FAQ about FASD

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What is the definition of FASD? 

FASD stands for Fetal Alcohol Spectrum Disorders.

What are Fetal Alcohol Spectrum Disorders?

Fetal Alcohol Spectrum Disorders, known by the initials FASD, is an umbrella term describing a range of disabilities that affect a child who was exposed to alcohol while in the womb. Different medical names are given to distinguish diagnostic findings in this group of disorders.

FASD is not a medical diagnosis. Other terms, such as Fetal Alcohol Syndrome (FAS), are used to provide medical diagnoses that physicians use for medical record keeping and billing purposes.

Some old descriptive terms that are now outdated are also still being used. Click here to see a chart of some of these.

How is FASD caused?

FASD is caused when an unborn child (fetus) is exposed to alcohol while in the womb (uterus) during pregnancy.

Can FASD be passed along through breast milk?

No, but growth, general health, and post-birth brain health can all be damaged if the mother breastfeeds her child.

Can biological fathers cause FASD?

No. Only prenatal (before birth) drinking in the womb caused a baby to be born with an FASD.

How does alcohol damage a baby's developing brain?

When a pregnant woman drinks alcohol during pregnancy, the baby’s alcohol levels reach that of the mother’s within minutes, through the umbilical cord. A baby is so small that the alcohol’s effects are much more damaging than they are to the woman.

Much damage can be done before the woman ever knows she is pregnant. During the first month of a baby’s life, cells organize to become the baby’s internal organs—including the brain and spinal cord.

Alcohol interferes with the baby’s ability to mobilize, differentiate, grow and replicate cells in the right place at the right time—especially cells in the brain and the central nervous system. Both continue to develop every day during pregnancy. Because this process is blocked or changed by the way alcohol affects cells, problems occur. Parts of the brain will be smaller than normal or even partially absent. Nerve connections between brain cells don’t form properly. Damaged brain cells, and nerve cells and fibers in the spinal cord transmit information poorly or they “misfire,” like an electrical wire with frayed insulation.

All of this adds up to damage that impacts every aspect of the child’s life.

How common are FASDs?

Experts estimate that 1 in 100births every year in industrialized countries in the world are affected by FASDs. In some countries, the number is calculated to be much higher.

How are FASDs prevented?

FASDs are prevented by completely avoiding drinking alcohol during pregnancy.

Are FASDs genetic or hereditary?

They are neither genetic nor hereditary. However, FASD tends to be generational. So, if a child has FASD, chances are that the child’s birth mother may have some form of it, too, because the maternal grandmother drank during pregnancy. The child's biological siblings (with the same birth mother) often have it as well, unless the mother doesn't drink during a pregnancy.

How is FASD recognized?

Characteristics of FASD fall into five broad categories:

  1. Maternal alcohol exposure (may or may not be able to be confirmed)
  2. Facial anomalies (may or may not be present)
  3. Growth retardation
    Babies’ heads are smaller than normal. Young children are small and slender. They don’t gain weight in a normal way, even when on high-nutrition diets. Their weight is very low compared to their height.
  4. Central nervous system problems
    This includes structural brain abnormalities as well as neurodevelopmental problems, such as difficulty feeding, poor eye-hand coordination and gait problems.
  5. Cognitive deficits
    This includes a wide range of learning and behavioral problems.

In addition, birth defects may co-exist with FASD because of the global damage that alcohol causes to a developing fetus.

Most characteristics of FASDs described above are easier to evaluate in babies and young children, but learning and behavioral problems persist throughout the lifespan.

The majority of people with FASD don’t have discernible facial abnormalities. The real disability lies in damage to the brain and central nervous system, which cause difficulties in memory, learning, emotions, and other activities of daily living.

Why is diagnosis of FASD important?

Studies show that the best outcomes for children with FASD happen when they receive appropriate intervention at the earliest age.

How are FASDs diagnosed?

Usually, a team including a physician, social workers, occupational and physical therapists, and psychologists work together to diagnose FASDs.

Often, a geneticist is part of the diagnostic process, in order to rule out genetic conditions that cause similar signs or symptoms. Some metabolic disorders (such as a thyroid imbalance), seizure disorders, toxin exposures, some mental health problems, and unrelated neurological problems, such as ADHD, may look like FASD. That’s why it's important to avoid self-diagnosing a child and to see a developmental pediatrician or FASD specialist in order to obtain a definitive diagnosis.

When a parent is looking for a diagnosis of a child suspected of having an FASD, they should bring as much information as possible to the doctor or clinic. This helps with the diagnosis. This includes:

  • History of the birth mother’s alcohol use, if possible
  • Any medical history available on the birth mother
  • Photos of the birth mother and father, if available
  • Medical records of your child’s physical exams, including documentation of your child’s physical growth and development
  • Medical records or personal notes of health problems such as hearing or vision problems, muscle weakness or seizures
  • Medical records or personal notes about potential central nervous system problems; for example, odd logic, inability to concentrate or stay on task, developmental delays, and other things you’ve observed
  • Results of neuropsychological tests or other assessments
  • School records that document academic progress and problems; also IEPs (Individualized Education Plans), if appropriate
  • Photos of your child (ideally from birth through present)

Click here for a more detailed, printable checklist.

Can FASD be cured?

The brain damage caused by prenatal alcohol exposure is permanent, and cannot be cured. But much can be done to compensate for the damage through education, training, a calm, structured and nurturing environment, and medical treatment.

People affected by FASD are everywhere, and the range of severity is broad among those affected. While many persons affected by FASD experience lifelong challenges and require external supports for their own safety and well-being, many more have friends and relationships, raise children of their own, work, play, and live fairly independent lives.

What medications are used to treat FASD?

Medications don't treat FASDs directly. Rather, medications are used to treat the symptoms of impairment or other problems associated with FASD. Click here for more information about treatment.

What are the characteristics of individuals with FASD?

Every person with FASD is unique and behaves differently. Global problems throughout life (due to impaired or interrupted neurological development) include: sensory integration and self-regulation problems, and problems with abstract thinking, decision making and executive functioning (planning, organizing, goal-setting).

Click this chart on the needs and challenges of people affected by FASD as they mature. (This is intended as general information—not a definitive guideline.) Here is additional information

Many people with FASD have a normal IQ. Some have a low IQ. Some have an above-normal IQ. However, all of them are brain damaged, and all need to learn how to use their own intelligence.

The brain damage caused by FASD is permanent. However, an affected child displays different characteristics and has different challenges at each stage of growth. The child’s emotional maturity lags behind his or her chronological age. This gap widens as the child grows because further emotional and psychosocial development is arrested due to their unique pattern of neurological impairment.