Canadian Task Force on Preventive Health Care

Overview The topic, children of alcoholics (COA), has not been previously addressed by the Canadian Task Force on the Periodic Health Examination. However, related topics, such as fetal alcohol syndrome and problem drinking, have been covered elsewhere in this book. The focus of this report is children aged 0 to 18 years, who live with an alcoholic, or alcohol-abusing parent. Clinical and research evidence worldwide clearly shows that COA are an at-risk population for diminished intellectual capacity and development, increased emotional problems, and a wide range of psychological and behavioral disorders. As well as being at risk, these children are also likely to experience long-term adverse consequences. Increased risk status comes from three sources: 1) genetic influences; 2) teratogenic factors during pregnancy; 3) environmental conditions related to the upbringing of the child by addicted parents. Several screening tests have been derived to identify children of alcoholics of which the Children of Alcoholics Screening Test (CAST) is the most frequently used child self-completed questionnaire. Services to COA are nearly non-existent, being limited to referral of children to individual or group therapy in Al-Atot or Al-Ateen. Although physicians have a low recognition rate of alcohol abuse in parents of hospitalized children, there is no evidence to show that routine screening of non-complainant offspring of alcoholic parents would improve the detection rate of various morbidities, or management of these children. However, physicians should be sensitive to the possibility of alcohol-related stressors in offspring of alcoholic, or alcohol-abusing parents, particularly in high-risk groups, such as children hospitalized for injury. Additionally, physicians are encouraged to offer support to COA and to assist COA to recognise that they have a right to seek assistance (C Recommendation). A separate chapter has also been prepared dealing with problem drinking (Chapter 42).