For years, Mary Ann Holman-Turner was puzzled by the erratic behavior of her foster child Emmanuel, whom she nicknames "Man-man."
Without apparent reason, he would hurl objects, slam doors and lie awake most of the night. In preschool, he had trouble sitting still and was unable to color inside the lines. Doctors wrongly diagnosed him with attention deficit hyperactivity disorder (ADHD) and prescribed him the stimulant Adderall to help him concentrate.
It was not until Man-man, now 15, turned 5 that Holman-Turner learned of a condition called fetal alcohol spectrum disorders (FASD), a range of mental and physical conditions caused by a mother's drinking during pregnancy. "Suddenly, it all made sense," said Holman-Turner, of Minneapolis. "My baby was misbehaving because he had brain damage, and everyone had failed to see it."
Now, under a new state law, foster parents in Minnesota are far less likely to be in the dark about one of the leading causes of developmental delays in children. Gov. Mark Dayton last week signed legislation that makes Minnesota the first state in the nation to require foster parents to receive training on how to recognize and treat the effects of prenatal alcohol exposure.
The law culminates years of grass-roots lobbying by disability advocates, and requires all newly licensed foster parents to receive an hour of training on parenting strategies for children with FASD. While the mandate is modest, public health advocates said it will bring increased attention to a condition that often goes undiagnosed and untreated. Because children with fetal alcohol syndrome often show no physical symptoms, they are frequently treated for emotional and behavioral problems, such as inattention and hyperactivity, that are actually the result of fetal brain damage, psychologists maintain. Many are misdiagnosed as having ADHD or anxiety disorders, and are given powerful combinations of medications.
"The system isn't broken for these kids. The system doesn't even exist," said Sara Messelt, executive director of the Minnesota Organization on Fetal Alcohol Syndrome, an advocacy group.
High risk in Minnesota
Public health officials estimate that about 7,000 children are born in Minnesota each year with alcohol exposure before birth, which puts them at risk of fetal alcohol spectrum disorders. The risk of exposure is particularly high in Minnesota — a state that in 2013 had the second-highest rate of alcohol consumption among women of childbearing age (ages 18 to 44), behind only North Dakota.
Among children in foster care, researchers have found that rates of fetal alcohol syndrome are as much as 10 times higher than the general population, because foster children often come from families with histories of alcohol abuse. Advocates and lawmakers said they expect mandatory training will help foster parents identify the early symptoms, which can include impulsivity, lack of comprehension and poor judgment.