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By Anne Blythe

The courtroom on the seventh floor of the Wake County Justice Center was quiet as Judge Vince Rozier read a report from the mother of the 28-year-old defendant awaiting sentencing.

That mother, Theresa Morris-Brown, is a petite 63-year-old woman with a gargantuan will to help the man she welcomed into her life as a 4-year-old. The boy, now grown, was arrested in June for pushing her to the ground and wrapping a belt around her neck.

In the unusual position of being both the defendant’s victim and mother, Morris-Brown pleaded with the judge not to send her son to prison.

“The reason that I stand here and I ask you not to give him active time is because active time is not going to make any difference to the things that have happened in the past,” Morris-Brown explained.

Desmond Brown sat beside a public defender, wearing the orange and white jumpsuit issued to him after he was booked into the Wake County Detention Center on June 19.

His mother had called the police after he pushed her to the ground while going after the prescribed painkillers she kept in her bra. He sat on top of her and squeezed a belt tight against the hand she slipped near her neck to stave off suffocation.

Brown got what he wanted, then grabbed his mother’s wallet and car keys and fled.

As much as it pained her to do it, Morris-Brown called the police.

She hoped an arrest might also arrest a pattern of behavior that neither she nor her son could control any more.

Morris-Brown asked the judge to take a long-term view of her son’s immediate needs.

“What I’d like to explain to your honor is that we have been trying to get some help for my son,” Morris-Brown said after Brown rose beside his attorney and pleaded guilty to the assault and related charges. ”He presently suffers from brain damage that was caused by prenatal exposure to alcohol.”

Brown, adopted 24 years ago by Morris-Brown and her then-husband, was born to a mother who used cocaine and consumed alcohol during her pregnancy.

Theresa Morris-Brown, 63, waits in a courtroom for her son’s case to go before a judge. She is trying to get him help for fetal alcohol syndrome disorder. Photo credit: Anne Blythe

It was not until last year, though, that he was diagnosed with fetal alcohol spectrum disorder. The diagnosis pinpointed and validated the source of problems that contributed to Brown repeating the 6th and 10th grades, having behavioral problems at school, and making poor decisions that had resulted in other brushes with the law.

“It keeps him from understanding consequences and understanding causes,” Morris-Brown told the judge. “It also makes his impulse-control very dull.”

Brown also cycles in and out of depression. He’s used alcohol and drugs to self-medicate, his mother acknowledged.

“By adding on the drug use and his mental health issues, it has made it very difficult to find the right kind of treatment for him that will allow him to learn ways of dealing with things versus impulsively dealing with things,” Morris-Brown told the judge.

‘Sweetest little thing’

Brown was 4 years old when Morris-Brown decided she would have him join her household.

She had been a foster parent already and taken in a girl who “pretty much” became her daughter even though there was no official adoption.

“I had always wanted to adopt,” Morris-Brown said. So she and her former husband used an adoption agency to add to their family.

“We spent a day and a half with Desmond and decided ‘this is our son,’ ” Morris-Brown recalled recently. “He was the sweetest little thing. He was this little itty bitty munchkin. My husband thought he looked like him.”

They brought him from Union County back to Wake County, where he has lived ever since.

‘North Carolina needs a task force’

Larry Burd, director of the North Dakota Fetal Alcohol Syndrome Center at the University of North Dakota School of Medicine and Health Sciences in Grand Fork, estimates that one in 20 people are affected by fetal alcohol spectrum disorder, referring to two recent studies looking at first-grade students to come to that conclusion.

He compared the results of these studies to research estimating that one in 56 children have been diagnosed with autism spectrum disorder. Attention to autism research and program funding has flourished in recent decades. Meanwhile, he argues, fetal alcohol spectrum disorder likely affects more people but public knowledge and understanding of it are nowhere near the recognition level of autism.

Burd and others working to enlighten the public about how many babies are born each year in the United States with fetal alcohol spectrum disorder hope to make screening for the disorder as routine as it is for autism.

He said this would allow physicians, community caregivers, schools, foster care programs, justice system workers and others to better recognize the genesis for certain behaviors and shortcomings in kids. That might result in better intervention, treatment and rehabilitation plans.

“What’s really lacking now,” Burd said in a recent telephone interview, “is organization and recognition at the state level. North Carolina needs a task force.”

Burd co-authored an article last year estimating that rates of the disorder are between 10 to 40 times higher in foster care, special education programs, indigenous populations and the juvenile and adult corrections systems.

Some people afflicted with the disorder might be smaller than average and have a small head size or abnormal facial features such as a smooth ridge between the upper lip and nose. But Burd argues outward symptoms are not always immediately obvious.

Other, less distinct symptoms include poor coordination, attention deficits, speech and language delays, poor memory, difficulties in school, especially math, poor judgment and reasoning skills and hyperactivity, according to a Centers for Disease Control and Prevention fact sheet.

“It has a tremendous range of expression,” Burd said.

No real answers

Morris-Brown noticed some developmental delays after bringing her son home from the adoption agency but initially chalked it up to the instability of his early life.

By the time he was in the 5th grade, though, Morris-Brown knew her son was going to need more specialized and individualized care. At school, an Individualized Education Plan was mapped out for him, but it failed to guide him successfully to a high school diploma.

Brown got angry when things did not come easily to him. He had limited ability to control his impulses.

“If he saw something he wanted, he would just take it,” Morris-Brown said. “More or less, it was from the home. …Money, jewelry. If it caught his eye, he would just take it.”

He also was lying to his mother more. Looking back, she wonders if he was just making up stories because of memory issues that accompany the disorder.

“The older he got, the more consequences there were,” Morris-Brown said.

He dropped out in the 11th grade after repeating his first year of middle school and his sophomore year in high school. He dropped out, eventually completing a GED.

“He just wouldn’t go back to school,” his mother said. “It wasn’t that he wouldn’t do things, it was that he couldn’t.”

Infographic credit: CDC

Morris-Brown, like other parents with children suffering from fetal alcohol spectrum disorder, talked about the downward spiral her son sometimes got in.

“He has an average IQ, he’s very smart in some things. Nowadays, he feels he’s smart in the ways of the street,” Morris-Brown said. “He can’t compete with the neuro-typical kids.”

The brain injury borne by his mother’s alcohol use left him developmentally behind his peers, resulting in frustration that sometimes leads to bleak spells with self-loathing and depression.

Brown has had years of therapy. His mother wonders whether his occasional drug use is his way of self-medicating for the darkness he slips into.

“He takes opiates,” Morris-Brown said in mid-October. “It probably was the drug of choice of the people he was hanging out with.”

Morris-Brown began to lock up the pain medicine she had been prescribed for the fibromyalgia that makes her bones and muscles ache. When the lock no longer deterred him, she carried the pills in her bra.

New paths for mother and son

As Morris-Brown stood before Judge Rozier, she knew both she and her son needed to forge new paths with behavioral changes for both of them.

She wonders if she had known earlier in his life what his true diagnosis was, perhaps neither of them would have been in the Wake County courtroom on Oct. 23.

Prenatal exposure to alcohol can cause abnormalities in the frontal lobe and prefrontal cortex, which control impulses, judgment and executive functions, brain imaging has shown.

“I didn’t know what I was doing,” Morris-Brown said. “It’s difficult, especially when they become adults. You try to guide them and help. I function as his ‘external brain.’ But once he became an adult, he didn’t want advice from his mother.”

The advantage of an earlier diagnosis might have meant that Morris-Brown, foster-care providers, school counselors, teachers, resource officers and the justice system that eventually netted him could have stressed his successes early on instead of magnifying developmental differences that reinforced a more negative self-image.

Rozier asked about Brown’s previous brushes with the law as he weighed the treatment plan presented to him as an alternative to imprisonment.

Neither the prosecutor nor the public defender offered much to the judge about the underlying disorder. Morris-Brown did most of the talking, opening up about her and her son’s story, she later said, to shine a light on the disorder and highlight a possible path for others who don’t have as staunch an advocate.

Brown is scheduled to be released from jail the first week of November and placed with one of Wake County’s mental health probation officers. He’ll go to a facility for nine months, where he will get mental health and drug treatment and take part in residential and job-skill programs.

Morris-Brown advocated for the court-ordered treatment. If her son does not comply, his probation can be revoked and incarceration restored. She asked for that, hoping to dissuade her son from dropping out of treatment as he has before.

“As blessed and as appreciative that I am that we ended up catching a judge that really wanted to listen and think it through,” Morris-Brown said, “that’s not normally what happens.”

Brown called his mother from jail hours after the judge made his ruling.

“He says he feels relieved,” Morris-Brown said. “He’s very remorseful for what happened.”

On June 19, before Brown was arrested, he returned to his mother’s home and told her he did not know why he did what he did.

“He told me the other day, he never would have thought he would have done something like that,” Morris-Brown said. “I think this whole thing has scared him.”

It delivered a blunt blow to Morris-Brown, too. She knows she has to wean him from depending so much on her, both emotionally and financially.

“He will need some kind of support. He will always need to have somebody he can rely on to help,” Morris-Brown said after the court hearing. “My dream is that we can get him in enough of these life-skill programs where he can become interdependent.”

Comprehensive coverage elusive

Another hurdle long term for Brown will be getting Medicaid. Morris-Brown has tried twice but been turned down both times.

Kathy Hotelling, another advocate in North Carolina for raising awareness about fetal alcohol spectrum disorder and the challenges and costs associated with it, said the best solution for Brown would be coverage through the Medicaid Innovations Waiver.

The program is designed to meet the needs of people who need long-term support for intellectual or developmental disabilities but would be better served  in their home or community instead of an institution.

But there’s a waiting list of 13,000 people for those services. Getting longer-term help could take years.

“He’s going to need long-term care,” Dedrick Battle, a social worker with Alliance Behavioral Health and Wake County court liaison, told the judge. “This is not just yearlong.”

Anne Blythe

Anne Blythe, a reporter in North Carolina for more than three decades, writes about oral health care, children's health and other topics for North Carolina Health News.

One reply on “Does North Carolina do enough to help children affected by a mom’s prenatal alcohol use?”

  1. Thank you, Anne, for a sensitive and powerful article about the ravages of alcohol on the fetus. If you feel your child may suffer from the effects of alcohol in utero, please take two actions: 1) look at NCFASD Informed, a non-profit dedicated to raising awareness of FASDs in NC. 2) contact me directly about how to get help.

    It is estimated that as many as 80% of children in the foster care system have an FASD. Unfortunately, 90% of all with an FASD are misdiagnosed and have the missing diagnosis of FASD.

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