Manchester is proud to be a trauma-informed city but we cannot support the majority of residents with trauma and break the cycle of adverse childhood experiences unless we are FASD and Neurobehaviourally informed too. 

FASD, Fetal Alcohol Spectrum Disorder is a hidden epidemic in Greater Manchester.  A Salford University study published in 2021 estimated that up to 4% of the population is likely to have FASD – that’s 2.5 times higher than autism.  The average life expectancy for individuals with FASD is only 34 years of age because they do not receive the interventions and support they need.  FASD is underdiagnosed and little understood by professionals and frontline workers.  There is an underserved stigma attached to it and often professionals, including medical, only learn about it as a very tiny part of their training.

FASD happens when a pregnant woman consumes alcohol.  Alcohol crosses the placenta and interferes with the development of the fetus, particularly the developing brain.  This has a significant impact on the executive brain function – the part responsible for organisation, self-regulation, working memory and flexible thinking.  It also results in some incredible strengths which, if a person with FASD is given support, may be developed and realised, such as creativity.

The mother is blameless and often a victim too – this is vital to note.  No mother knowingly damages her developing child – she drinks because she doesn’t know she is pregnant, doesn’t know the impact of alcohol or has an alcohol abuse disorder and cannot control her drinking.  We must remove the stigma.

FASD is a brain and body disability with lifelong impact and up to 400 comorbidities including Attention Deficit Hyperactive Disorder (ADHD), Autism Spectrum Disorder (ASD), sensory issues including Sensory Processing Disorders (SPD), developmental trauma and secondary and tertiary conditions such as depression, anxiety, loneliness, poor academic outcomes, suicide, homelessness and criminality.   

Often individuals with FASD are diagnosed with an “alphabet soup” of labels to account for their behaviours but not FASD and internalise their problems leading to the secondary and tertiary conditions.  Where they receive support, it is not FASD or neurobehaviourally informed so the support fails or exacerbates their problems.

Any engagement with an individual with FASD must begin with the FASD regardless of their secondary and tertiary conditions including trauma. This means particularly supporting with challenges to executive brain function.

For example, individuals needing treatment for addictions need support to attend each appointment.  Those that have fallen into debt can’t be helped with a debt repayment plan unless the cause of the debt, the disability that means they need help with maths and organisation is addressed. Schools must work from a brain and nurture-based approach rather than behaviour change (rewards and sanctions).

In 2022, following campaigning by groups such as the FASD Alliance, NICE published Quality Standards on FASD and Greater Manchester CCG have acted on the majority of these to prevent alcohol drinking in pregnancy.  However, there is much to do in the areas of follow-up and in diagnosing children and adults.

This Council calls on its Officers to:-

(1)       Explore the ability to ensure trauma informed training includes FASD and Neurobehavior awareness with an understanding that FASD is a brain and body disability and interventions and engagement need to be led by FASD-friendly approaches.

(2)       Explore how services can become more FASD-friendly and aware.

(3)       Work with health services to act on NICE guidelines for early diagnosis and a management plan following diagnosis (NICE Quality Standard 5) “Because FASD has lifelong effects, a staged management plan may be needed to anticipate upcoming problems at planned intervals and revision should be considered at all transition stages in the person's life.”

(4)       Work with schools and other organisations in providing appropriate training courses.

(5)       Explore possibilities for the provision of further support for children and adults seeking an FASD diagnosis.

Proposed by Councillor Alijah, seconded by Councillor Azra AIi and supported by Councillors Akbar, Doswell, Foley, Hilal and T Robinson

Councillor Alijah submitted the following motion, which was seconded by Councillor Doswell.

Manchester is proud to be a trauma-informed city but we cannot support the majority of residents with trauma and break the cycle of adverse childhood experiences unless we are FASD and Neurobehaviourally informed too. 

FASD, Fetal Alcohol Spectrum Disorder is a hidden epidemic in Greater Manchester.  A Salford University study published in 2021 estimated that up to 4% of the population is likely to have FASD – that’s 2.5 times higher than autism.  The average life expectancy for individuals with FASD is only 34 years of age because they do not receive the interventions and support they need.  FASD is underdiagnosed and little understood by professionals and frontline workers.  There is an underserved stigma attached to it and often professionals, including medical, only learn about it as a very tiny part of their training.

FASD happens when a pregnant woman consumes alcohol.  Alcohol crosses the placenta and interferes with the development of the fetus, particularly the developing brain.  This has a significant impact on the executive brain function – the part responsible for organisation, self-regulation, working memory and flexible thinking.  It also results in some incredible strengths which, if a person with FASD is given support, may be developed and realised, such as creativity.

The mother is blameless and often a victim too – this is vital to note.  No mother knowingly damages her developing child – she drinks because she doesn’t know she is pregnant, doesn’t know the impact of alcohol or has an alcohol abuse disorder and cannot control her drinking.  We must remove the stigma.

FASD is a brain and body disability with lifelong impact and up to 400 comorbidities including Attention Deficit Hyperactive Disorder (ADHD), Autism Spectrum Disorder (ASD), sensory issues including Sensory Processing Disorders (SPD), developmental trauma and secondary and tertiary conditions such as depression, anxiety, loneliness, poor academic outcomes, suicide, homelessness and criminality.   

Often individuals with FASD are diagnosed with an “alphabet soup” of labels to account for their behaviours but not FASD and internalise their problems leading to the secondary and tertiary conditions.  Where they receive support, it is not FASD or neurobehaviourally informed so the support fails or exacerbates their problems.

Any engagement with an individual with FASD must begin with the FASD regardless of their secondary and tertiary conditions including trauma. This means particularly supporting with challenges to executive brain function.

For example, individuals needing treatment for addictions need support to attend each appointment.  Those that have fallen into debt can’t be helped with a debt repayment plan unless the cause of the debt, the disability that means they need help with maths and organisation is addressed. Schools must work from a brain and nurture-based approach rather than behaviour change (rewards and sanctions).

In 2022, following campaigning by groups such as the FASD Alliance, NICE published Quality Standards on FASD and Greater Manchester CCG have acted on the majority of these to prevent alcohol drinking in pregnancy.  However, there is much to do in the areas of follow-up and in diagnosing children and adults.

Manchester council should:

(1)       Explore the ability to ensure trauma informed training includes FASD and Neurobehavior awareness with an understanding that FASD is a brain and body disability and interventions and engagement need to be led by FASD-friendly approaches.

(2)       Explore how services can become more FASD-friendly and aware.

(3)       Work with health services to act on NICE guidelines for early diagnosis and a management plan following diagnosis (NICE Quality Standard 5) “Because FASD has lifelong effects, a staged management plan may be needed to anticipate upcoming problems at planned intervals and revision should be considered at all transition stages in the person's life.”

(4)       Work with schools and other organisations in providing appropriate training courses.

(5)       Explore possibilities for the provision of further support for children and adults seeking an FASD diagnosis.

On the motion being put to the vote, the Lord Mayor declared it carried unanimously.

Resolution

This Council agrees to:-

(1)       Explore the ability to ensure trauma informed training includes FASD and Neurobehavior awareness with an understanding that FASD is a brain and body disability and interventions and engagement need to be led by FASD-friendly approaches.

(2)       Explore how services can become more FASD-friendly and aware.

(3)       Work with health services to act on NICE guidelines for early diagnosis and a management plan following diagnosis (NICE Quality Standard 5) “Because FASD has lifelong effects, a staged management plan may be needed to anticipate upcoming problems at planned intervals and revision should be considered at all transition stages in the person's life.”

(4)       Work with schools and other organisations in providing appropriate training courses.

(5)       Explore possibilities for the provision of further support for children and adults seeking an FASD diagnosis.

Resolution

That the Council:-

(1)       Explore the ability to ensure trauma informed training includes FASD and Neurobehavior awareness with an understanding that FASD is a brain and body disability and interventions and engagement need to be led by FASD-friendly approaches.

(2)       Explore how services can become more FASD-friendly and aware.

(3)       Work with health services to act on NICE guidelines for early diagnosis and a management plan following diagnosis (NICE Quality Standard 5) “Because FASD has lifelong effects, a staged management plan may be needed to anticipate upcoming problems at planned intervals and revision should be considered at all transition stages in the person's life.”

(4)       Work with schools and other organisations in providing appropriate training courses.

(5)       Explore possibilities for the provision of further support for children and adults seeking an FASD diagnosis.