Fetal Alcohol Spectrum Disorder

Author: 
Adoptive Families Association of BC
Source: 
AFABC Special Needs Database

Definition
Fetal Alcohol Syndrome (FAS) and Fetal Alcohol Effect (FAE) are classified under Fetal Alcohol Spectrum Disorder (FASD). FASD is a medical diagnosis for a birth defect syndrome caused by alcohol use during pregnancy. Alcohol is a “teratogen” that is toxic to the baby’s developing brain. Damage can occur in various regions of the brain, depending on which areas are developing at the time the alcohol is consumed.

Causes

  • Consumption of alcohol by birth mother during pregnancy.

Characteristics
Children diagnosed with Fetal Alcohol Syndrome may have specific facial features, slow growth both before and after birth, and brain injury. Children diagnosed with Fetal Alcohol Effect may lack the outward physical appearance of alcohol damage and have some of the above characteristics. Or they may demonstrate all of the characteristics, but there is no proof that their birth mother drank.

There are three characteristics associated with a diagnosis of FAS. Not all children will look the same; the effects range from severe to mild. The degree of the effects depends on the amount of alcohol the baby was exposed to during the pregnancy, the time the alcohol exposure took place during the pregnancy, and the mother’s health and age:

  • Growth deficiencies
  • Altered facial features
  • Central nervous system damage

Most affected areas of the brain are:

  • Frontal lobes: executive functions, impulse control, judgment
  • Corpus Callosum: passes information from the left brain (rules) logic to the right brain (impulse control, feelings)
  • Cerebellum: coordination, movement, behaviour/processes spatial memory and behaviors like perseveration and inability to switch modes, perception of time perception
  • Hippocampus: learning and memory
  • Hypothalamus: controls appetite, emotions, temperature, and pain sensation

Not all children with FASD are alike, with some displaying more of the reasoning and behavioural problems than the physical features. Each child will have individual needs and may display varying degrees of symptoms.

Attention and focus:

  • Agitated, unable to sit down
  • Difficulty playing independently
  • Talk incessantly
  • Easily distracted
  • Unable to sit still or to calm self

Education:

  • Requires constant reminders, cannot understand abstracts
  • Lacks of motivation to learn, does not generalize
  • Has academic delays

Social:

  • Has difficulty keeping or making friends; misses social cues
  • Doesn’t understand social expectations
  • Requires constant supervision
  • Doesn’t learn from mistakes
  • Often aggressive

Sensitivity:

  • Resists change in any form
  • Has low frustration level
  • Overstimulated by public areas such as shopping centers
  • Overly sensitive/over reactive to touch, movement, sights, smells or sounds
  • Has difficulty in regulating emotions

Physical:

  • Has problems going to sleep
  • Exhibits unusual physical characteristics
  • Experiences eating difficulties
  • Overreacts to or under reacts to pain
  • Exaggerated feelings with roller coaster emotions

Children with FAS or partial FAS do have some positive characteristics that make them easy to love:

  • Tendency to be very affectionate and loving
  • Tendency to forgive others for not understanding them
  • Willingness to continue trying in spite of the odds
  • Good sense of humor
  • Willingness to try new things
  • Tendency to be cheerful
  • Great aptitude for artistic, musical, and creative pursuits
  • Tendency to be compassionate and nurturing towards animals and younger children.

Treatment
FAS/FAE is a lifetime disability. It is not curable. A child does not grow out of it. However, early diagnosis, along with intensive and appropriate intervention, can make enormous differences in the prognosis of a child. Also, a stable, protective living environment is immeasurably valuable in counteracting some of the adverse characteristic associated with this disability. 

Early intervention can help prevent secondary disabilities such as mental health problems, dropping out of school, trouble with the law and substance abuse.

Complications
Secondary disabilities refer to disabilities or problems that emerge as a result of the disorders experienced by a person with FAS. Most often, they relate to a person’s inability to adapt or address challenges that are common in the lives of all individuals:

  • Attachment issues
  • Inappropriate sexual behaviours
  • Mental health problems
  • Disruptive school experience
  • Trouble with the law
  • Drug or alcohol problems
  • Employment difficulties

FAS affects more than just the skeletal (growth deficiencies) and cognitive ( nervous system damage) aspects of development.  Prenatal exposure to alcohol is a leading cause of preventable birth defects including Spina Bifida and Down Syndrome. This early exposure may also result in a variety of congenital heart defects, as well as damaged or underdeveloped kidneys.


This resource is by no means intended as a substitute for a doctor's advice or diagnosis. Any concerns you may have with regard to your child's health and development should be discussed with a professional in an appropriate field.