Fetal alcohol spectrum disorders (FASDs)

 

Facts about FASDs

Fetal alcohol spectrum

disorders (FASDs) are a 

group of conditions that

can occur in a person

whose mother drank

alcohol during pregnancy. 

These effects can include 

physical problems and 

problems with behavior

and learning. Often, a person

with an FASD has a mix of

these problems.

Cause and Prevention

FASDs are caused by a woman drinking alcohol during pregnancy. There is no known amount of alcohol that is safe to drink while pregnant. There is also no safe time to drink during pregnancy and no safe kind of alcohol to drink while pregnant.

To prevent FASDs, a woman should not drink alcohol while she is pregnant, or even when she might get pregnant. This is because a woman could get pregnant and not know for several weeks or more.  In the United States, half of pregnancies are unplanned.

Signs and Symptoms

FASDs refer to the whole range of effects that can happen to a person whose mother drank alcohol during pregnancy. These conditions can affect each person in different ways, and can range from mild to severe.

A person with an FASD might have:

• Abnormal facial features, such as a smooth ridge between the nose and upper lip (this ridge is called the philtrum)
• Small head size
• Shorter-than-average height
• Low body weight
• Poor coordination
• Hyperactive behavior
• Difficulty paying attention
• Poor memory
• Difficulty in school (especially with math)
• Learning disabilities
• Speech and language delays
• Intellectual disability or low IQ
• Poor reasoning and judgment skills
• Sleep and sucking problems as a baby
• Vision or hearing problems
• Problems with the heart, kidneys, or bones 

Types of FASDs

Different terms are used to describe FASDs, depending on the type of symptoms.

• Fetal Alcohol Syndrome (FAS): FAS represents the severe end of the FASD spectrum. Fetal death is the most extreme outcome from drinking alcohol during pregnancy. People with FAS might have abnormal facial features, growth problems, and central nervous system (CNS) problems. People with FAS can have problems with learning, memory, attention span, communication, vision, or hearing. They might have a mix of these problems. People with FAS often have a hard time in school and trouble getting along with others.
  
  
• Alcohol-Related Neurodevelopmental Disorder (ARND): People with ARND might have intellectual disabilities and problems with behavior and learning. They might do poorly in school and have difficulties with math, memory, attention, judgment, and poor impulse control.
  
  
• Alcohol-Related Birth Defects (ARBD):  People with ARBD might have problems with the heart, kidneys, or bones or with hearing. They might have a mix of these.

The term fetal alcohol effects (FAE) was previously used to describe intellectual disabilities and problems with behavior and learning in a person whose mother drank alcohol during pregnancy. In 1996, the Institute of Medicine (IOM) replaced FAE with the terms alcohol-related neurodevelopmental disorder (ARND) and alcohol-related birth defects (ARBD).

Diagnosis

The term FASDs is not meant for use as a clinical diagnosis. CDC worked with a group of experts and organizations to review the research and develop guidelines for diagnosing FAS. The guidelines were developed for FAS only. CDC and its partners are working to put together diagnostic criteria for other FASDs, such as ARND. Clinical and scientific research on these conditions is going on now.
Diagnosing FAS can be hard because there is no medical test, like a blood test, for it.  And other disorders, such as ADHD (attention-deficit/hyperactivity disorder) and Williams syndrome, have some symptoms like FAS.

To diagnose FAS, doctors look for:

• Abnormal facial features (e.g., smooth ridge between nose and upper lip)
• Lower-than-average height, weight, or both
• Central nervous system problems (e.g., small head size, problems with attention and hyperactivity, poor coordination)
• Prenatal alcohol exposure; although confirmation is not required to make a diagnosis

Treatment

 FASDs last a lifetime. There is no cure for FASDs, but research shows that early intervention treatment services can improve a child’s development. 

There are many types of treatment options, including medication to help with some symptoms, behavior and education therapy, parent training, and other alternative approaches.  No one treatment is right for every child.
Good treatment plans will include close monitoring, follow-ups, and changes as needed along the way.
Also, “protective factors” can help reduce the effects of FASDs and help people with these conditions reach their full potential.

Protective factors include:

• Diagnosis before 6 years of age
• Loving, nurturing, and stable home environment during the school years
• Absence of violence
• Involvement in special education and social services
  

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