The 'brutal reality' for alcohol-damaged children
A mother has laid bare the "brutal reality" of bringing up her adoptive son after he was left damaged by exposure to alcohol in the womb.
Judith Knox says her 12-year-old son has a range of behavioural problems as a result of Foetal Alcohol Spectrum Disorder (FASD).
It is estimated that as many as 172,000 people could be affected by the disorder in Scotland.
But Ms Knox said it took six years for her son to be properly diagnosed.
FASD is an umbrella term that describes the adverse physical and emotional conditions that affect people whose mother drank during pregnancy.
A new support service for parents and carers, called FASD Hub Scotland, has now been launched.
Ms Knox, who does not want to name her son or identify him through recent pictures, said the service was long overdue.
She told BBC Scotland: "This has put a lot of strain on the family.
"Your parenting is always being scrutinised and he just wants 100% of your attention, 100% of the time."
The 51-year-old and her ex-husband adopted their son at the age of seven months and he quickly began to exhibit a raft of worrying behaviour.
This included biting his fingers until they bled in a bid to stave off sleep, picking plaster from the walls to eat and ignoring the range of toys his family had bought him.
Her son was eventually diagnosed with FASD at the age of six, after doctors initially wrongly thought he had Attention Deficit Hyperactivity Disorder. But his behaviour continued to push his family to their limits.
"It was difficult then and it is still difficult," said Ms Knox, who is based in Fife.
"Sometimes you go around covering up bruises, that is the brutal reality.
"He has huge problems with social interaction, he is very intense and a lot of children find that difficult.
"He can also get involved in risky behaviours because of his disability, because of a lack of impulse control and it can lead down a road of vulnerability."
She added: "People have stopped and taken videos of my son taking a meltdown and us trying to protect ourselves.
"If we go out for the day we have to have a plan B, C, D and E."
Why is drinking during pregnancy so bad?
The NHS recommends the safest approach for pregnant women is not to drink alcohol at all to keep risks to their babies to a minimum.
The risks occur when alcohol passes across the placenta from the mother to the developing foetus.
The foetus cannot process alcohol effectively until the liver is fully developed and high levels of alcohol can affect the development of organs and the brain.
It is thought foetuses are most at risk during the first three months of pregnancy when organs are forming - but damage can occur at any time.
Those affected by FASD can have a range of issues, such as differences in their facial features as well as learning and behavioural difficulties.
It is estimated approximately 3.2% of babies born in the UK are affected by FASD, which is nearly four times the rate of autism, but it often goes undiagnosed or is misunderstood by doctors and the public alike.
Children looked after or adopted are at significantly increased risk of having FASD, with 75% of children referred for adoption having a history of alcohol exposure during pregnancy, according to Scottish government figures.
Ms Knox said that, despite the severe challenges with her son's behaviour, he remained very caring and described him as "charming and very funny".
She added the teenager, who is a resident at a specialist support school, plays the drums and guitar, which is when he is at his happiest.
Looking to the future, she said her aspirations for him were simple.
"I hope he can tell the time, deal with money and keep himself safe and not end up in a bad situation," she said.
'We cannot cure FASD'
The FASD Hub Scotland will provide direct support services for people affected by, or living with, FASD.
Ms Knox, who will work on the new service being launched by Adoption UK Scotland, said it would be a boon for people in her situation.
"I was given no information about the condition or where I could go for help and advice," she said. "At that time, I knew of no other parent or carer in the same position and I felt very alone and isolated."
Project Lead Aliy Brown added: "We cannot cure FASD, but many people can live very successfully with it, if provided with the right support at the right time."
The support service has been given £140,000 by the Scottish government.
Public Health Minister Joe FitzPatrick said: "A diagnosis of FASD is difficult for families and we can't underestimate the challenges each diagnosis brings.
"It is vital that we recognise the needs of this group of children and young people and ensure that the right support is available to them and their families when they most need it."