What is FASD?
Although the use of 'fetal' may imply that it only relates to babies; children, young people and adults can have FASD. The effects of fetal alcohol exposure may not be seen at birth. FASD ocurs in all parts of Australian society where alcohol is consumed. It has lifelong consequences, is extremely costly to our health, education, disability and justice systems and the personal costs to families living with FASD are enormous.
In 2014-2015 clinicians across the country trialled a FASD Diagnostic Instrument for Australia that had been developed by an Australian FASD Collaboration led by Professor Carol Bower from Telethon Kids Institute and Professor Elizabeth Elliott from the University of Sydney. Just as the Australian Diagnostic Instrument was finalised, a revised Canadian guide onthe diagnosis of FASD was published and so the Australian FASD Diagnostic Instrument was reviewed and modifications made.
The Australian FASD Diagnostic Instrument is harmonised with the Canadian Guidelines to adopt the concept that Fetal Alcohol Spectrum Disorder be used as a diagnostic term. Within FASD there are two categories:
- FASD with three sentinel facial features (similar to the previous diagnostic category of Fetal Alcohol Syndrome)
- FASD with less than three sentinel facial features (which encompasses the previous diagnostic categories of Partial Fetal Alcohol Syndrome and Neurodevelopmental Disorder - Alcohol Exposed)
Sentinel Facial Features
Less than a third of people will have FASD with three sentinel 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 FASD with three sentinel facial features 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
What are the problems for people with FASD?
- Developmental delay
- 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 - irritability, 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
PLEASE NOTE: THE AUSTRALIAN GUIDE TO THE DIAGNOSIS OF FASD WAS UPDATED ON 13 MAY 2016