What is Fetal Alcohol Spectrum Disorder?
Fetal Alcohol Spectrum Disorder, or FASD, is an umbrella term used to describe the range of permanent disabilities caused by prenatal exposure to alcohol. Prenatal exposure to alcohol is a leading cause of preventable birth defects. Alcohol can interfere with the growth and development of the fetal body systems, especially the central nervous system (the brain and spinal cord). Although it can vary from mild to severe the effects can include physical, mental, behavioural, and/or learning disabilities with possible lifelong implications. It is one of the top three known causes of developmental delay in children in Canada along with Spina Bifida and Down Syndrome. The greatest risks of FASD are associated with high levels of drinking, including binge drinking, or heavy drinking. Right now, there is no way of knowing how much alcohol is safe to drink during pregnancy. Less is better. None is best. FASD is a life-long condition.
There are four terms commonly used to describe FASD:
Fetal Alcohol Syndrome(FAS): most severe and visibly identifiable form of FASD. FAS is characterized as: growth deficiency; a unique cluster of minor facial abnormalities; severe CNS abnormalities; and prenatal alcohol exposure.
Partial Fetal Alcohol Syndrome (pFAS): a diagnostic classification for patients who present most but not all the growth deficiency and/facial features of FAS; severe SNS abnormalities; and prenatal alcohol exposure.
Alcohol Related Birth Defects(ARBD): patients with ARBD have problems with how some of their organs were formed and function including: heart, kidney, bones, hearing, and vision.
Alcohol-Related Neurodevelopmental Disorder (ARND): patients with ARND have issues with their brain and nervous system formation and functionality. There are no facial abnormalities or growth deficiencies.
Neurobehavioural Disorder associated with Prenatal Alcohol Exposure (ND-PAE): patients with ND-PAE have problems with thinking, behaviour, and life skills. This is due to alcohol exposure during pregnancy.
How is it manifested?
Although there is great variability in the characteristics of children with FASD, three common traits include:
- slowed growth
- small birth weight and head circumference
- small in stature
Distinct facial features
- thin upper lip
- smooth philtrum (groove between upper lip and nose)
- small eye openings
- flat mid-face
Central nervous system deficits
- learning disabilities
- developmental delays
- inappropriate social skills
- difficulty learning from consequences
- poor concentration
- memory problems
- difficulty following instructions
Children may have problems in all three areas, or just one, depending on how they are affected. Often children will have normal growth and facial features, but display central nervous system deficits.
Who is affected?
The exact number of children born with FASD is unknown. FASD affects approximately 1% of people living in Canada and it is believed to be 5 out of every 100 live births worldwide.
How is it diagnosed or detected?
The criteria for the diagnosis of FASD are based on the presence of the following
- evidence of excessive maternal drinking during pregnancy
- characteristic facial dysmorphology (e.g., microcephaly, poorly-developed philtrum, thin upper lip and flattened maxillary area)
- pre- and/or postnatal growth delays (weight, length and/or height below the 10th percentile
- central nervous system (CNS) damage (e.g., signs of neurological abnormality, developmental delay, intellectual impairment, or neurobehavioural anomalies).
Motherisk: The Hospital For Sick Children – www.motherisk.org
Motherisk is dedicated to providing information and guidance to pregnant or lactating patients and their health care providers regarding the fetal risks associated with alcohol, drug, chemical, infection, disease and radiation exposure(s) during pregnancy.
Breaking the Cycle – www.breakingthecycle.ca
Breaking the Cycle is a unique early identification and prevention program for pregnant and/or parenting women who are using substances, and for their young children. The program was created with a holistic approach in mind, to serve women and children living in high-risk circumstances that, in addition to substance use, include homelessness, violence, poverty, poor health and nutrition, and chaotic and unstable environments.
Public Health Agency of Canada – www.phac-aspc.gc.ca/hp-ps/dca-dea/prog-ini/fasd-etcaf/index-eng.php
The Public Health Agency of Canada offers a variety of resources including an information booklet, national reports, and studies on FASD.
FAS/E Information Service
Toll-free in Canada, 1-800-559-4514
Provides links to support groups, prevention projects, resource centres, and experts on FASD.
Canadian Centre on Substance Abuse (CCSA) – www.ccsa.ca
The CCSA is Canada’s national addictions agency. Its mission is to provide objective, evidence-based information and advice that will help reduce the health, social and economic harm associated with substance abuse and addictions.
Best Start: Ontario’s Maternal, Newborn and Early Child Development Resource Centre – www.beststart.org
Best Start is a provincial resource centre that seeks to enhance the capacity of service providers to implement effective health promotion programs for expectant and new parents (including both mom and dad), newborns and young children.
Centre for Addiction and Mental Health (CAMH) – http://www.camh.ca
CAMH is Canada’s largest mental health and addiction teaching hospitals and one of the world leading research centres in the areas of addiction and mental health. It is a client-centred care program. Its website provides information about FASD as well as available resources for families.
Books and Literature:
Living with FASD: A Guide for Parents
By Sara Graefe
Living with Prenatal Drug Exposure
By Lisa Cowan, Jennifer Lee and Emilie Cameron
The content contained in this document is for general information purposes. It is not the intention to diagnose or treat a child.