opportunities at least twice a year to expand their knowledge about FASD.

This year the group formed two key sub-committee groups. The first sub-committee is focused on FASD diagnosis issues. The second committee is focused on interventions for children diagnosed with FASD. Members of the FASD task force have taken the initiative to start an FASD family support group that serves families with a child diagnosed with FASD through the project. The support group meets monthly and is open to the foster parents, biological parents, grandparents and adoptive parents and has been very well received by the families.

Early interventions for children diagnosed with an FASD, placement stability in home, school, or child care settings remain the focus of this initiative. When children are diagnosed with an FASD early in life the risk of adverse life events and secondary disabilities can be reduced.