Fetal Alcohol Spectrum Disorder (FASD) is an umbrella term covering a range of disorders caused by prenatal alcohol exposure, including Fetal Alcohol Syndrome, Partial Fetal Alcohol Syndrome and Neurodevelopmental Disorders - Alcohol Exposed. FASD is not a clinical diagnosis in itself.
The effects of fetal alcohol exposure are life-long and may not be seen at birth. A minority of children will have Fetal Alcohol Syndrome or Partial Fetal Alcohol Syndrome which can be identified by abnormal facial features (with or without other birth defects), poor growth and abnormalities of the brain or neurological problems. The majority of children with FASD will look normal but will have learning or behavioural problems associated with the primary brain damage.
Fetal Alcohol Syndrome
Fetal Alcohol Syndrome is at the most severe end of the
spectrum of fetal alcohol disorders. The facial features include
small eye openings, a thin upper lip, a flat midface and an absence
or elongated groove between the upper lip and nose. Babies with
Fetal Alcohol Syndrome will have a low birth weight and fail
to thrive despite receiving adequate nutrition after birth; and
children may be small for their age. Babies born with Fetal Alcohol
Syndrome will have a small head and brain abnormalities. The
damage to the brain can result in behavioural problems; language
and speech problems; vision and hearing problems; and problems with
thinking, judgement and reasoning. There is no biomarker for the
diagnosis of Fetal Alcohol Syndrome. (A biomarker is a term used to
describe a test such as blood, urine or faeces to identify the
severity or presence of a disease.)
Partial Fetal Alcohol Syndrome
A baby or child with Partial Fetal Alcohol Syndrome will
have some but not all of the symptoms of Fetal Alcohol
Syndrome.
Facial Features
The facial development of the fetus occurs mainly between weeks 4 and 8. The distinctive facial features of Fetal Alcohol Syndrome and Partial Fetal Alcohol Syndrome are included in the photos below. Photos have been reproduced with permission from Susan Astley, University of Washington
For more information please go to the University of Washington FAS Diagnostic & Prevention Network website
- A smooth philtrum (no groove between the upper lip and nose)
- Thin vermillion border (thin upper lip)
- Short palpebral fissures (small eye openings)
Neurodevelopmental Disorders - Alcohol Exposed
The majority of babies and children with FASD will fall within this
category. These babies and children will not have the facial
features of Fetal Alcohol Syndrome but will have a range of
symptoms caused by damage to different parts of the brain. These
symptoms can include a delay in reaching milestones such as walking
and talking; poor hand eye coordination; unable to complete complex
tasks that involve planning, problem solving and judgement; and
difficulties with motor function and social interactions. Children
may also have poor academic performance and lack the ability to
control their emotions.
Children with diagnoses included under the fetal alcohol
disorders spectrum often have:
- Brain damage
- Low IQ
- Birth defects
- Poor growth
- Developmental delay
- Language and speech deficits
- Problems with sensory systems - vision, hearing, touch
- Motor coordination problems
- Difficulty sleeping
- High levels of activity
- Difficulty remembering and are not able to generalise their learning
- A short attention span
- Problems with abstract thinking
- Poor judgement and not able to understand the consequences of their actions
- Social and behavioural problems
- Difficulty forming and maintaining relationships and indiscriminately friendly
Babies and infant symptoms can include:
- Irritability
- Poor feeding
- Low birth weight
- Decreased muscle tone and poor coordination
- Delayed development such as walking and talking
- Hypersensitivity to noise, light and touch
- Bonding problems
Researchers and parents say that it is not 'bad behaviour' but the
actions of an infant or child who has damage to their brain and who
is unable to control what they do.
Brain Development
- Alcohol affects the development of the unborn baby's brain
- The brain continues to develop throughout the pregnancy and until we reach the age of 19 or 20
- Many children will have neurodevelopmental disorders (impairment of the growth and development of the brain)
- Children with neurodevelopmental disorders don't learn from their mistakes and they don't understand cause and consequence and they can't be disciplined in the normal way.
In an interview with the Australian newspaper on 20 June 2011 Sue
Miers AM, National spokesperson for The National Organisation for Fetal Alcohol
Syndrome and Related Disorders (NOFASARD) was quoted as
saying:
"They (children with a FASD) often also have sensory disorders
and get easily overwhelmed in high sensory environments like
classrooms.
Then they don't complete school, and have secondary issues such
as being involved in the juvenile justice system. About 90 per cent
end up with mental health issues, and 50 per cent with drug or
alcohol problems."
The drawing below shows which parts of the brain are responsible for our actions and behaviours
What does the brain do?
Early recognition of alcohol-exposed infants and early diagnosis of FASDs is crucial to allow a process of assessment and therapy for children at the earliest age possible to facilitate their development. The aim is to improve long term outcomes for children, to help treat vulnerable women and their families, and to prevent subsequent births of affected children.
History of Fetal Alcohol Spectrum Disorders
|
Date |
Development
|
|
Biblical, ancient Greek and Roman |
References to a possible awareness of the links between maternal alcohol consumption and negative child outcomes
|
|
Gaelic Scotland |
Mother and nurse were not permitted to drink ale while pregnant or breast feeding
|
|
1899 England |
Dr William Sullivan noted the higher rates of stillbirth for 120 alcoholic prisoners compared to their sober female relatives and suggested a link to alcohol consumption
|
|
1968 France |
Dr Paul Lemoine studied the distinctive features of children whose mothers were alcoholics
|
|
1968-1969 USA |
Researchers at the University of Washington Medical School documented the development of children of 11 alcoholic mothers
|
|
1973 USA |
Dr Kenneth Lyons and Dr David Weyhe Smith from the University of Washington Medical School identified a pattern of facial, limb and cardiovascular defects in 8 unrelated children born to alcoholic mothers - called it Fetal Alcohol Syndrome
|
|
1982 USA |
Dr Sterling Clarren confirmed that alcohol was a teratogen (A teratogen is a drug, chemical or even infection that interrupts or alters the normal development of a fetus, including the development of the brain or other major organs. Other examples of teratogens include Rubella, radiation, mercury and thalidomide)
|
|
1983 - 2012 |
Over time, new research has identified a range of effects (including physical, behavioral, and cognitive) that can arise from prenatal alcohol exposure. The term Fetal Alcohol Spectrum Disorder (FASD) has developed to include Fetal Alcohol Syndrome as well as other conditions resulting from prenatal alcohol exposure
|
Support Services
If you would like to talk to someone about stopping drinking and the effects of alcohol; or want to find a service in your state or territory, the following websites provide information on services and organisations around Australia. These links do not imply any endorsement, support or commercial gain by the Alcohol and Pregnancy Research Group or the Telethon Institute for Child Health Research.
Women and Newborn Drug and Alcohol Service (King Edward Memorial Hospital, Perth Western Australia) or read the brochure
Women's Health and Family Services (Perth, Western Australia)
The Women's Alcohol and Drug Service (Royal Women's Hospital, Melbourne Victoria)
Alcohol and drug treatment and information services (List for each state and territory)
Drug and Alcohol Services - National, State and Territory Services and Organisations
Other links
Read about our project The development of a screening and diagnostic instrument for FASD in Australia.
Read the stories and comments from parents in Living with children with a Fetal Alcohol Spectrum Disorder
Want more information - go to Where to go for assistance and Links (websites for parents, carers, teachers, workers in the justice system and health professionals).