Fetal Alcohol Spectrum Disorders FAQ

The information in this FAQ was collected from different places.  The language and terms used are different, indeed, the language of prenatal alcohol exposure has been changing  over the last few decades. So sometimes it is fetal alcohol syndrome (FAS),  another time it is fetal alcohol spectrum disorders (FASD), or fetal alcohol effects (FAE), or partial fetal alcohol syndrome (PFAS). 

Definition of FASD 

What are Fetal Alcohol Spectrum Disorders

How can I recognize FASD

Why is diagnosis important

Medications

What can Families Do

Characteristics of Individuals with FASD

Typical Difficulties for persons with an FASD

Secondary Disabilities of persons with an FASD

Characteristics often seen in newborns or infants with FASD

Characteristics often seen in preschool aged children with FASD

Characteristics often seen in Elementary School Aged Children with FASD

Characteristics often seen in adolescents and young adults with FASD

Fetal Alcohol Spectrum Disorders  “FASD” is one of the newer terms introduced to this field, and there is no agreement on how or when to use it.  FASD is a descriptive term and not a diagnostic term.  The term “FASD” indicates that there are a variety of effects of prenatal alcohol exposure.  FASD is not a diagnosis. 

Although the various fetal alcohol spectrum disorders are permanent conditions, specific symptoms may be treatable or manageable. Thus, the definition notes possible lifelong implications, depending on the specific nature of the disorder and the individual affected.

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What are Feal Alcohol Spectrum Disorders?

FASD is an umbrella term describing the range of effects that can occur in an individual whose mother drank alcohol during pregnancy. These effects may include physical, behavioral, mental, and/or learning disabilities with possible lifelong implications. FASD is not a diagnostic term. It refers to several conditions.

The most well-known diagnosis is fetal alcohol syndrome (FAS). Signs of FAS include distinct facial features (smooth philtrum [groove between nose and upper lip], thin upper lip, small eye openings), growth deficiencies, and central nervous system (CNS) defects.

The Institute of Medicine has identified three other diagnoses:

• Partial FAS: facial anomalies and other symptoms without all the signs of FAS

• Alcohol-related neurodevelopmental disorder (ARND): CNS defects and behavior problems or cognitive deficits (e.g., speech delays, hyperactivity)

• Alcohol-related birth defects (ARBD): damage to organs, bones, or muscles

 Another term that has been used over the last 30 years is Fetal Alcohol Effects (FAE).

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How can I recognize FASD?

Only trained professionals can make a diagnosis. Teachers or relatives may identify a problem, but they cannot diagnose an FASD.

Signs that may indicate the need for assessment include:

• Sleeping, breathing, or feeding problems

• Small head or facial or dental anomalies

• Heart defects or other organ dysfunction

• Deformities of joints, limbs, and fingers

• Slow physical growth before or after birth

• Vision or hearing problems

• Mental retardation or delayed development

• Behavior problems

• Maternal alcohol use

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Why is Diagnosis Important?

Because most people with FASD have no visible signs of alcohol exposure, their problems may be wrongly blamed on poor parenting or on other disorders. Early diagnosis and intervention contribute to positive long-term outcomes.2 Accurate diagnosis can:

• Help the person receive appropriate services.

• Aid communication among clinicians, caregivers, educators, and families

• Provide better self-awareness and understanding by family members.  

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Medications

Psychiatric medications can be helpful for some individuals with FASD.  However, some individuals do not respond as expected, so it is important that medications are closely monitored by a physician comfortable prescribing psychiatric medication to children with developmental disabilities.  It is recommended that medication be prescribed and monitored by a child psychiatrist, developmental pediatrician, or a pediatrician with expertise in developmental issues.

What Can Families Do?

Being a parent or caregiver of a child with a Fetal Alcohol Spectrum Disorder can be challenging as it can be with any child.  Knowing what works for other families can increase your happy times and reduce your frustrations.  Talking with other parents is often valuable.  Some ways of working and talking to your child with Fetal Alcohol Spectrum Disorders have been found to work better than others.  Some of these suggestions are listed below.

There are many resources for parents: books, articles, web sites, service providers, other parents, and support groups.  Toward the end of this packet is a list of resources to get you started.  This list is not long.  However, it includes books and web sites that have lead to more resources that you may want to explore.  You can explore as far as you wish.

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Characteristics of Individuals with FASD

The following was adapted from the FASD Center for Excellence.  The original information is on their website at http://fascenter.samhsa.gov

Overall difficulties for persons with an FASD

• Taking in information
• Storing information
• Recalling information when necessary
• Using information appropriately in a specific situation
• Lower IQ
• Impaired ability in reading, spelling, and arithmetic
• Lower level of adaptive functioning; more significantly impaired than IQ would indicated

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Typical difficulties for persons with an FASD

• Sensory Integration Issues
  • Are overly sensitive to sensory input
    • Upset by bright lights or loud noises
    • Annoyed by tags in shirts or seams in socks
    • Bothered by certain textures of food
  • Have problems sensing where their body is in space (clumsy)
• Memory problems
  • Multiplication
  • Time sequencing

• Information Processing Problems
  • Do not complete tasks or chores and may appear to be oppositional
  • Have trouble determining what to do in a given situation
  • Do not ask questions because they want to fit in.
  • Say the understand when they do not
  • Have verbal expressive skills that often exceed their level of understanding
  • Misinterpret others’ words, actions, or body movements
  • Have trouble following multiple directions
• Self-Esteem and Personal Issues
  • Function unevenly in school, work, and development
  • Experience multiple loses
  • Are seen as lazy, uncooperative, and unmotivated
  • Have hygiene problems
• Multiple Issues
  • Cannot entertain themselves
  • Have trouble changing tasks
  • Do not accurately pick up social cues

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Secondary Disabilities of persons with an FASD

• Mental health issues
• Disrupted school experience
• Trouble with the law
• Inappropriate sexual behavior
• Confinement in jail or treatment facilities
• Alcohol and drug problems
• Dependent living
• Employment problems

Streissguth, et al. (1996)

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Characteristics often seen in Newborns or Infants with FASD

• Difficulty Sleeping - Unpredictable Sleep/Wake Cycle

• Electroencephalogram (EEG) Abnormalities

• Failure to Thrive

• Feeding Difficulties including Weak Sucking Reflex

• Heart Defects, Kidney Problems, or Skeletal Anomalies

• Increased Sensitivity to Light and Sound - Easily Overstimulated

• Neurological Dysfunctions

• Poor Fine Motor Control

• Poor Gross Motor Control

• Seizures, Tremors, or Jitteriness

• Small Size

• Susceptibility to Infections

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Characteristics often seen in Preschool Aged Children with FASD

• Emotional Over-Reaction and Tantrums

• Hyperactivity

• Lack of Impulse Control

• Mental Retardation

• Poor eye- hand and physical coordination.

• Poor Judgment (Often seen as difficulty recognizing danger including not fearing strangers.  Children of this age may seem overly friendly.)

• Small Size

• Speech Delays (May include poor articulation, slow vocabulary or grammar development, or perseverative speech.)

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Characteristics often seen in Elementary School Aged Children with FASD

• Attention Deficits

• Hyperactivity

• Language Difficulties (Delayed Development or Difficulties with Expressive or Receptive Language)

• Learning Disabilities or Cognitive Disabilities

• Memory Difficulties

• Poor Impulse Control (Often seen as lying, stealing or defiant acts.)

• Small Size

• Social Difficulties (May include overly friendly, immaturity, easily influenced and difficulty with choices.)

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 Characteristics often seen in Adolescents and Young Adults with FASD

• Difficulties with Abstract Reasoning

• Difficulty Anticipating Consequences

• Low Academic Achievement

• Low Self-Esteem

• Memory Impairments

• More Pronounced Impulsiveness (Often seen as lying, stealing or defiant acts

• Poor Judgment

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Last modified: 03/22/08