Alaska is on the forefront of states trying to create a systematic way of diagnosing and treating FAS, said Diane Casto, program manager for the Alaska Department of Health and Social Services' Office of FAS. The state began its concentrated effort at addressing FAS in 1997.
"We knew we had a huge problem, we knew that anecdotally we had one of the highest rates of FAS in the nation, and we knew that our state was not doing enough to truly address this 100 percent preventable disability," Casto said.
She was appointed by then-commissioner of Health and Social Services Karen Perdue in January 1998 to manage a $300,000 budget for assessing FAS in Alaska.
"I was told to start looking at the issue, find out what needs to be done and make it happen," she said. When she looked at the issue, though, she realized that there was no accurate data for the situation, and no formal diagnostic system to generate that data.
Casto's initial attempts at diagnosing and assessing the proliferation of FAS in Alaska were aided by a $29 million grant given to the Office of FAS by the federal Substance Abuse and Mental Health Services Administration.
"We received (the grant) to develop a very comprehensive statewide approach to FAS," Casto said. "That's when we were really able to start reaching out and developing our process for all of this."
The Office of FAS now has 13 FAS diagnostic teams in towns throughout the state and plans to open two more - one in Juneau and a second team in Anchorage - this year.
The project's analysis component resulted in the 2001 Status Update published last year. According to the study, Alaska diagnosed 1.4 babies per 1,000 live births with FAS in 2001, more than any of the other five states that publish such statistics. Alaska Natives gave birth to 4.8 babies with FAS per 1,000 live births.
In addition to diagnosing and analyzing the situation, the office of FAS has started a media campaign to increase public knowledge of the effects of alcohol during pregnancy.
"One of the things we're really trying to do is to change the public's attitude about drinking and pregnancy," Casto said. "There's a lot of misinformation out there ... We're saying that during pregnancy, the only safe choice is none at all."
That message is displayed in posters, brochures, television and newspaper ads throughout the state.
Finally, the FAS project aims to train workers. The office has partnered with the Division of Juvenile Justice and the Department of Corrections to train staff to recognize FAS symptoms.
"If we can start getting people to truly start understanding this disability, we will have started system change," Casto said. "They will understand the disease, they'll know what to look for, and understand how they can change their service delivery system to meet those needs."
Christine Schmid can be reached at firstname.lastname@example.org.