Many people like to feel intensely. Some people watch the melodrama of soap operas, knowing that every day they will get a jolt of intense, passionate emotion.

Some people like the sensation of speed and the adrenaline rush that comes with it. Other people call out to God, asking Him to give them a ?blessing?, and what they mean is that they want to have an intense experience of God. Some people experience intensity through rage, so they become intensely angry. Others like to take stimulants to make them feel high.

Other people just want to tone down the intensity of life, because it feels too strong. They shut the doors, extinguish the lights and sit alone, isolated from people, demands, problems and frustrations. Sometimes they take pills to dampen the impact of life.

Many people can?t feel like they want to unless they put some kind of chemical into their brains, and one of the most common substances used by people for this is alcohol. There are many things that could be said about the way people use alcohol (it?s a very common substance used in Bermuda), but one I encounter on a regular basis is the result of alcohol consumption on a baby as it grows inside its mother?s womb.

A significant body of literature associates maternal alcohol consumption during pregnancy with poor neurobehavioral outcomes in children. These children can be diagnosed with foetal alcohol syndrome (FAS) or alcohol-related neurodevelopmental deficit (ARND).

FAS is the more commonly recognised condition and is identified partly through physical abnormalities of the head and face. However, children with prenatal alcohol exposure on a regular basis can develop ARND in which there is no physical sign of prenatal developmental disability. The final months of gestation seem the most critical for the development of such problems.

As in FAS, children with ARND show cognitive and attention deficiencies, increased activity levels, problems in inhibition and self regulation, perseverative behaviour, expressive language and motor deficits. These symptoms all result from insufficient brain development as a result of the presence of alcohol in the mother?s blood system. They tend to acquire mood disorders such as bipolar or major depression. Such children are also frequently less responsive to medications and more resistant to traditional insight-oriented and cognitive behavioural therapies.

If you look closely at that list of symptoms, what you?ll see is a similarity to attention deficit hyperactivity disorder (ADHD). In fact, FAS, ARND and ADHD all share a common dysfunction of the executive centre in the brain.

Thus, in many cases it?s not that Johnny doesn?t get the right diet; it?s that whatever diet Johnny gets is going to be metabolised by the same brain and the circumstances of life will be just as difficult for him to organise.

Medications can help, but cognitive or insight psychotherapy has mixed returns; that is, they can help a person deal with the frustrations that come from trying to manage an executive dysfunction, and they can help to strategize organisational adjustments, but they cannot actually correct the dysfunction.

Positive experience can. It has been shown to ameliorate the influence of prenatal alcohol-related deficits; a nurturing home environment between the ages of 8 and 12 and extensive motor skill training can be both behaviourally and anatomically corrective.

These children can often benefit from behavioural approaches that reinforce desired actions and extinguish undesired performance.

The trick for parents, however, is in discovering what is experienced as positive by the child in question and having enough in themselves to create that experience in the family. Usually such families are torn apart by the burden and the relentless challenge children with an executive dysfunction present. Such families require more support from others than might otherwise be the case.