Quick FASD Facts | Definitions | How Alcohol Affects the Prenatal Brain | Characteristics | Primary & Secondary Disabilities | Solutions

 

Quick FASD Facts || top

• 1 in 690 babies will be born with Fetal Alcohol Syndrome this year in Canada. ⁱ
• 1 in 100 - will be born with Fetal Alcohol Spectrum Disorder this year in Canada. ⁱⁱ
• The number of individuals born with these afflictions exceeds the numbers of individuals born with Spina Bifida, Down Syndrome, Muscular Dystrophy and confirmed HIV infection combined.ⁱⁱⁱ
• FASD is currently the leading known cause of mental retardation in western civilization.^iv
  
• There is no known safe type, amount, or time to use alcohol during pregnancy.
  
• FASD is not an inherited disease.  This means that a mother diagnosed with FASD will not pass it to her child if she does not drink while she is pregnant.
• Alcohol-related birth effects are entirely preventable, simply by refraining from the consumption of alcohol during pregnancy. 

 

Definitions || top

Fetal Alcohol Spectrum Disorder (FASD): an umbrella term that describes a range of disabilities that occur as a direct result of alcohol consumption during pregnancy.

Fetal Alcohol Syndrome (FAS): This term refers to certain birth defects and serious, life-long mental and emotional impairments that may be suffered by a child as the result of heavy alcohol consumption by its mother during pregnancy.

Fetal Alcohol Effects (FAE): A disorder associated with cognitive and behavioral difficulties in children whose birth mothers drank alcohol during her pregnancy. Symptoms are similar to Fetal Alcohol Syndrome (FAS), but less severe or comprehensive.

Partial Fetal Alcohol Syndrome (pFAS): Individuals with Partial Fetal Alcohol Syndrome have a confirmed history of prenatal alcohol exposure, but may lack growth deficiency or the complete facial stigmata. Central nervous system damage is present at the same level as FAS. These individuals have the same functional disabilities but "look" less like FAS.

Alcohol-Related Neurodevelopmental Disorder (ARND): Includes characteristics common to FAS – including growth deficiency, some FAS facial features, clinically significant structural, neurological or functional impairment, and prenatal exposure to alcohol.

Alcohol-Related Birth Defects (ARBD):  Physical or cognitive deficits, which can range form mild to severe, that a child experiences as the result of alcohol consumption by its mother during pregnancy. This term includes, but is not limited to, Fetal Alcohol Syndrome (FAS) and Fetal Alcohol Effects (FAE).

 

How Alcohol Affects the Prenatal Brain || top
The alcohol molecule is very tiny and passes easily across the placenta from mother to child, as early as 2 weeks after conception, until birth.  Although alcohol can affect the development of all cells and organs, the brain is particularly vulnerable to the effects of alcohol exposure, and damage can occur throughout the term of pregnancy.

6-week old infant brains (left: brain without prenatal alcohol exposure;
right: brain with prenatal alcohol exposure)
Image courtesy of Dr. Sterling Clarren, University of Washington (1986).

 

Characteristics and Symptoms of FASD || top

Developmental Delays - Most children with FASD have developmental delays and some have lower than normal IQ levels.  The degree of physiological characteristics usually corresponds with the degree of developmental delays.  Most children with FSD have IQs that are legally considered in the “normal” range.

Central Nervous System - Most infants with FASD are irritable, don’t eat or sleep well, are extra sensitive to sensory stimulation, and have a strong startle reflex.  They may hyperextend their heads or limbs, and can exhibit hypertonia (too much muscle tone), hypotonia (to little muscle tone), or both.

Physiological Anomalies - Babies with FASD may have low birth weight, and may have trouble gaining weight.  The head circumference may be smaller than normal.  Some infants may have heart defects or suffer anomalies to the ears, eyes, liver or joints.

Facial Features (see diagram below)*
Babies with FASD have many (but not always all) of the following characteristics:

• epicanthal folds (extra folds of skin originating under the eyes)
  
• small, widely spaced eyes
  
• flat midface
  
• short, upturned nose
  
• smooth, wide philtrum (absent or flattened groove between nose and lips)
  
• thin upper lip
  
• underdeveloped jaw
  _{*note: facial characteristics may not be as apparent immediately after birth or during adolescence or adulthood as they are between the ages of two and ten.}

Invisible but Serious*
The most serious characteristics of FASD are the invisible symptioms of neurological  damage that result from prenatal exposure to alcohol. These include:

• attention deficits
  
• memory deficits
  
• hyperactivity
  
• difficulty with abstract concepts (math, time, money)
  
• poor problem-solving skills
  
• difficulty learning from consequences
  
• poor judgment
  
• immature behaviour
  
• poor impulse control
  _{*note: These symptoms are not “behaviour problems” but are a result of permanent, unchanging damage to the brain (static encephalopathy) and are not always within the child’s control.}

 

What Problems Might They Have? || top

Primary Disabilities of FAS/FAE are functional deficits that reflect the CNS dysfunctions inherent in the FAS or FAE diagnosis.
Children with FAS/E often have difficulties with behavioural, cognitive and physical functioning.  Growth deficiencies, delayed development, mental retardation, attention deficit and/or hyperactivity, learning disorders, social and emotional difficulties, vision and hearing deficits, speech and language deficits, facial and skeletal abnormalities, and cardiac anomalies are common problems among children with FAS/E.  The children also display deficits in verbal learning, language, perception and intellectual development.

Secondary Disabilities of FAS/FAE are those that arise after birth and presumably could be improved through better understanding and appropriate interventions.
On average:

• over 90% suffer from mental health issues
  
• over 60% experience disrupted school experience
  
• over 60% have trouble with the law
  
• over 50% confinement
  
• over 50% exhibit inappropriate sexual behaviour
  
• over 30% experience alcohol/drug problems
  
• over 80% have problems with employment
  
• over 80% have problems with independent living

 

What are the Solutions? || top

Family members working together with healthcare professionals and social service providers play an important role in the solution. Health and human service providers who are knowledgeable on the effects of prenatal substance abuse, and feel comfortable discussing the topic, are essential in educating pregnant women and women of childbearing age about the risks of drinking while pregnant. Family members, as well as providers can help women at risk by:

• routinely asking about their use of alcohol and other substances;
  
• advising them to completely avoid alcohol while pregnant;
  
• helping women who risk-drink to set safe drinking goals;
  
• linking women to appropriate services and resources;
  
• support their loved one in seeking help; and
• encouraging partners, family and friends to support their loved one in seeking help.

All alcohol-related birth effects are 100% preventable.