An expert is calling for more support for those with fetal alcohol spectrum disorder (FASD) - a neurodiverse condition not officially recognised as a disability.
A leading cause of intellectual disability, FASD is similar to a brain injury and has lifelong symptoms. The Ministry of Health says issues for those who have FASD often increase with age.
It's estimated about 3000 babies each year in New Zealand are born with FASD - but that's only based on international evidence, as there are no statistics on its prevalence here.
Anita Gibbs, an associate professor of social work and criminology from the University of Otago, says it's believed to be about three-and-a-half times as prevalent as autism.
"The prevalence rates are incredibly high - but we don't actually have the official prevalence rates in this country, so we guess basically," Professor Gibbs told Newshub.
"It's a reasonable guess of about 3000 children being born every year with this disability - but it's unrecognised through the Disability and Support Services at this stage, and we hope that will change.
"It's almost like we haven't known about it in New Zealand but the international research has been around for 50-70 years, so with our high drinking rates it's almost like, 'do we actually want to know about it?'
"Because whilst it's a hidden disability, I sense that it's an unwanted disability because a lot of people who suffer get socially ostracised or stigmatised."
Neuropsychologist Dr Brandon Park, who founded New Focus Academy to help adolescents with developmental delays says FASD, or any kind of prenatal substance exposure, is included under the neurodiversity umbrella because of the wide range of effects it can have on the brain of a foetus.
"The degree of symptoms depends on timing, frequency, amount of parent substance use - but it can be unpredictable," he explains.
"All of these substances have an effect on adult's brains. Before birth, as a child's brain is rapidly developing, they are even more vulnerable to the effects of these substances."
Professor Gibbs says the behaviour of those with FASD is often seen as antisocial and the impact of FASD on families, including parents, is huge.
"In reality, if they were given the correct support and help, it probably wouldn't be the case. They know stuff is up with their kids and they ask for help, and they often get turned down because, even when they get diagnosed, they might not get funding."
She says simple, everyday tasks can be a struggle for children with FASD.
"The children get lost, I think… they're seen as children who might be naughty and able to sort themselves out, but they find that very difficult on a daily basis and they need a lot more help than they're actually getting."
FASD is permanent and can't be treated due to the damage alcohol causes to the brain. Professor Gibbs says the effects of FASD often lead to hyperactivity and concentration struggles.
"It's pretty full-on for families who have children born with FASD, and most people wouldn't identify it necessarily because they wouldn't know it could impact. Still, there's this myth that a few drinks [while pregnant] are OK, but the international guidelines and research tells us that really, there's no safe limit."
Professor Gibbs says it's a long, hard journey for many parents who have children with FASD. She says more support is needed in schools and professionals need to be trained to understand the disorder.
"We need to give these children a break because they're trying to be the square peg fitting into a round hole. They try really hard and people get impatient with them."
But there remains no support or help in New Zealand's education system for children with FASD. Professor Gibbs is fighting to change that.
"When you think of other disabilities, you'd provide additional aids and supports and accommodations, and we don't do enough of that with these brain-injured kids because we can't see it in the same way," she says.
"We need to give them more time to do stuff - to do tasks… We just need to treat them sometimes as if they're younger than their actual chronological age because they've got a bit more maturing to do down the track because their brain has been harmed in some way."
Until more is done, the outcomes for children with FASD are grim. The Ministry of Health says children born with FASD are at higher risk of substance abuse and mental health problems, and of eventually ending up in the criminal justice system.
The ministry released an action plan on FASD in 2016, aiming to expand on several social and public health sector resources about the condition.
"These initiatives are undertaken by a number of organisations including the Health Promotion Agency and public health units and non-Governmental groups such as Alcohol Healthwatch," it says.
But Professor Gibbs hopes to see more done in the near future.
"We need to have recognised services for some of these children to enable them to have that flourishing life."
