What is FASD?

What is FASD?

 

Fetal Alcohol Spectrum Disorders

 

Fetal Alcohol Spectrum Disorders (FASD) is an umbrella term which refers to a range of conditions caused by prenatal exposure to alcohol.

 

The range of conditions within the spectrum include:

  • Fetal Alcohol Syndrome
  • Partial Fetal Alcohol Syndrome 
  • Neurodevelopmental Disorders - Alcohol Exposed

 

Although the use of 'fetal' may imply that these conditions only relate to babies; children, young people and adults can have one of these conditions. The effects of fetal alcohol exposure are life-long and may not be seen at birth.

 

 

Fetal Alcohol Syndrome

 

A minority of children will have Fetal Alcohol Syndrome (FAS) or Partial Fetal Alcohol Syndrome (pFAS) which can be identified by abnormal facial features:

  • a smooth philtrum (no groove between the upper lip and nose)
  • thin vermillion border (thin upper lip)
  • short palpebral fissures (small eye openings)

 

 

The facial development of the fetus occurs mainly between weeks 4 and 8 (often before a woman knows she is pregnant). The distinctive facial features of Fetal Alcohol Syndrome and Partial Fetal Alcohol Syndrome are included in the photos below. Photos have been reproduced with permission from Susan Astley, University of Washington

For more information please go to the University of Washington FAS Diagnostic & Prevention Network website

 

 

FAS Facial features

 

 

 

  

Children with  Fetal Alcohol Syndrome will also have:

  • low birth weight 
  • a small head (microcephaly)
  • poor growth 
  • brain damage
  • social and behavioural problems
  • delayed development
  • low IQ

 

 

Birth defects are not unique to prenatal alcohol exposure and may have other causes.  Birth defects identified in children exposed to alcohol in pregnancy can include:

  • heart defects
  • cleft lip and palate
  • genital defects
  • kidney problems
  • cerebral palsy
  • limb anomalies such as curved little fingers, extra fingers or toes, additional creases in hand

 

 

 

Partial Fetal Alcohol Syndrome

A baby or child with Partial Fetal Alcohol Syndrome will have some but not all of the symptoms of Fetal Alcohol Syndrome.

 

 

 

Neurodevelopmental Disorders - Alcohol Exposed

The majority of children with FASD will fall within this category. They will not have the facial features of Fetal Alcohol Syndrome but will have a range of symptoms caused by damage to the brain structure of the developing fetus and will have lifelong effects on the person.

 

 

The diagram below shows which parts of the brain are responsible for how we think, act and behave and the problems that may be caused by prenatal alcohol exposure.

 

 

Brain development & alcohol

 

 

What are the possible effects on babies and infants:

 

  • low birth weight
  • decreased muscle tone and poor coordination
  • delayed development such as walking and talking
  • hypersensitivity to noise, light and touch
  • bonding problems
  • irritability
  • poor feeding
  • poor waking/sleeping patterns

 

 

What are the problems?

 

  • Developmental delay
  • Poor growth
  • Low IQ - only a small percentage of people will have an 'Intellectual Disability' (IQ <70) ... most will register at the lower end of normal. But a low IQ indicates a degree of cognitive impairment
  • Poor language and communication skills - may seem competent and agree but not understand
  • Slow cognitive and auditory pace
  • Poor memory and short attention span
  • Poor judgement and inability to understand cause and effect
  • Repeating the same actions or behaviours in the absence of a rationale for that behaviour or emotion
  • Poor organisational and planning skills
  • Difficulty with abstract concepts
  • Problems with maths, time and money
  • Impaired judgement and impulsivity
  • Emotional - irrability, angry, frustrated, immature
  • Sensory problems - noise, lighting, pain, cold
  • Motor co-ordination problems
  • Difficulty sleeping
  • High levels of activity
  • Social and behavioural problems
  • Difficulty forming and maintaining relationships and sometimes being indiscriminately friendly

 

 These can lead to ...

 

  • Difficutly planning, setting golas, being on time and complying with legal obligations
  • Issues at school
  • Multiple foster care placements
  • Reduced self-esteem and depression
  • Inappropriate sexual behaviour (victim and perpetrator)
  • Inability to live independently
  • Unemployment
  • Poverty
  • Trouble with the law

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Researchers and parents say that it is not 'bad behaviour' but the actions of a person who has damage to their brain and who is unable to control what they do.  

 

 

People with a FASD grow, change and improve if their enviornment provides support for their cognitive differences. Early recognition of alcohol-exposed infants and early diagnosis of FASD is crucial to allow a process of assessment and therapy for children at the earliest age possible to improve their social, health and educational outcomes; an decrease the risk of secondary disabilities such as school failure, unemployment, substance abuse, mental health disorders, and engagement with the criminal justice system

 

 

The aim is to improve long term outcomes for children, to help treat vulnerable women and their families, and to prevent subsequent births of affected children. Read more about Diagnosing FASD.

 

 

 

 

Is FASD a new phenomena? 

There is reference to negative child outcomes from alcohol consumption during pregnancy as far back as the ancient Greeks and Romans and in medical literature from England in the 1800's.  Read more about the history of FASD


               

 

 

Australian FASD Advocacy and Support Organisations

 

 

NOFASD logo

 

NOFASD Australia is an independent not-for-profit charitable organisation. They are the national peak organisation representing the interests of individuals and families living with Fetal Alcohol Spectrum Disorders (FASD). Their Vision is the prevention of alcohol exposed pregnancies in Australia and an improved quality of life for those living with FASD. For more information please visit the website, contact them via email or phone 1300 306 238

 

 

 

 

 

rffada logo

 

rffada is a national not-for-profit health promotion charity dedicated to ensuring that individuals affected prenatally by alcohol have access to diagnostic services, support and multidisciplinary management planning in Australia and that carers and parents are supported with a "no blame no shame" ethos. For more information please visit the website or contact them via email.

 

 

 

 

 


 

What are the problems?

Developmental delay

Poor growth

Low IQ - only a small percentage of people with FASD will have an intellectual disability … most register at the lower end of normal.  But a low IQ indicates a degree of cognitive impairment

Poor language & communication skills - may seem competent and agree but not understand

Slow cognitive & auditory pace

Poor memory and short attention span

Poor judgement and inability to understand cause and effect 

Repeating the same actions or behaviours in the absence of a rationale for that behaviour or emotion

Poor organisational and planning skills

Difficulty with abstract concepts

Problems with maths, time and money

Impaired judgement & impulsivity

Emotional - irritability, angry, frustrated

Immature

Sensory problems - noise, lighting, pain, cold

Motor coordination problems

Difficulty sleeping

High levels of activity

Social and behavioural problems

Difficulty forming and maintaining relationships and sometimes being indiscriminately friendly

Cost of FASD to the community

International research estimates a lifetime cost of US$2.5 million per person with FAS - includes service use and loss of productivity (Popova et al 2011)