IMPACT OF PRENATAL ALCOHOL EXPOSURE ON CHILD DEVELOPMENT

Cuabo, Anthony M.

Dullano, Eunice

Estrella, Alexa Zoe A.

Geronimo, Honeylen

Rebalde, Chrish
Background Information

Kalex Suarez, who is 7 years old, is a member of his family who lives in a small

apartment unit. Although his mother was 20 years old during her pregnancy, she

continued to hang out with her friends drinking alcohol and smoking weed. She didn't

undergo any changes until the baby's arrival, and in her postpartum period, she had a

slight change, including avoiding hangouts with friends and drinking/smoking. Alcohol

consumption during pregnancy causes cognitive deficiencies in a variety of categories,

including general intellectual function, executive function, learning, memory, and visual

reasoning (Doyle & Mattson, 2015).

When he was an infant, Kalex’s mother needed to stop her studies to take care

of him while his father worked in a construction area (laborer) 10 hours a day. When

Kalex was 2 years old, Kalex’s mother returned to her vices and dropped him off 3 times

a week in her aunt’s house therefore she couldn't take care of Kalex. At the age of 4

years old, he showed a sign of late development and that concerned his family. At 5

years old, they enrolled Kalex to the special program also known as the Special

Education (SPED) that the government provided and he regularly attended his

afternoon program near their place. Most of the time, Kalex’s aunt always takes care of

him instead of her mother, given the fact that her mother got pregnant in the early age,

therefore she didn’t enjoy her adolescence. At the age of 7 years old, Kalex's family

moved to the other side of the province which is the Panabo City for the reason that his

father's next project was located there therefore they have a new environment. During

the new environment, Kalex’s mother still didn’t take care of him despite the delayed

development of his child because of the abuse during the pregnancy and his aunt is not
with him. At that time, medical issues occurred where Kalex easily acquired diseases

because of the poor nutrition and external factors (ventilation, cleanliness of the house,

hygiene, and etc.) and he suffered from emotional distress.

Kalex's father is a Filipino who works in construction. He completed Grade 11 but

didn't continue with the remaining year of Senior High School. Meanwhile, his mother is

a Filipino and a stay-at-home mom. Also, she didn't continue her senior high school due

to early pregnancy, and the father of Kalex is taking care of their needs. Their

relationship has been going strong for 10 years and their first child is Kalex. His father

and Kalex always attended Holy Mass because the families of his father are devoted in

the Catholic Church.

Physical/ Motor Development

Kalex was born with problems in his physical appearance; he doesn’t weigh as

the normal weight of a child, he has small eyes, head and smooth philtrum. And when

he was 4 years old Kalex showed signs of late development. There's a lot of times that

Kalex's mother always notices his unusual progress because it often happens, just like

when Kalex's mother is teaching him to write, she notices that he doesn't hold crayons

with mature grasps, can't build towers with blocks, lacks coordination with his body in

running and jumping, and can't recognize or copy basic shapes. By the age of 5 Kalex

has poor fine motor skills and has a predicament in controlling things like eating with a

spoon, having trouble dressing alone by himself and can’t print letters. He also lacked
strength; he always had a hard time carrying small things like his bag, a glass of water,

and his bag.

(Vygotsky) coined the phrase zone of proximal development and defined it as the

distance between what a child can learn alone and what that child can learn when

assisted by someone else, usually an adult. When his family noticed his unusual

gesture and behavior at the age of 4, Kalex was immediately enrolled in a special

program (SPED) when he turned 5. After a year at SPED, Kalex made small

improvements. Before, he's been unable to perform activities involving a lot of running

for the reason that he always stumbles when he tries to, so he is always excluded from

activities that involve running. But after enrolling in SPED, Kalex is slowly learning how

to control his body movements, and he even knows how to use scissors, but still with

supervision.

According to (Dynamic Systems Theory), physical/motor development is viewed

as a complex interaction between the child's nervous system, body, and environment.

There are some areas for improvement in Kalex's physical and motor development. For

gross motor skills, he should be involved more in outdoor activities such as running,

jumping, climbing, and playing on playground equipment. For fine motor skills, he

should continue to practice writing and anything else that helps to enhance his fine

motor skills.

Language Development

At three years old, Kalex has a fairly little vocabulary. He has trouble expressing

himself and can only speak in a few words. Since he became five years old, Kalex has
had trouble comprehending and responding to basic questions or directions. Kalex has

a vague orientation and hard-to-understand speech sounds when he speaks. He

doesn't interact with people very much. He usually interacts less and is calmer

throughout preschool. For his age, Kalex has not developed his linguistic skills to the

fullest. His inability to communicate stems from the lack of parental participation. When

Kalex was just two years old, his mother reverted to her previous vices, leaving Kalex

with his aunt and causing him to grow apart from his parents.

Kalex, a three-year-old with limited vocabulary, struggles with basic questions

and directions, and struggles with speech sounds. His lack of parental involvement

contributes to his verbal development, and he should focus on improving his

communication skills to enhance social connections and eloquent expression

Cognitive/ Moral Development

At the age of 4, Kalex Suarez exhibited signs of delayed cognitive development,

struggling in social interactions and displaying limited verbal skills compared to peers .

His reliance on non-verbal communication raised concerns for his family. Upon enrolling

him in Special Education, challenges in foundational learning were identified,

emphasizing the early emergence of cognitive difficulties.

Upon entering school at 6, Kalex faced significant challenges in executing

step-by-step directions and organizing tasks, indicating potential issues with executive
functions and suggesting difficulties in planning and organization that impacted his

academic performance.

Despite cognitive struggles, Kalex's moral development was nurtured through

regular attendance at Catholic Mass with his father, providing a foundation for ethical

teachings and contributing to his understanding of right and wrong. This shared

experience cultivated a moral compass, enhancing his awareness of values and ethical

considerations in daily life.

From a theoretical perspective, Kalex's delayed cognitive development aligns with

Vygotsky's sociocultural theory, emphasizing the impact of social interactions and

cultural influences on cognitive growth (Vygotsky). Additionally, his executive function

challenges may be viewed through the lens of Piaget's theory, highlighting the

importance of cognitive structures for tasks like planning and organization (Piaget).

Bruner's theory, with its focus on scaffolding and cultural influences on cognitive

development, further enriches the understanding of Kalex's learning challenges

(Bruner). Interventions and support aimed at both social and cognitive aspects, drawing

from these theories, could contribute to Kalex's overall development

Socio-Emotional Development

In Kalex's early years, he faces challenges in forming secure emotional connections,

mainly due to inconsistent maternal care linked to his mother's early vices and changes

in living arrangements. This inconsistency hinders Kalex's ability to develop a stable

emotional foundation. When separated from his aunt, he displays heightened anxiety,

clinging to her and resisting interactions with peers, indicating potential insecure

attachment patterns. Attachment theory, pioneered by John Bowlby, emphasizes the

crucial role of consistent and responsive caregiving in fostering healthy socio-emotional

development.

Examining Kalex's socio-emotional development through Urie Bronfenbrenner's

ecological systems theory reveals the interplay between immediate and broader

environmental factors. Changes in Kalex's family living arrangements introduce

disruptions in his immediate environment (microsystem), impacting his emotional

well-being. These micro-level changes, such as interactions with a different caregiver

and unfamiliar peers, influence his adaptation to new environments. Simultaneously,

societal attitudes and cultural expectations (macrosystem) contribute to Kalex's

challenges, highlighting the interconnectedness of family dynamics, immediate

surroundings, and broader societal influences on his socio-emotional development.

Despite the presence of extended family, Kalex's reliance on his aunt suggests a

potential lack of a primary caregiver during critical developmental stages. The absence

of consistent maternal presence has affected Kalex's sense of security and trust in

relationships. This dependency on his aunt underscores the broader impact of family

dynamics on his socio-emotional development, emphasizing the need to address both

immediate caregiving challenges and the enduring effects of an unstable family

microsystem.

PROBLEMS AND SYMPTOMS

Below are the problems and symptoms that have been persistent to prenatal alcohol

exposure:

1. Poor coordination

2. Learning Disabilities

3. Speech and Language delays

4. Poor social skills

5. Trouble getting along with others

6. Predicament in physical appearance

BEHAVIORAL OBSERVATIONS

In the context of our study, his struggles in motor skills, both fine and gross,

manifest through challenges in holding crayons, running, and carrying small items.

Moreover, his linguistic difficulties are apparent in limited vocabulary, unclear speech

sounds, and struggles with comprehension. The cognitive aspects are marked by

difficulties in social interactions, expressing himself, and following step-by-step

directions. Furthermore, he suffered from emotional distress due to the separation from

his aunt that resulted in tantrums. These observations collectively depict a complex
interplay of factors influencing Kalex's holistic development, emphasizing the need for

targeted interventions and support across various domains.

THEORETICAL PERSPECTIVE

BEHAVIORAL LEARNING THEORY

Kalex Suarez's developmental difficulties can be meaningfully interpreted using

the behavioral learning theory, a fundamental element of behaviorism. This theory,

grounded in conditioning principles and observable behavior, elucidates how his

experiences are shaped by environmental stimuli, reinforcement, and learned

responses. Kalex's enrollment in the Special Education (SPED) program aligns with

operant conditioning principles, where positive reinforcement contributes to noticeable

advancements in his motor skills, as demonstrated by his newfound proficiency with

scissors. Challenges he faces in following directions and planning during class projects

resonate with the theory's focus on learned responses influenced by the environment,

indicating the impact of limited exposure to specific stimuli or reinforcement. The social

learning aspect is evident in Kalex's language development struggles and difficulties in

social interactions, underscoring the significance of observational learning and the

deficiency in social modeling due to inadequate parental involvement. Additionally,

Kalex's reliance on his aunt as a primary caregiver underscores the theory's assertion

that behaviors are acquired through interactions with the environment, highlighting the
formative role of early experiences. In summary, the behavioral learning theory provides

a comprehensive framework for understanding Kalex's developmental journey, offering

valuable insights for personalized interventions and support.

SOCIAL LEARNING THEORY

Analyzing Kalex Suarez's developmental path through the perspective of social

learning theory yields a nuanced comprehension of how observed behaviors and social

interactions significantly shape his socio-emotional growth. Based on Albert Bandura's

principles, this theory proposes that individuals acquire behaviors by imitating and

modeling others within their social sphere. Kalex's exposure to irregular maternal care

and dependence on his aunt as his primary caregiver exemplifies the theory's emphasis

on learned behaviors, especially in the realm of attachment patterns.

The potential emergence of attachment issues, evident in heightened anxiety and

reluctance to be apart from his aunt, reinforces the theory's claim that such behaviors

are acquired through observation. Additionally, social learning theory effectively explains

Kalex's struggles in language development, where limited parental involvement has

impeded linguistic skills due to a lack of modeling and interaction in his immediate social

surroundings.

Social learning theory underscores the significance of microsystems, such as

family dynamics, in shaping socio-emotional development. Kalex's adjustment to new

environments is not solely influenced by immediate caregivers but also by broader

societal attitudes and cultural expectations. In essence, social learning theory offers a

holistic framework for comprehending Kalex's developmental hurdles, stressing the

necessity of interventions that consider the social context, provide positive role models,

and foster supportive social environments to nurture his overall development.

TREATMENT PLAN

The treatment plan for Kalex Suarez is designed with several key objectives aimed at

addressing his developmental challenges and promoting overall well-being.

Maladaptive behaviors/traits Recovery Capital/Strengths

● Family Support
● Social and Communication
● Peer Support
Challenges.
● Engagement in productive
● Hyperactivity
activities
● Attention Issues

● Balance and Coordination issues

LONG TERM

● Address maladaptive behaviors ● Implement behavioral modification

and traits through targeted techniques, such as positive
interventions. reinforcement, to target specific
maladaptive behaviors. Introduce
skill-building programs to enhance

● Foster ongoing language
development.
● Promote sustained physical and
motor development.
● Strengthen family bonds and
create a supportive home
environment.
SHORT TERM
● Enhance language development
through positive modeling.
● Jumpstart physical development
coping mechanisms and emotional
regulation.
● Maintain consistent interaction
between Kalex and his parents,
extending positive modeling.
Collaborate with educators for
continued language support in the
school setting.
● Encourage ongoing participation in
outdoor activities. Collaborate with
physical therapists to create a
personalized exercise plan.
Monitor and adjust activities based
on Kalex's progress, ensuring a
balance between gross and fine
motor skill development.
● Conduct regular family therapy
sessions to address
communication barriers and
enhance understanding. Provide
ongoing education on child
development, emphasizing the
importance of consistent care and
positive interactions. Monitor family
dynamics and make adjustments
to interventions as needed.
● Schedule regular, short intervals of
focused interaction between Kalex
and his parents for
language-building activities.
Encourage storytelling, reading,
and engaging conversations.
Provide parents with simple
language stimulation exercises to
practice at home.
● Initiate a routine of outdoor
 through outdoor engagement.
● Actively involve both parents in
promoting motor skills.
● Monitor and adjust interventions
based on short-term progress.
activities, such as daily walks,
simple exercises, and play in a
park. Ensure both parents actively
participate. Observe and record
Kalex's engagement and progress
in physical activities.
● Facilitate family engagement in
physical activities at home. Provide
a list of simple exercises and
games that enhance gross and fine
motor skills. Encourage parents to
document and share observations.
● Schedule a follow-up meeting to
assess the effectiveness of
implemented strategies. Collect
feedback from parents, educators,
and any involved professionals.
Adjust the treatment plan as
needed for ongoing success.

OVERALL IMPRESSION

Kalex Suarez faces intricate developmental challenges, with prenatal alcohol exposure

potentially affecting his brain and central nervous system, leading to difficulties in

cognitive, motor, and socio-emotional areas. Inconsistent maternal care adds

complexity, impacting attachment formation and socio-emotional well-being. The

environment he's been raised in, marked by inconsistency and stressors, contributes to

challenges in cognitive, language, and motor skills, as well as socio-emotional struggles

like anxiety and separation resistance. Kalex needs a comprehensive, tailored approach

involving collaboration among healthcare professionals, educators, and caregivers to

address these interconnected developmental issues effectively.

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Exposure (ND-PAE): Review of Evidence and Guidelines for Assessment. Curr Dev

Disord Rep. 2015;2(3):175–186. Doi: 10.1007/s40474-015-0054-6.

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processes. Cambridge, MA: Harvard University Press.

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The Ecology of Human Development: Experiments by Nature and Design (1979). By Urie

Bronfenbrenne.

Bruner, J. S. (1986). Actual Minds, Possible Worlds. Harvard University Press.

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