What Are Fetal Alcohol Spectrum Disorders?
Fetal alcohol spectrum disorders (FASDs) are developmental disorders. Developmental disorders (or developmental disabilities) are a group of conditions and impairments in physical, learning, language or behavior that affect daily life. These disorders are primarily diagnosed in children, but present before the age of 22.
FASDs are a group of conditions that can occur in a person who was exposed to alcohol before birth. These effects can include physical problems and problems with behavior and learning. Often, a person with an FASD has a mix of these problems. A baby who is exposed to alcohol before birth can be born with an FASD.
Children with FASDs often have problems with learning, attention, memory and problem solving, along with poor coordination, impulsiveness, and speech and hearing impairments. As children with FASDs grow up, school behaviors, emotional and social problems often get worse.
Types of Fetal Alcohol Spectrum Disorders
Fetal alcohol spectrum disorders (FASDs) are a group of conditions that can occur in a person who was exposed to alcohol before birth. These disorders are labeled under the umbrella term “spectrum” depending upon the symptoms or conditions present.
- Fetal Alcohol Syndrome (FAS): Low body weight, poor coordination, hyperactive behavior, difficulty with attention, poor memory, difficulty in school, learning disabilities, speech and language delays.
- Partial Fetal Alcohol Syndrome (pFAS): Milder symptoms of the above
- Alcohol-related birth defects (ARBD): A mix of any of the following possible problems with the heart, kidneys or bones, or with hearing
- Neurobehavioral disorder associated with prenatal alcohol exposure (ND-PAE): Problems with thinking, behavior and life skills
Causes of Fetal Alcohol Spectrum Disorders
FASDs can occur when a person is exposed to alcohol before birth. Alcohol in the mother’s blood passes to the baby through the umbilical cord.
There is no known safe amount of alcohol during pregnancy or when trying to get pregnant. There is also no safe time to drink during pregnancy. Alcohol can cause problems for a developing baby throughout pregnancy, including before a woman knows she’s pregnant. All types of alcohol are equally harmful, including all wines and beer.
Risk Factors for Fetal Alcohol Spectrum Disorders
To prevent FASDs, a woman should avoid alcohol if she is pregnant or might be pregnant. This is because a woman could get pregnant and not know for up to four to six weeks.
It is never too late to stop alcohol use during pregnancy. Because brain growth takes place throughout pregnancy, stopping alcohol use will improve the baby’s health and well-being.
FASDs are preventable if a baby is not exposed to alcohol before birth.
Screening for & Preventing Fetal Alcohol Spectrum Disorders
To prevent FASDs, a woman should avoid alcohol if she is pregnant or might be pregnant. This is because a woman could get pregnant and not know for up to four to six weeks.
It is never too late to stop alcohol use during pregnancy. Because brain growth takes place throughout pregnancy, stopping alcohol use will improve the baby’s health and well-being.
FASDs are preventable if a baby is not exposed to alcohol before birth.
Signs & Symptoms of Fetal Alcohol Spectrum Disorders
FASDs refer to a collection of diagnoses that represent the range of effects that can happen to a person who was exposed to alcohol before birth. These conditions can affect each person in different ways, and can range from mild to severe.
A person with an FASD might have:
- Low body weight
- Poor coordination
- Hyperactive behavior
- Difficulty with attention
- Poor memory
- Difficulty in school (especially with math)
- Learning disabilities
- Speech and language delays
- Intellectual disability or low IQ
- Poor reasoning and judgment skills
- Sleep and sucking problems as a baby
- Vision or hearing problems
- Problems with the heart, kidneys or bones
- Shorter-than-average height
- Small head size
- Abnormal facial features, such as a smooth ridge between the nose and upper lip (this ridge is called the philtrum)
Diagnosing Fetal Alcohol Spectrum Disorders
Diagnosing FASDs can be hard because there is no medical test (like a blood test) for these conditions. And other disorders, such as ADHD and Williams syndrome, have some symptoms like FAS.
To diagnose FASDs, doctors look for:
- Prenatal alcohol exposure, although confirmation is not required to make a diagnosis
- Central nervous system problems (e.g., small head size, problems with attention and hyperactivity, poor coordination)
- Lower-than-average height, weight or both
- Abnormal facial features (e.g., smooth ridge between nose and upper lip)
Treating Fetal Alcohol Spectrum Disorders
FASDs last a lifetime. There is no cure for FASDs, but research shows that early intervention treatment services can improve a child’s development.
There are many types of treatment options, including medication to help with some symptoms, behavior and education therapy, parent training and other alternative approaches. No one treatment is right for every child. Good treatment plans will include close monitoring, follow-ups and changes as needed along the way.
Also, protective factors can help reduce the effects of FASDs and help people with these conditions reach their full potential.
Protective factors include:
- Diagnosis before six years of age
- Loving, nurturing and stable home environment during the school years
- Absence of violence
- Involvement in special education and social services
Living with Fetal Alcohol Spectrum Disorders
If you or your doctor thinks there could be a problem, ask your pediatrician or primary care physician for a referral to a specialist (someone who knows about FASDs), such as a developmental pediatrician, child psychologist or clinical geneticist. In some cities, there are clinics whose staff have special training in diagnosing and treating children with FASDs. To find doctors and clinics in your area, visit the National and State Resource Directory.
At the same time as you ask the doctor for a referral to a specialist, call your state or territory’s early intervention program to request a free evaluation to find out if your child can get services to help. This is sometimes called a "Child Find" evaluation You do not need to wait for a doctor’s referral or a medical diagnosis to make this call.
Where to call for a free evaluation from the state depends on your child’s age:
If your child is younger than three years old, call your state or territory’s early intervention program and say: “I have concerns about my child’s development, and I would like to have my child evaluated to find out if they are eligible for early intervention services.”
If your child is three years old or older, contact your local public school system.
Even if your child is not old enough for kindergarten or enrolled in a public school, call your local elementary school or board of education and ask to speak with someone who can help you have your child evaluated.