Question Period Note: Fetal alcohol spectrum disorder and the Impacts of COVID-19

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• The Government of Canada recognizes that FASD is a serious public health issue. Services and supports for FASD are multi-jurisdictional and multi-sectoral, and addressing FASD will take a coordinated effort across federal departments and across all levels of government.
• Funding of $1.5 million is allocated through the Public Health Agency of Canada’s FASD National Strategic Projects Fund (NSPF) on an annual basis to collaborate with key stakeholders across Canada to develop nationally applicable tools, resources and knowledge that can be used to prevent FASD and improve outcomes for those who are already affected, including their families and communities.
• The Government of Canada is continuing to explore options to work with key partners to address existing knowledge gaps regarding national prevalence estimates of FASD in Canada, which will inform effective approaches to FASD awareness and prevention.

IF PRESSED ON ACTIONS BEING TAKEN
• The Government of Canada is continuing to advance action on Fetal Alcohol Spectrum Disorder (FASD) awareness, prevention, diagnosis, and intervention. This work is especially relevant given evidence that some Canadians have increased their alcohol consumption during the COVID-19 pandemic and the impacts this may have on pregnancy and FASD.

• Through the Networks of Centres of Excellence Program (NCE), the Government of Canada is also supporting research to improve the outcomes for children and families impacted by neurodevelopmental disabilities, including FASD.

• The Public Health Agency of Canada also leads surveillance activities with respect to maternal and child health issues, including prenatal alcohol exposure and neurodevelopmental disorders such as FASD, and is piloting options for FASD prevalence estimation.

IF PRESSED ON FASD
• FASD is a diagnostic term used to describe impacts on the brain and body of individuals prenatally exposed to alcohol. FASD is a lifelong disability.
• Individuals with FASD will experience some degree of challenges in their daily living, and may need support with motor skills, physical health, learning, memory, attention, communication, emotional regulation, and social skills to reach their full potential. Each individual with FASD is unique and has areas of both strengths and challenges.
• FASD is the leading known cause of preventable developmental disability in Canada. If someone is pregnant or planning to become pregnant, the safest choice is to drink no alcohol at all.

Fetal Alcohol Spectrum Disorder (FASD) is a diagnostic term used to describe the impact on the brain and body of individuals prenatally exposed to alcohol. It is a lifelong disability and people with FASD will experience some degree of challenges with their motor skills, physical health, learning, memory, attention, emotional regulation, and social skills. The number of people with the disorder is unknown. Recent studies from Canada, the US and Europe estimate that 1% to 5% of the population have the disorder.

A 2013 cost-of-illness study examined the impact of FASD on the material welfare of Canadian society by analyzing the direct costs of resources spent on health care, law enforcement, children and youth in care, special education, supportive housing, and long-term care. The results from this analysis demonstrated that the economic cost associated with FASD in Canada was approximately $1.8 billion annually in direct costs alone.

Further, Indigenous partners have signalled the importance of preventing FASD through two recommendations in the Truth and Reconciliation Commission of Canada’s Calls to Action (#33 and #34). These recommendations focus on FASD, calling for culturally appropriate preventive programs and criminal justice system reform.

The Public Health Agency of Canada (PHAC) is the federal lead for addressing FASD in Canada through the FASD Initiative, which includes the FASD National Strategic Projects Fund (NSPF). The Fund allocates $1.5 million annually for projects that promote education and awareness; harm reduction approaches; and research into the social determinants of health that impact alcohol consumption and FASD.

Six contribution agreements were funded through the NSPF in 2021-22. These projects supported prevention and reduction of stigma, and reached an audience of non-pregnant women of childbearing age, pregnant women and their partners, young adults, individuals with FASD, service providers and policy makers. Project activities included the development of guidelines for practitioners to use for screening and talking to women about alcohol use in pregnancy, modifying a school-based FASD curriculum to be taught in Canada, promotion of FASD prevention in Inuit communities, and virtual FASD training sessions for justice professionals, among others.

PHAC also leads surveillance activities with respect to maternal and child health issues, including prenatal alcohol exposure and neurodevelopmental disorders such as FASD. Through the Centre for Surveillance and Applied Research (CSAR), PHAC is piloting system models for FASD prevalence estimation, with a view to identifying proper surveillance approaches for FASD. This includes determining the quality and feasibility of using existing national data sources and piloting other promising methods to monitor trends in FASD incidence and prevalence over time. As part of prevalence estimation activities, PHAC published a short scientific paper titled FASD prevalence among children and youth: results from the 2019 Canadian Health Survey on Children and Youth in the Health Promotion and Chronic Disease Prevention in Canada journal.

The Government of Canada also promotes healthy pregnancies, including FASD awareness and prevention, through other supportive policy and programs by (1): supporting evidence-based policy and guidance for health practitioners and the general public on prenatal issues; and (2) investing in community-based programs to promote the health of pregnant people, young children and families facing barriers to health equity, through the Canada Prenatal Nutrition Program (CPNP) and the Community Action Program for Children (CAPC). Many CAPC and CPNP funded projects offer trusted, stigma-free and culturally inclusive education resources, in-person and virtual programming and referrals to other health services related to alcohol and substance use during pregnancy and breastfeeding. They also provide support to children with FASD and their parents.

PHAC’s FASD Initiative (which includes the National Strategic Projects Fund) is currently undergoing a planned evaluation through the Office of Audit and Evaluation. The results of the evaluation will inform the development of a new FASD Five-Year Strategic Plan, and will guide future investments.

Indigenous Services Canada (ISC) currently invests $17.9 million annually to support FASD prevention activities in First Nations and Inuit communities through regionally based solutions. This includes a funding increase as part of the Budget 2017 announcement of an additional $83.2 million over five years to expand Indigenous maternal and child health services with $3.7 million ongoing for FASD starting in 2022-23.

Health Canada leads the Canadian Drugs and Substances Strategy (CDSS) that aims to protect the health and safety of all Canadians by minimizing harms from substance use for individuals, families and communities, including harms caused by alcohol consumption (e.g., FASD). Health Canada also provides grants and contribution funding through the Substance Use and Addictions Program (SUAP) to respond to drug and substance use issues, including efforts related to FASD.

The Canadian Institutes of Health Research (CIHR) invests over $6.5 million in projects that are currently investigating social epigenetics, the use of magnetic resonance imaging (MRI), brain development and mental health, proteins that may be developmentally protective, pediatric neuroimaging, neurobiomarkers, and nutritional preventive intervention in the context of FASD.

The Kids Brain Health Network (KBHN) is receiving $50.8 million from 2009-2024 to improve the outcomes for children and families impacted by neurodevelopmental disabilities, including FASD as a national Network Centre of Excellence under the Networks of Centres of Excellence Program (NCE). The NCE is a Canadian government initiative, which funds partnerships between universities, industry, government and not-for-profit organizations to create large-scale research networks. As a research network, KBHN engages with community groups, non-profit organizations, industry, parents, clinicians, health professionals, provincial and federal governments to advance knowledge to improve outcomes for children with neurodevelopmental disabilities, including FASD, and their families.

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