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The Broken Cord: A Family's Ongoing Struggle with Fetal Alcohol Syndrome.

The Broken Cord: A Family's Ongoing Struggle with Fetal Alcohol Syndrome. M. Dorris. New York,: Harper & Row, 1989. 300 pp. 18.95.

It has been less than 20 years since researchers identified a number of newborn traits associated with maternal alcohol consumption. Those traits include prenatal and postnatal growth deficiency, distinct facial malformations, small head circumference, central nervous system dysfunctions, and organ malformations. Today this collection of symptoms and subsequent developmental lags in most areas of growth, health problems, and varying degrees of mental deficiency are widely accepted features of fetal alcohol syndrome (FAS). Less pronounced symptoms may constitute fetal alcohol effect (FAE).

The Broken Cord is the account of Michael Dorris' search to understand his adopted son, Adam, now in his early 20s. The book is a highly personalized case history which recounts not only Adam's uneven, delayed development, but the joys, fears, disbelief, love, and frustrations experienced by his family as they struggle with the challenges presented by FAS. Woven into the account is Dorris' investigation of possible contributors to maternal alcohol abuse, review of current medical knowledge about causes and effects of the syndrome, and exploration of treatment approaches. He has drawn material from medical research, sociological and anthropological studies, and interviews with persons involved in prevention and treatment, and most of all from firsthand experience.

Dorris, who is a professor of Native American Studies at Danmouth College, adopted Adam as a single parent in 1973 when Adam was 3 years old. He had been born nearly 7 weeks premature to a heavily drinking mother; and he had been physically abused, neglected, and malnourished and was suffering from pneumonia when he was removed from her custody at age I and placed in foster care. Despite Adam's diagnosis of mental retardation, Dorris eagerly accepted the opportunity to adopt the "hard to place" boy. He said, "I believe in the positive impact of environment, and with me he'll catch up" (p. 10).

Over the next 16 years, Adam experienced the positive impact of an environment that nurtured, stimulated, and supported his development. Nevertheless, his growth was slow and uneven, requiring years of instruction, practice, and reinforcement before he was toilet trained, recognized colors, could count beyond 3, or correctly used pronouns. When confronted with Adam's slow progress compared with preschool and elementary classmates, and later, an adopted younger brother and sister, Dorris blamed the early deprivation and anticipated a time when he would spurt intellectually, emotionally, and physically.

For the most part, Adam's teachers were encouraging and nurturing, at least through elementary school. They liked him and believed that he could learn. Dorris gives Adam's special education teachers special credit:

One teacher who worked with him for 7 years was a realist who acted as though she had a short memory-that is, she had the ability to forget setbacks and to maintain steady optimism even when, year after year, she was required to repeat identical lessons for Adam "...She believed as fiercely as I that Adam had unrealized resources ... She worked long hours for little pay and spent many evenings researching in the library to develop new techniques ... She concentrated on each of her students as if he or she were the only child in the world, and because of her each of them surpassed what had been regarded as maximum potential" (pp. 111- 1 12).

However, despite the efforts of his teachers and Dorris, Adam fell further behind his peers. By high school, Adam was failing academically, considered unmotivated, a misfit, and a conduct problem. To Dorris, Adam's most pervasive problems were absence of imagination, lack of motivation, and failure to learn from experience and to anticipate the future.

Although "FAS is an equal opportunity affliction"-it occurs among all nationalities and income groups-some sociocultural groups are at greater risk. Dorris cites Jeaneen Grey Eagle, director of a drug and alcohol rehabilitation effort on the Pine Ridge Reservation in South Dakota (where Adam was born), whose conservative estimate is that 25% of the reservation children are impaired because of widespread maternal alcohol abuse. The problem is exacerbated by associated problems of poverty and inadequate nutrition and prenatal care.

Are there solutions? Dorris is pessimistic that interventions currently exist that can significantly alter the outcomes for children like Adam. Rather, prevention is the key to FAS and FAE, which he considers abuse as damaging as hitting a child over the head with a baseball bat. While education of prospective mothers about the dangers of alcohol is essential, Dorris believes that social acceptance and even encouragement of maternal drinking of any amounts of alcohol must be curbed. In cases of repeated instances of bearing FAS children, he even considers sterilization and incarceration of pregnant mothers-approaches "antithetical to every self-evident liberal belief I cherished" (p. 167).

A Broken Cord is a highly disturbing book. In the United States, an estimated 70,000 fetal alcohol-impaired children are born each year, costing hundreds of millions of dollars in medical care, special education, social services, and lost income. Though these statistics are alarming, they are impersonal. Michael Dorris brings them to life by telling Adam's unique story.

Reviewed by ROBERT H. ZABEL, Professor of special Education, Kansas State University, Manhattan, Kansas.
COPYRIGHT 1991 Council for Exceptional Children
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 1991 Gale, Cengage Learning. All rights reserved.

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Author:Zabel, Robert H.
Publication:Exceptional Children
Article Type:Book Review
Date:Feb 1, 1991
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