Fetal 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, mental, social, behavioral, and/or learning disabilities with possible lifelong implications.
Podcast: Foundations of Fetal Alcohol Syndrome
The term FASD is not intended for use as a clinical diagnosis. It refers to conditions such as Fetal Alcohol Syndrome (FAS), Prenatal Alcohol Exposure (PAE), Alcohol-Related Neurodevelopmental Disorder (ARND), Fetal Alcohol Effects (FAE), and Alcohol Related Birth Defects (ARBD).
Fetal Alcohol Syndrome (FAS) is a medical diagnosis for a specific pattern of characteristics resulting from the effects of prenatal alcohol exposure. These characteristics include: growth retardation (being small for age); microcephaly (smaller than normal head); short palpebral fissures (small eye slits); smooth philtrum (vertical groove between the upper lip and nose); a thin upper lip; central nervous system (brain and spinal cord) damage causing behavioral and cognitive (thinking and learning) problems. This diagnosis is usually made by a dysmorphologist, clinical geneticist or developmental pediatrician.
Prenatal Alcohol Exposure is a term used by some researchers to describe individuals with a confirmed history of prenatal alcohol exposure, who may or may not meet diagnostic criteria for an FASD.
Alcohol-Related Neurodevelopmental Disorder is diagnosed when a child meets the criteria for brain damage but does not have all of the facial features or growth retardation of FAS. ARND is not a less severe form of FAS. In many cases, the brain damage in a patient with ARND is as extensive as that in a patient with FAS.
Fetal Alcohol Effects is a term previously used in earlier studies to describe individuals who meet some, but not all of the diagnostic criteria for FAS.
Alcohol-related birth defects are physical abnormalities associated with prenatal alcohol exposure. These include: abnormalities of the eyes and the ability to see and process visual information; abnormalities of the ears and the ability to hear and process auditory information; abnormality in the structure of the heart and the associated cardiac systems; and abnormalities in the limbs.
The prevalence of FASD is increasing. Each year, as many as 40,000 babies are born with an FASD, or 10 in 1000 live births. Rates are comparable or greater than other common disabilities including Down syndrome and spina bifida. FASD is 100 percent preventable yet is the leading known cause of mental retardation (NOFAS 2009).
The symptoms vary in severity and may include physical defects, cognitive deficits, and behavior problems. Many children with prenatal alcohol exposure need special education services and few are able to live independently as adults. Some become involved in criminal activity and are incarcerated. These multi-faceted problems make prenatal alcohol exposure extremely expensive to treat and address. Diagnosis can be difficult, and finding effective medications and therapies is a challenge.
The costs of FAS to society and for each alcohol-affected individual are very high. The most recent estimate from NIAAA is that FAS costs the Nation over $4 billion each year. The lifetime cost for each child with FAS is $2 million or more, depending on the costs included. (Chuck Lupton, SAMHSA FASD Center for Excellence, 2003)
Early diagnosis and treatment for FASD can help children reach their fullest potential, lessen secondary disabilities and problems, and help families better understand and cope. These secondary disabilities include: mental health issues, disrupted school experience, trouble with the law, confinement, inappropriate sexual behavior and alcohol and drug problems.