Definition
By Mayo Clinic staff
Fetal alcohol syndrome (FAS) is a condition that results from prenatal alcohol exposure. If you drink during pregnancy, you place your baby at risk of fetal alcohol syndrome.
The defects that are part of fetal alcohol syndrome are irreversible and can include serious physical, mental and behavioral problems, though they vary from one child to another.
As many as 40,000 babies are born with some type of alcohol-related damage each year in the United States.
If you suspect that your child has fetal alcohol syndrome, talk to your doctor as soon as possible. Early diagnosis may reduce the risk of problems associated with fetal alcohol syndrome, including troubles at school, with substance abuse and with the law.
Symptoms
By Mayo Clinic staff
Fetal alcohol syndrome isn't a single birth defect. It's a cluster of related problems and the most severe of a group of consequences of prenatal alcohol exposure. Collectively, the range of disorders is known as fetal alcohol spectrum disorders (FASD).
Fetal alcohol syndrome is a common — yet preventable — cause of mental retardation. The severity of mental problems varies, with some children experiencing them to a far greater degree than others.
§ Poor coordination
§ Sleep problems
§ Mental retardation and delayed development
§ Learning disorders
§ Abnormal behavior, such as a short attention span, hyperactivity, poor impulse control, extreme nervousness and anxiety
The facial features seen with fetal alcohol syndrome may also occur in normal, healthy children. Distinguishing normal facial features from those of fetal alcohol syndrome requires expertise.
Doctors may use other terms to describe some of the signs of fetal alcohol syndrome. Alcohol-related neurodevelopmental disorder (ARND) refers to the mental and behavioral impairments that occur as a result of fetal exposure to alcohol. Alcohol-related birth defects (ARBDs) refer to the physical defects that occur from fetal alcohol exposure.
When to see a doctor
If you're pregnant and can't stop drinking, ask your obstetrician or other health care provider for help.
Because early diagnosis may help reduce the risk of long-term problems for children with FAS, let your child's doctor know if you drank alcohol while you were pregnant. Don't wait for problems to arise before seeking help.
If you've adopted a child or are providing foster care, you may not know if your child's biological mother drank alcohol while pregnant — and it may not initially occur to you that your child may have fetal alcohol syndrome. However, if your child demonstrates learning and behavioral problems, talk with your child's doctor so that the underlying cause might be identified.
Causes
By Mayo Clinic staff
When you drink alcohol, it enters your bloodstream and reaches your developing fetus by crossing the placenta. Because a fetus metabolizes alcohol more slowly than an adult does, your developing baby's blood alcohol concentrations are higher than those in your body. Alcohol also interferes with the delivery of oxygen and optimal nutrition to your baby's developing tissues, organs and brain.
The more you drink while pregnant, the greater the risk to your unborn baby. The risk is present at any time during pregnancy. However, impairment of facial features, the heart and other organs, bones, and the central nervous system may occur as a result of drinking alcohol during the first trimester, when these parts of the fetus are in key stages of development. In the early weeks of the first trimester, many women may not be aware that they're pregnant. Alcohol may affect the brain of the fetus at any time during pregnancy.
Risk factors
By Mayo Clinic staff
Although doctors aren't sure how much alcohol you'd have to drink to place your baby at risk, they do know that the more you drink, the greater the chance of problems. Because there's no known safe amount of alcohol consumption during pregnancy, don't drink alcohol if you are or think you are pregnant or you're attempting to become pregnant. You could put your baby at risk even before you realize you're pregnant.
Tests and diagnosis
By Mayo Clinic staff
Although doctors can't diagnose fetal alcohol syndrome before a baby is born, they can assess the health of mother and baby during pregnancy. If you report the timing and amount of alcohol consumption, your obstetrician or other health care provider can help determine the risk of fetal alcohol syndrome.
If you let your child's doctor know that you were drinking while you were pregnant, he or she can be on the lookout for signs and symptoms of this syndrome in your child's initial weeks, months and years of life. To make a diagnosis, doctors will assess:
§ Growth
§ Facial features
§ Heart defects
§ Hearing
§ Vision
§ Cognitive ability
§ Language development
§ Motor skills
§ Behavior
Doctors may refer children with possible fetal alcohol syndrome to a medical genetics specialist to rule out other disorders with similar signs and symptoms.
If one child in your family is diagnosed with fetal alcohol syndrome, it's important to evaluate his or her siblings to determine whether they also have fetal alcohol syndrome.
Coping and support
By Mayo Clinic staff
The psychological and emotional problems associated with fetal alcohol syndrome can be difficult to manage. Families and children with fetal alcohol syndrome may benefit greatly from the support of professionals and other families who have experience with FAS. Ask your doctor or public health nurse for local sources of support for families and children with FAS.
As a parent of a child with fetal alcohol syndrome, you may find the following suggestions helpful in dealing with behavioral problems associated with the syndrome:
§ Implement daily routines to which your child can become accustomed.
§ Create and enforce simple rules and limits.
§ Point out and use rewards to reinforce acceptable behavior.
§ Because many children with fetal alcohol syndrome are vulnerable, guard against their being taken advantage of by others.
§ Teach your child skills for daily living.
A stable, nurturing home is the single most important factor in protecting children with FAS from some of the problems they're at risk of later in life, including drug abuse, dropping out of school and encounters with the juvenile justice system.
If you've given birth to a child with fetal alcohol syndrome, you may benefit from substance abuse counseling and treatment programs that can help you conquer your misuse of alcohol.
Prevention
By Mayo Clinic staff
Doctors haven't identified a safe level of alcohol that a pregnant woman can consume. But, experts do know that FAS is completely preventable if women don't consume alcohol during pregnancy.
These guidelines can help prevent fetal alcohol syndrome:
§ Stop drinking alcohol altogether if you're planning to become pregnant, because your baby's brain, heart and blood vessels begin to develop in the early weeks of pregnancy. If you haven't already stopped drinking, stop as soon as you know you're pregnant or if you even think you might be pregnant. It's never too late to stop drinking during your pregnancy, but the sooner you stop, the better it is for your baby.
§ Continue to avoid alcohol throughout your pregnancy. Fetal alcohol syndrome is completely preventable in children whose mothers don't drink during pregnancy.
§ Consider giving up alcohol during your childbearing years if you're sexually active and you're having unprotected sex. Many pregnancies are unplanned, and damage can occur in the earliest weeks of pregnancy.
§ If you have an alcohol problem, get help before you get pregnant. Get professional help to determine your level of dependence on alcohol and to develop a treatment plan.
FAS is only the tip of the iceberg in terms of outcomes. In fact, only a minority (10-40%) of the children of chronic alcoholic women are diagnosed with FAS. What makes some individuals more susceptible than others?. What are the risk factors associated with prenatal alcohol exposure? There are a number of factors that may contribute to increased risk to the adverse effects of prenatal alcohol. First, the higher the dose of alcohol, the greater the likelihood that the child will exhibit fetal alcohol effects. The pattern of exposure is also important. Both human and animal studies have found that binge drinking (drinking a large amount of alcohol in a short period of time), which produces high blood alcohol levels, is more damaging to the fetus than chronic alcohol exposure that produces lower blood alcohol levels. Thus, peak blood alcohol level may be an important factor.
In addition, the developmental timing of alcohol exposure may influence the outcome. For example, the facial features associated with prenatal alcohol treatment appear to be related to alcohol exposure during the first trimester. Obviously, as different organs undergo development at different times, when the embryo or fetus is exposed is going to be important in determining the outcome. The brain undergoes a very prolonged developmental course and therefore, may be susceptible to fetal alcohol effects throughout gestation. In addition, genetic factors, nutritional factors, parity, and synergistic reaction with other drugs may influence the effects of prenatal alcohol exposure.
| “Take Ten”
FASD Awareness Survey Kit
.
These are the goals:
· Raise awareness about the danger of alcohol use during pregnancy and the seriousness of Fetal
Alcohol Spectrum Disorders
· Gather data about the information level of people in different demographic groups
This is how it works:
· Take ten minutes to review the information in this packet.
· Make the necessary preparations before your class or group meets (see instructions).
· Take ten minutes to conduct the survey in your classroom or group.
· Send the survey sheets back to the FAS Center (see instructions).
Your efforts are appreciated. It is important to raise awareness about the dangers of alcohol use during
pregnancy and the seriousness of Fetal Alcohol Spectrum Disorders. Your participation can help
ensure healthier babies in the future and a healthier community today.Please provide the following demographic information. All personal information will remain confidential.
Gender: M/F Student? Yes/No Grade:_______ Highest level of education: HS/College/Grad Degree
Occupation: Health/Education/Social Services/Other City/State:__________________________________
1. What substance causes the most birth defects?
2. What one substance in pregnancy causes the most brain damage in babies?
3. Do you know what FASD stands for?
4. What disability is more common, Fetal Alcohol or Autism?
5. Do you know how much alcohol is safe during pregnancy?
6. What kinds of birth defects can alcohol cause?
7. How long do the effects of FASD last?
8. What does a child with an FASD look like?
9. What kind of women are most likely to drink during pregnancy?
10. Do you know how to prevent alcohol related birth defects?
When you have completed the survey, fill out the information requested, and mail this to
FAS Center
AZ DES DDD
4710 E. 29th St.
Tucson, AZ, 85711.
Thank you for participating in this FASD survey project!
The sources for information in this Quiz include March of Dimes, National Institute on Alcohol
Abuse and Alcoholism, the FASD Center for Excellence, the National Organization on Fetal
Alcohol Syndrome, and the Institute of Medicine. Citations can be found on the web site of the
FAS Community Resource Center at www.FASCRC.com
Answers
1. What substance causes the most birth defects? ALCOHOL (during pregnancy)
Alcohol consumption during pregnancy can cause problems during the baby’s development.
2. What one substance in pregnancy causes the most brain damage in babies? ALCOHOL (during
pregnancy)
Alcohol does more damage to the developing baby’s brain than any other substance of abuse..
3. Do you know what FASD stands for? FETAL ALCOHOL SPECTRUM DISORDERS
FASDs can be mild or severe.
4. What disability is more common, FASD or Autism? FASD
Fetal Alcohol Spectrum Disorders occur more frequently than Autism Spectrum Disorders.
5. Do you know how much alcohol is safe during pregnancy? NONE
Light or moderate drinking during pregnancy can cause problems. When the pregnant mother takes a drink, it is
just like giving a drink directly to the baby, because the blood alcohol content (BAC) in the baby is equal to that
in the mother.
6. What kinds of birth defects can alcohol cause? ALL KINDS
Alcohol during pregnancy can cause heart defects, cerebral palsy, vision and hearing problems, attention deficit
disorder, hyperactivity, memory problems, learning disabilities, and behavior problems. Alcohol can also cause
small birth weight, miscarriage, or death.
7. How long do the effects of FASD last? LIFETIME
The problems for people with FASDs get worse as they get older, because the brain damage causes them to have
problems with school, relationships, and jobs, with planning their life, managing money, making decisions, and
controlling their behavior.
8. What does a child with an FASD look like? NORMAL Some people with full Fetal Alcohol Syndrome
have intellectual impairment and short stature. But most people with fetal alcohol disorders have normal IQ and
no physical signs. They just have a hard time controlling their behavior.
9. What kind of women are most likely to drink during pregnancy? ALL KINDS
This is not just a problem with poor women, alcoholic women, or minorities. Half of all women are drinking at
the time they get pregnant. And half of all pregnancies are unplanned. Women with a college education are
more likely to drink during pregnancy than high school dropouts. And the higher the household income, the
higher the risk of drinking during pregnancy. Alcohol consumption during pregnancy occurs in all ethnic
groups.
10. Do you know how to prevent alcohol related birth defects? DON’T DRINK
It is important for both the man and the woman to stay alcohol free before, during, and after pregnancy. FASDs
are 100% preventable.
Primary Disabilities:
The following primary cognitive disabilities associated with FAS/ARND are caused by brain damage. Many of them overlap with diagnoses for other disabilities. Therefore many children will be misdiagnosed or underdiagnosed with such disorders as Attention Deficit Hyperactivity Disorder (ADHD), Oppositional Defiant Disorder (ODD), Obsessive Compulsive Disorder (OCD), Sensory Integration Disorder (SID), and Learning Disabilities (LD), among others:
- Developmental delays – often acts younger than his or her age
- Inconsistent performance – seems to “get it” one day and lose it the next. Leads people to believe that the child is intentionally being difficult.
- Hyperactivity – constantly in motion
- Impulsivity – says and does whatever comes to mind without thinking about consequences
- Attention deficits, distractibility – at times their lack of ability to stay focused on a task for very long is due to attention deficits; may also be easily distracted
- Disorganization – messy, can’t find things, unprepared for school or work
- Poor social skills – has problems making and keeping friends, doesn’t understand social cues or body language
- Literal thinking – doesn’t understand subtle jokes or statements that have double meanings; take things very literally. For example, don’t say, “Hit the road” when you mean “Leave” or “Cut it out” when you mean “Stop”.
- Difficulty with abstractions – struggles with abstract concepts such as math, money management, time, ownership, and consequences.
- Difficulty with transitions – needs help when switching from one activity to another. May become very involved in current activity and will have difficulty changing to a new one especially if it is felt that the current activity is incomplete.
- Memory problems – difficulty storing and retrieving information
- Processing deficits – may think more slowly, may only understand every third word of normally paced conversation.
- Ability to repeat instructions, but inability to put them into action – can “talk the talk but not walk the walk”
- Inability to predict outcomes or understand consequences and cause/effect – poor judgment
- Difficulty generalizing from one situation to another – a lesson learned in one situation does not carry over to a new situation.
Secondary Disabilities
Secondary disabilities are those that result from the primary disabilities. For example, due to damage to certain brain regions, a person with FAS/ARND may have poor judgment. This could lead to the secondary disability of getting into trouble with the law. Ann Streissguth, Ph.D. of the University of Washington, a pioneer and recognized authority in the field of FAS, completed a study in 1996 identifying these secondary disabilities. They include:
- Trouble with the law – secondary to poor judgment, inability to understand consequences, and boundary issues
- Mental health problems – secondary to damage to brain regions and chemical imbalances
- Disrupted school experience – secondary to developmental delays, inconsistent performance, hyperactivity, impulsivity, distractibility, attention deficits, disorganization, poor social skills, difficulty with abstractions, memory problems, processing deficits, difficulty with transitions
- Confinement – secondary to poor judgment and boundary issues
- Alcohol and drug problems – possibly self medicating to compensate for damage to brain regions and chemical imbalances
- Problems with employment – secondary to developmental delays, poor social skills, difficulty with abstractions like time, etc.
- Dependent living – secondary to difficulty with abstractions like time, money management, poor social skills, developmental delays
- Inappropriate sexual behavior – secondary to boundary issues, poor social skills, inability to understand consequences
With early and ongoing support and services, children with FAS/ARND are less likely to develop these secondary disabilities.
Dr. Streissguth, in the same study, identified factors that decreased incidence or reduced the effect of the secondary disabilities. These factors include:
- Living in a stable and nurturant home for over 72% of life
- Being diagnosed before the age of 6
- Never having experienced violence against oneself
- Staying in each living situation for an average of more than 2.8 years.
- Experiencing a good quality home from ages 8-12 years
- Applied for and eligible for services for the developmentally disabled
- Having a diagnosis of FAS rather than ARND
- Having basic needs met for at least 13% of life
Quick Facts
- Prenatal exposure to alcohol and other drugs is the leading cause of preventable birth defects in the country.
- 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, behavioral, and/or learning disabilities with possible lifelong implications.
- Each year, as many as 40,000 babies are born with an FASD, costing the nation about $4 billion. (Source: FASD Center for Excellence)
- A person with FASD may need multiple services involving numerous agencies in various service systems spread across a number of locations. It is rare to find coordination of services or case management for persons with FASD. Depending on the individual’s specific needs, several dozen providers may be involved.
- Although the various effects of FASD are permanent conditions, specific symptoms may be treatable or manageable. People with FASD can grow, improve and function in life with proper support.
- FASD is a 100 percent preventable birth defect. All women of child-bearing age need to know not a single drop!
Fetal alcohol spectrum disorders (FASD) are caused by the effects of maternal alcohol consumption during pregnancy. Fetal alcohol syndrome (FAS) is the most clinically recognizable form of FASD and is characterized by a pattern of minor facial anomalies, prenatal and postnatal growth retardation, and functional or structural central nervous system (CNS) abnormalities. The consequences are lifelong, and the behavioral and learning difficulties are often greater than the degree of neurocognitive impairment. Alcoholrelated neurodevelopmental disorder also is a clinically recognizable diagnosis in the continuum of FASD and describes the clinical outcome when the facial features typical of FAS are absent.
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