School-age children with fetal alcohol spectrum disorders (FASD) have complex clinical profiles and

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School-age children with fetal alcohol spectrum disorders (FASD) have complex clinical profiles and often struggle to socially communicate in effective and successful ways (Coggins, Olswang, Carmichael Olson, & Timler, 2003). It has been estimated that elementary school–age students may spend up to one-quarter to one-half of their school day engaged in paper-and-pencil tasks, which include handwriting (McHale & Cermak, 1992). Difficulties with handwriting can affect many aspects of a child’s participation in class. For example, poor handwriting can increase frustration with and avoidance of classroom tasks, thereby negatively influencing behavior (Kern & Bambara, 2002).
Children with fetal alcohol spectrum disorders (FASD) often exhibit
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Childbearing-aged women in substance abuse treatment have also identified the judgmental attitudes of staff as a primary obstacle in their own prior attempts in seeking help to stop drinking (Schober & Annis, 1996; Texas Office for the Prevention of Developmental Disabilities [TOPDD], 2005). Furthermore, most physicians lack training on alcohol-related problems (Kennedy, 2005); few feel secure in diagnosing alcohol-related problems; significant numbers misdiagnose alcohol problems; and most do not believe that treatment is effective (Kennedy, 2005). In contrast, social workers have been trained to work with clients in an empathetic style and in a recent survey, over 80% reported having received training or education on substance abuse treatment (National Association of Social Workers, Practice Research Network, 2001). This combination of skills makes many social workers uniquely qualified to screen childbearing and pregnant women for current drinking. This is not to suggest that social workers are the only ones qualified to conduct screenings, but certainly viable members of the multidisciplinary team to do so. For those that do undertake such responsibilities, there are several tools that are available to assist in these efforts.
For childbearing-aged women, the CAGE (Ewing, 1984), a four-item measure designed to detect alcoholism in individuals 16 years and older, may be useful. Answering yes to two or more of the following items is considered clinically

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