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Background: The Canadian fetal alcohol spectrum disorder (FASD) diagnostic guideline provides clinicians with the process and procedure to reach an accurate diagnosis. However, organisational structure, culture, and resource utilisation vary. The objectives of this study were to identify the key challenges and strengths of successful FASD diagnostic clinics. Method: Qualitative interviews were conducted with 12 key informants from 10 clinics representing different regions, populations served, and clinic structures. Data analysis was performed using iterative thematic inquiry. Results: Three themes related to challenges and four themes related to strengths were identified. Human resources were identified as both a challenge and strength. Additional challenges were diagnostic capacity and system level support. Additional strengths were clinic adaptability, relational connections, and culturally responsive approaches. Conclusions: FASD clinics are more alike than not in their approach to assessment and diagnosis. Some clinics are facing similar challenges that others have overcome, supporting the need for mentorship and consistent operating standards. [ABSTRACT FROM AUTHOR]

Access to diagnostic and assessment services for fetal alcohol spectrum disorder in adults is relatively rare in the world. Since 2002, the Lakeland Centre for Fetal Alcohol Spectrum Disorder (LCFASD) in northeastern Alberta has been providing community-based, mobile diagnostic and assessment services for adults prenatally exposed to alcohol. This article describes the community-based model developed by the LCFASD, the clinical findings of the diagnostic team and the successes and challenges experienced by the team. L'acces a des services de diagnostic et d'evaluation des troubles du spectre de l'alcoolisation foetale chez les adultes est relativement rare dans le monde. Depuis 2002, le Lakeland Centre for Fetal Alcohol Spectrum Disorder (LCFASD), au nord-est de l'Alberta, fournit des services communautaires mobiles de diagnostic et de traitement des adultes qui ont ete exposes a l'alcool avant la naissance. Cet article decrit le modele communautaire cree par le LCFASD et les constatations cliniques de l'equipe de diagnostic, ses succes et les defis auxquels elle est confrontee., INTRODUCTION The Lakeland Centre for Fetal Alcohol Spectrum Disorder (LCFASD) in Cold Lake, Alta., opened in 2001 to support a local group of hard-working and dedicated professionals who were contributing [...]

Mixed-income housing is an increasingly popular approach to providing affordable housing. The technique largely went unnoticed until developers of mixed-income housing constructed buildings containing separate entrances for rich and poor residents. The ensuing "poor door" controversy illustrated that mixed-income housing, as both a method of affordable housing production and an integration strategy, is in unacknowledged tension with itself. This Article argues that mixedincome housing is implemented as a surreptitious form of racial and economic integration that accommodates and replicates prevailing race and class assumptions detrimental to the needs and interests of low to moderate-income individuals in need of housing. The mixed-income housing strategy, at its heart, serves as a form of discrimination management--a way to work around the race and class discriminatory impulses of residents within a development and within a particular jurisdiction. This Article recommends ways in which to think more critically about this important question of community design in ways that account more honestly for the limits and possibilities of how we may choose to use affordable housing for race and class integration. [ABSTRACT FROM AUTHOR]

While the nature of the formal transition to adulthood has changed over the past decade, it continues to be premised on the notion of achieving independence. Individuals with Fetal Alcohol Spectrum Disorder (FASD), however, may never reach full independence in their adult years, instead more so achieving interdependence. Consequently, their transition into adulthood may be particularly challenging because of the expectation of increased responsibilities and autonomy in many areas of life. While there is considerable interest in the area of transitional aged youth and youth leaving care, there is much less research addressing the needs of those with developmental disabilities, particularly FASD, leaving care and transitioning to adult services. It is not clear what services currently exist in Canada for transitional aged youth with FASD. Furthermore, it is also unknown to what extent existing programs enable youth with FASD to successfully transition into adulthood. Using a state of- the-art review method, the purpose of this project was to review the literature on transition planning processes for youth with FASD from across Canada to determine the strengths and challenges of these existing transition planning tools, and to provide recommendations for the future for youth with FASD and their families. [ABSTRACT FROM AUTHOR]

A central, symbolic image supporting property ownership is the image of stability. This symbol motivates most because it allows for settled expectations, promotes investment, and fulfills a psychological need for predictability. Despite the symbolic image, property is home to principles that promote instability, albeit a stable instability. This Article considers an overlooked but fundamental issue: the recurring instability experienced by minority property owners in ownership of their homes. This is not an instability one might attribute solely to insufficient financial resources to retain ownership, but instead reflects an ongoing pattern, exemplified throughout the twentieth century, of purposeful involuntary divestment of land owned by members of racial minorities, particularly Black Americans. The subprime mortgage crisis, the most current manifestation of this involuntary land loss, can be attributed to property doctrine's policy embrace of markets and importation of contract principles such as the "freedom of contract"This embrace of markets and contracts ignores the reality that real estate markets are racially segregated, and due to the nature of those disparate markets, easily exploitable. The current racially concentrated subprime mortgage crisis has torn the stable property image apart by revealing longstanding truths: that fraud, exploitation, and desperation are not anomalous. These truths present a disquieting reality: that the persistent and enduring experience for minorities is instability. They also present an overlooked insight that there is a dark side of property ownership: that fraud, exploitation, and desperation are the bad that enables the good of property markets. Because this "bad" is both ubiquitous and geographically situated, it suggests that stability for some within the system of property ownership is provided at the expense of instability for others. This Article argues that we should begin to pay attention to an under- theorized stick in the bundle of property rights: "the right to keep". [ABSTRACT FROM AUTHOR]

Presents information on the Empowerment Zone Program, a community and economic development program in the United States. Domestic trilogy of economic, community and community economic development; Development as a post-civil-rights-era strategy; Analysis on the Empowerment Zone Program's attempt to split the difference between economic and community development.

The article presents a response to the criticism on Fetal Alcohol Spectrum Disorder: Canadian guidelines for diagnosis by McLennan and Braunberger. It states evidence, interventions, and treatment continuously evolve and fair and objective assessment still continue to provide guidance and broad range of treatments such as occupational therapy and social skills training for neurological and cognitive deficits and FASD are included and addresses all criticisms.

Background: Diagnosis of fetal alcohol spectrum disorder (FASD) is relevant for the reduction of long term adverse sequalae. However, the diagnostic guidelines require a multidisciplinary approach which may hinder access to diagnostic and management services. Most diagnostic clinics are located in urban areas. There is less emphasis on the operations, capacities, and outcomes from rural diagnostic clinics., Methods: Over a ten and half years of clinic operations to diagnose children and subsequently adults, all consenting adults provided answers to interviews, participated in measurements and other diagnostic procedures. Information was collected on their contact with mental health services. Comparison of the findings with those from other established clinics included variables relevant to outcome measures., Results: 375 individuals were referred, assessed and diagnosed according to the existing guidelines for FASD diagnosis. Alcohol-related neurodevelopmental disorder (ARND), which was closely associated with age, was the most prevalent FASD diagnosis. One third of those diagnosed had IQ above the average range and ADHD was the most relevant clinical correlate. The diagnostic clinic was able to complete diagnosis on potentially 37.5% of likely affected individuals., Conclusion: FASD can be diagnosed in children and adults in a rural setting. ADHD and other mental disorders should be a focus for treatment in affected individuals especially adults. It is important to consider the impact of age on the outcome of FASD. To increase diagnostic capacity, clinic operations could be modelled similarly.

There are few FASD multi-disciplinary diagnostic teams in rural regions of Canada. Families often have difficulty accessing their services because of the lack of clinics available in Canada and the distance rural residents must travel to access one. Since its grass-roots beginning in 1995, the Lakeland Centre for FASD in north eastern Alberta has developed a community-based FASD diagnostic services model that utilizes the resources available in local communities and enhances the support to individuals and families living far away from urban centers. The article describes the history of the Lakeland Centre for FASD relative to the development of the model and diagnostic process used to diagnose children and adults. Rural adaptations to similar urban models are discussed. Critical elements to rural, in-kind services are also discussed along with ongoing challenges. Acknowledging the change in terminology over the years covered by this article, the term FASD (Fetal Alcohol Spectrum Disorder) is used throughout.