Fetal Alcohol Spectrum Disorder

What is FASD?

Fetal Alcohol Spectrum Disorder (FASD) is a group conditions recognized by the International Classification of Diagnoses (ICD-10) occurring in children due to in utero exposure to ethanol when the mother consumes alcohol during pregnancy. It is characterized by a cluster of irreversible birth defects including abnormalities in physical, mental, and behavior development with varying degrees of severity.

Alcohol can harm a baby at any stage during pregnancy, including the earliest stages before a woman is even aware that she is pregnant. 

Effects can include physical and behavioral problems such as trouble with:

  • Learning and remembering
  • Understanding and following directions
  • Controlling emotions
  • Communicating and socializing
  • Daily life skills such as feeding and bathing

Fetal Alcohol Syndrome is the most serious type of FASD. Common abnormalities in people with Fetal Alcohol Syndrome are:

  • Growth deficiency (prenatal and postnatal)
  • Joint abnormalities
  • Facial abnormalities
  • Mental deficiencies

Causes

Prenatal exposure to alcohol in any quantity

Identification

The identification of FASD is made through clinical presentation, after having ruled out other diagnostic possibilities to explain the neurodevelopmental disorder, although it can be identified with the presence of specific facial features.

Assessment & Diagnosis

There are no laboratory tests to confirm the diagnosis of FASD. Instead, the assessment must be made in a clinical environment which can include cognitive, psychometric, and behavioral assessments as well as a physical examination. Like other neurodevelopmental disorders, early diagnosis allows for earlier interventions which can result in improved outcomes (Alex at al, 2012).

Management

Although there is no cure for FASD, evidence shows that treatment, particularly early interventions, can help with managing its impact. That said, due to its varying degrees of effects and severity, treatment must be determined at an individual level, as Koren et al state: “as a diagnosis of FASD in and of itself does not provide enough information on the appropriate treatment that must be provided, a careful assessment of each individual is essential.” Like in other types of disabilities, it is important to recognize the variety of presentations that is possible and pursue a functional and individualized approach. This will frequently require the input from a team of professionals not only from the health system but also from the educational system in order to put supports in place that help children and youth to best regulate their behaviors and learn to the best of their potential. “Current educational strategies therefore have to be symptomatically based (Hannigan and Bermann 2000), and a personalized approach to assessment and intervention is needed (Carpenter et al, 2011). Paley and O’Conner (2009:259) emphasize the importance of ‘thorough assessments that are designed to evaluate functioning across multiple domains.’“(in Carpenter et al, 2014)

Related Disorders

ADHD, ODD/CD, Learning Disabilities, Behavioural Disorders

Literature

Alex, K., & Feldmann, R. (2012). Children and Adolescents with Fetal Alcohol Syndrome (FAS): Better Social and Emotional Integration After Early Diagnosis [Kinder und Jugendliche mit Fetalem Alkoholsyndrom ( FAS ): Bei frühzeitiger Diagnose bessere soziale und emotionale Entwicklung.] Klin Padiatr, 224, 66–71.

Carpenter, B. (2014). Evolving Pedagogy For Children and Young People with Fetal Alcohol Spectrum Disorders. In B. Carpenter, C. Blackburn, & J. Egerton (Eds.), Fetal Alcohol Spectrum Disorders - Interdisciplinary Perspectives (pp. 123 – 140). Oxon, UK and New York, USA: Routledge.

Koren, G., Zelner, I., & Nash, K. (2014). Foetal alcohol spectrum disorder: identifying the neurobehavioural phenotype and effective interventions. Curr Opin Psychiatry, 27(2), 98–104. http://doi.org/10.1097/yco.0000000000000038