Prenatal Development

By: Robert Kruchio



The development of a newborn from an embryo is a delicate process that can have long lasting consequences on the individual if it is interrupted. Substances known as teratogens have serious consequences if the fetus is exposed during sensitive periods, and some effects can occur regardless of developmental stage. In addition to Teratogens there can be inherited genetic conditions that develop after birth, including Downs Syndrome, Tay-Sachs disease, Fragile X Syndrome, Sickle Cell Anemia, and other rare conditions (Epigee, 2009).

Prenatal development describes the development of a baby beginning from contraception to birth. By the end of the first month the organism has developed rudimentary organs, including heart, liver, kidney, lungs, intestinal tract and the nervous system. In the second month the embryo begins to take a more human like appearance as the forehead becomes prominent, limbs form, and sex organs begin to form as the size increases. Rudimentary bone structure begins to form in the second month. The third month features the development of teeth buds, and vocal cords. The liver and stomach start producing waste. The start of the second trimester, and the fourth month, begins with the development of the lower body. The skin darkens and muscular maturation is prominent. The fifth and sixth month sees the continued growth of the fetus, with sweat glands beginning to function and the eyes opening. The third trimester is marked by the organism being able to respond to external signals received.  The incubation is concluded in the eighth and ninth month where the baby develops into its full form becoming quite active, the heart rate increases, and finally the baby is born. Throughout the entire pregnancy the infants brain continues to develop, and a teratogen can have serious ramifications at any time on cognitive abilities (Childhood Development, 2008).

There is a vast array of teratogens that have detrimental effects on the fetus (for a complete online list please go to http://msds.chem.ox.ac.uk/teratogens.html), of which the most commonly available to the public are alcohol, prescriptions, and a variety of drugs.

Alcohol consumed during pregnancy is well known to have a teratogenic effect, resulting in a baby with facial and growth abnormalities, and psychological disorders (Effect of Alcohol on Reproduction, 2009). These characteristics are typically summarized as Fetal Alcohol Syndrome, FAS. Alcohol, specifically Ethanol, is detrimental to a fetus if it is consumed at any time during pregnancy or in any quantity, and its effect is heightened when consumed earlier in the pregnancy and in larger doses. Physically a child with FAS has reduced birth weight and has stunted growth. There are characteristic facial features, including widely spaced, small eyes, flat face with an upturned nose, a smooth philtrum and a thin upper lip. Facial appearance may be unaltered in a child whose mother did not have alcohol in her system when the face was forming (Alcohol as a Teratogen, 2003).

There are a wide range of psychological symptoms that are observed in a child with FAS, many of which are given here (Alcohol as a Teratogen, 2003):

Attention Deficiency

Memory Deficiency

Hyperactivity

Poor Impulse Control

Immature Social Behaviour

Inappropriately friendly to strangers

Poor problem solving skills

Difficulty with abstract concepts

Poor judgment

Inability to manage money

Lack of control over emotions

Unable to learn from consequences

Children with FAS have IQ of 65 on average, which borders on a moderate mental handicap. Symptoms of FAS do not improve with age, and the combination of factors leads to social isolation, and problem solving ability throughout the life of those affected (Effect of Alcohol on Reproduction, 2009). 

In the classroom the symptoms of FAS pose many problems. Socially, students with FAS are not able to adjust and may often congregate with students in lower grade levels. They are tempermental and need guidance, support and attention to function in society. This makes it difficult to let them work independently, and they may require a dedicated counsellor to oversee their time at school. Mentally it can be very difficult for a FAS student to keep up in the classroom. They have a poor ability to focus on one task, are often restless, and are likely to become frustrated if they are unable to understand. Coupled with a low IQ this can pose a problem to teach them, and keeping up with healthy children their age is not possible. As such, it is likely that they will need a curriculum planned for them that is appropriate for their abilities. Those who suffer from FAS do so throughout their lives as the conditions are untreatable.

There are prevention methods in place for FAS, the primary of which is promoting awareness in young mothers who are at risk of exposing a baby. A secondary prevention method utilized is frequent screening to check for pregnancy to prevent substance exposure while the mother is unaware. Ultimately it falls to the mother at any age to prevent becoming pregnant unknowingly and not continue consuming alcohol while pregnant (Alcohol as a Teratogen, 2003).

 Nicotine usage has not been found to directly affect fetal growth or have any syndrome connected with it, but its exposure during pregnancy leads to an elevated risk of the baby becoming a smoker later in life (Teratogens, 2009).

In addition to nicotine, many street drugs such as cocaine, and some formerly prescribed medications no longer in use, can have adverse affects on a fetus. Mothers who have street drugs in their system risk both hurting the development of their infant, and elevated risks of babies who are addicted to the exposed substance (Teratogens, 2009). Street drugs pose a variety of health risks depending on the substance abuse, in the case of cocaine it can lead to miscarriage, reduced fetal growth and low birth weight, and vascular defects. No syndrome is directly linked to cocaine exposure, although research is still ongoing. Formerly a prescription for treating morning after sickness, called Thalidomide, was causing defectively formed limbs in babies. It has since been banned from use (Dalessio, 2001)..

Some medications, such as anticonvulsants, can cause inhibited cognitive abilities in children exposed during pregnancy. This poses a problem for epileptic mothers as seizures are otherwise uncontrollable without medication. Babies exposed to anticoagulant medication can also exhibit hypoplasias (underformation) of the face and fingers, and microcephaly (Dalessio, 2001).

The protocol for handling a child who has had exposure to any of these teratogens must be dealt with on a case by case basis, as the symptoms can vary greatly depending on the time of exposure, dose, and substance.

Along with teratogens many genetic birth defects are also possible. While many of these diseases, such as Tay-Sachs, are fatal there are others that have manageable conditions such as Downs Syndrome. Downs syndrome occurs when an extra chromosome 21 is present. It causes delays in the mental development of the baby, and characteristic features including a flattened facial appearance, protruding tongue, small ears, and an upward slant in the eyes. Downs Syndrome can result in health problems, but this is not true in every case. Medical conditions can develop including hypo or hyperactive thyroid, respiratory problems, obesity, a weakened immune system, and childhood leukemia. Sufferers of Downs syndrome also appear flimsy as they have poorly developed muscle structure. Downs syndrome effects the ability of the student to learn, reducing the rate at which they are able to understand concepts but not preventing it. They are able to learn concepts and skills but do so at a slower rate than healthier counterparts (Downs Syndrome, 2008).

Bearing this in mind, it is important to remember when handling a Downs Syndrome student that they are capable of learning but patience is required, and the way it is taught must be changed. It is important to keep a feeling of self esteem and confidence in the student, and be inclusive in the classroom where possible. A student with Downs Syndrome can have a functional short term memory and is capable of learning, but will likely not develop past the abilities of a 6-8 year old student. It is important to use concrete examples and hands on activities where appropriate to maintain focus through their short attention span. Patience is the key, and with the right support and instructions a Downs Syndrome student is capable of learning and success (Downs Syndrome, 2008).

It is important for students with conditions such as FAS to have support available to them, both inside and outside the classroom. Their characteristically lower IQ puts them at a disadvantage to other students and hinders their ability to keep up in a lesson. As a result, they will learn less and alternatives must be used to teach them. Manipulatives that give them a visual representation of what they are doing is one such alternative. If the child is uncooperative, possibly due to compounding problems, then it may be necessary to remove them from a classroom altogether and have a special aid worker care for them.

There are many problems that can manifest in students due to problems with prenatal development and it is important for teachers to take the initiative to find out about them, as some may be more obvious than others. Contacting parents, reading student files and finding out background history are all important when considering this element of the classroom.

 

 

References

 

Alcohol as a Teratogen – Fetal Alcohol Syndrome. (2008). Retrieved March 11, 2009 from the Department of Environmental and Public Health:  http://people.uwec.edu/piercech/fas/fas...htm


Approximate Timetable of Prenatal Development. (2008). Retrieved  March 11, 2009 from

Childhood Development Institute:

http://www.childdevelopmentinfo.com/development/prenataldevelopment.shtml

Dalessio, Donald J. Anticonvulsant Drugs Are Teratogens. Journal Watch Neurology. June 8, 2001

 

Schwarz EB, Maselli J, Norton M. Prescription of Teratogenic Medications in United States

Ambulatory Practices. Journal of Medicine vol. 118, 1240 - 1249, 2005

 

Scott, Charles I. Down Syndrome. (2008). Retrieved March 11, 2009 from Kids Health:

http://kidshealth.org/parent/medical/genetic/down_syndrome.html

Teaching Down's Syndrome Students. 2009. Retrieved from Special Education:

http://specialed.about.com/od/disabilities/a/downs.htm

 

Teratogens. Retrieved from the Greater Baltimore Medical Center:

http://www.gbmc.org/genetics/harveygenetics/prenataldx/PatientInformation/teratogens.cfm

Tourmaa , Tuula E. The Adverse Effects of Alcohol on Reproduction. Retrieved from FAS Community

Resource Center: http://www.come-over.to/FAS/alcohol.html March 11, 2009.

Williams, M.T. Genetic Problems with Baby. Retrieved March 11, 2009 from Epigee, Womens Health:

http://www.epigee.org/pregnancy/genetic_disorders.html

 

Document available on a web page:
Chou, L., McClintock, R., Moretti, F., Nix, D. H. (1993). Technology and education: New wine in new bottles:
Choosing pasts and imagining educational futures. Retrieved August 24, 2000, from Columbia University, Institute for Learning Technologies Web site: http://www.ilt.columbia.edu/publications/papers/newwine1.html

Journal article, personal author(s):
Senden, T. J., Moock, K. H., Gerald, J. F., Burch, W. M., Bowitt, R. J., Ling, C. D., et al. (1997). The physical and chemical nature of technigas.
Journal of Nuclear Medicine, 38(10), 1327-33.