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Understanding Fetal Alcohol Spectrum Disorder: Causes, Diagnosis, and Lifespan Effects

Fetal Alcohol Spectrum Disorder (FASD) is a preventable condition caused by maternal alcohol consumption during pregnancy, leading to lifelong challenges. This guide explores FASD's various forms: Fetal Alcohol Syndrome (FAS), Partial Fetal Alcohol Syndrome (PFAS), Alcohol Related Neurodevelopmental Disorders (ARND), and Alcohol Related Birth Defects (ARBD). We examine the diagnosis criteria, prevalence rates, cognitive and social impairments, and the crucial impact of early intervention and education. Awareness and prevention strategies are essential to combat this societal issue.

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Understanding Fetal Alcohol Spectrum Disorder: Causes, Diagnosis, and Lifespan Effects

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  1. Fetal Alcohol Spectrum Disorder: A Preventable Epidemic Barry S Parsonson PhD Explore & Applied Psychology International

  2. FASD: Causes • FASD is caused by maternal consumption of alcohol during pregnancy; • Alcohol affects developing neural and physical systems differentially according to timing in relation to fetal development stage, amounts consumed and duration of exposure; • The minimum amount causing some effect is currently not known, hence advice against all alcohol consumption when pregnant; • FASD is thus entirely preventable!

  3. FASD Diagnosis • There are four internationally agreed classes of FASD based on assessment of severity using a 4-digit code relating to FAS characteristics; • FAS, PFAS, ARND, & ARBD: • In each case, confirmed evidence of maternal prenatal alcohol misuse is required; • DSM-V does not include FASD as a diagnosis although it is described and identified as a “Condition for further study”!

  4. FASD Diagnosis 1-FAS • Fetal Alcohol Syndrome (FAS) is the most severe form. It includes: • Facial Anomalies (small eye slits, thin upper lip, smooth philtrum) and Microcephaly; • Growth Deficiency (height or weight <10%ile) • CNS Damage with evidence of structural and/or functional brain abnormality; • Confirmed Prenatal Alcohol Exposure (needed if cluster of facial anomalies not present).

  5. Facial Anomalies of FAS

  6. FASD Diagnosis 2-PFAS Partial Fetal Alcohol Syndrome (PFAS) is characterised by: • Growth Deficiency (height or weight <10%ile) • CNS Damage with evidence of structural and/or functional brain abnormality; • Confirmed Prenatal Alcohol Exposure (Reliable evidence of maternal alcohol misuse).

  7. FASD Diagnosis 3- ARND Alcohol Related Neurodevelopmental Disorder (ARND) is characterised by: • CNS Damage: Evidence of structural or functional brain abnormality; • Confirmed Prenatal Alcohol Exposure (Reliable evidence of maternal alcohol misuse).

  8. FASD Diagnosis 4-ARBD Alcohol Related Birth Defects (ARBD) is classified by: • Physical Defects: Heart, Kidney or other anomalies present at Birth; • Confirmed Prenatal Alcohol Exposure: Reliable evidence of maternal Alcohol Misuse.

  9. FASD Prevalence • A Base Rate of 1% of the School Age population is estimated from a number of US, Canadian and European Studies; • Some communities have rates of up to 8.5%; • Preliminary NZ data lead to guesstimates of at least 3000 school-age children with FASD; • Accurate data are difficult to obtain and probably underestimate the true situation. • FASD is now the most common cause of ID.

  10. Post-Natal FASD Effects on Cognition & Learning • Executive functioning (Planning, attention) • Memory (encoding, rote, working & spatial) • Reasoning (verbal, abstract, numerical) • Language (learning, comprehension, meaning) • Sensorimotor (visual/motor integration, visual-spatial processing) • Attention (short span, distractible, often ADHD labelled)

  11. Distribution of IQ Scores

  12. FASD Effects on Communication & Sensory Functioning • Delayed Language Development • Impaired receptive & expressive language • Difficulties in language production & comprehension affect learning • Poor social communication affects relationship building • Hearing disorders found common in a small FAS clinic sample

  13. FASD Behavioural Effects • Physical Aggression • Lying and Confabulation • Impulsiveness and hyperactivity • Cheating, stealing, bullying & animal cruelty • Lack of remorse • Emotional lability • Substance abuse & self-harming

  14. FASD Lifespan Effects Collectively, these Cognitive, Learning, Social, Communication and Behavioural deficits have lifetime effects. Data from samples indicate: • Family life (85% of children in foster care FASD) • Educational achievement (60% excluded) • Mental Health (87% 5-13 y.o.; 23% adults suicide) • Criminality (60% of FASD teens, many Prisoners) • Relationship and Employment difficulties are common.

  15. Discussion Questions • How do we, as a profession, intervene by way of increasing awareness and promoting prevention? • Education? Who, when, how? • Increase Political and Public awareness? What strategies might work? • What about the “Binge Drinking” Culture – Does it contribute? If so, how to change that? • What can we offer to those on the FASD spectrum? In Schools, Prisons, the Community?

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