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Fetal Alcohol Spectrum Disorders

Learn about Fetal Alcohol Spectrum Disorders (FASD), its history, prevalence, and effects on individuals due to maternal alcohol consumption during pregnancy. FASD includes physical, mental, behavioral, and learning disabilities with lifelong implications.

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Fetal Alcohol Spectrum Disorders

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  1. Fetal Alcohol Spectrum Disorders Fetal Alcohol Syndrome Fetal Alcohol Effects Alcohol-Related Neurodevelopmental Disorder Alcohol-Related Birth Defects

  2. 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.” National Organization on Fetal Alcohol Syndrome terminology, 2004

  3. FASD History • Thoughts and concerns regarding alcohol consumption’s effects on procreation or pregnancy are not new (centuries old), though reportedly different1,2 • First ‘official’ documentation in 1899 • Breakthrough in 1960’s and 1970’s: • In 1968 Dr. Paul Lemoine studied 127 children with features and symptoms related to prenatal alcohol exposure • In 1970’s further study in Seattle termed the condition “fetal alcohol syndrome” \Source: Clarren, Sterling K. Recognition of Fetal Alcohol Syndrome. JAMA. 1981;245(23):2436-2439. doi: 10.1001/jama.1981.03310480052033 2Abel, Ernest L.. "Was the Fetal Alcohol Syndrome Recognized by the Greeks and Romans?." Alcohol and Alcoholism 34.6 (1999): 868-872. Was the Fetal Alcohol Syndrome Recognized by the Greeks and Romans?. Web. 20 Feb. 2014.

  4. FASD Prevalence • Approximated • Among United States births: • < 1 in 100,000 born with HIV • 1.5 in 1000 born with Down Syndrome • 6 in 1000 born with Fetal Alcohol Spectrum Disorder • Morgan Fawcett (YouTube, 0-1:55) Source: Centers for Disease Control

  5. Fetal Alcohol Syndrome (FAS) • Affects ~2 babies per 1000 (CDC) • FAS is the leading cause of intellectual delay • FAS is the leading cause of birth defects • Caused by a mother’s heavy drinking during pregnancy • Central nervous system (brain, spinal cord) damage • Untreated, this primary disability can lead to secondary disabilities • Environmental issues complicate the condition • Many FAS-affected children in foster care • Prevalence: 60 out of 1000* • FAS is irreversible *Lange, Shannon, Kevin Shield, Jurgen Rehm, and Svetlana Popova. "Prevalence of Fetal Alcohol Spectrum Disorders in Child Care Settings: A Meta-analysis." Pediatrics 142.4 (2013): e980-e995. Pediatrics.org. Web. 7 Nov. 2013.

  6. Four Fetal Alcohol Syndrome Criteria • Growth problems • Specific facial features • Central nervous system damage or dysfunction • Prenatal alcohol exposure • 4-Digit Diagnostic Code (WA State Diagnostic & Prevention Network)

  7. Growth Problems • Growth retardation • Bone growth - prenatally and postnatally • Height • Weight • Head circumference • Heart malformations

  8. Low Birth WeightSource: Clinical Advisor. Fetal Alcohol Spectrum Disorders. http://www.clinicaladvisor.com/fetal-alcohol-spectrum-disorders/slideshow/585/#4

  9. FAS Physical Characteristics • Facial characteristics • Small head • Small eyes • Large cheeks • Thin upper lip • Flat nose • Clinical presentation (AAFP, 2005)

  10. Vision IssuesSource: Clinical Advisor. Fetal Alcohol Spectrum Disorders. http://www.clinicaladvisor.com/fetal-alcohol-spectrum-disorders/slideshow/585/#2

  11. Fetal Alcohol Syndrome (FAS) Cognitive Characteristics • Learning differences • Visual-spatial learning • Objects on table (remembered, not placed correctly) • Slower reaction times (eye movements - geometric patterns) • Difficulty planning, organizing • Difficulty letting go of problem-solving strategies, even when they do not work • Memory deficits • Early stages, rather than recall (different from Down’s Syndrome) • Attention deficits • May be misdiagnosed ADHD • May focus and maintain attention well, but shift attention poorly Source: NIAAA, Alcohol Alert, December 2000

  12. Brain SizeSource: The Clinical Advisor. Fetal Alcohol Spectrum Disorders. http://www.clinicaladvisor.com/fetal-alcohol-spectrum-disorders/slideshow/585/#1

  13. Fetal Alcohol Syndrome Vignettes(Fetal Alcohol Syndrome, National Academies Press:1996. Page 54) http://books.nap.edu/books/0309052920/html/54.html#pagetop

  14. Fetal Alcohol Effects (FAE) • Those affected with prenatal alcohol exposure • Those without all the symptoms of FAS • Growth deficiencies • Behavior problems • Substance abuse • Cognitive deficits • Some facial features • FAE now known as two diagnoses: Alcohol-Related Neurodevelopmental Disorder, Alcohol-Related Birth Defects

  15. Alcohol-Related Neurodevelopmental Disorder • Issues related to nervous system: • Communication problems • Memory problems • Learning differences • Visual & spatial skill problems • Problems with motor skills

  16. Alcohol-Related Birth Defects • Defects in major organ systems: • Abnormal development • Underdevelopment • Heart • Kidneys • Eyes, ears • Skeleton

  17. Is Any Amount of Alcohol Considered Safe? • There is no “safe” amount of alcohol consumption (Chart: MN Department of Health) • Most physicians will recommend pregnant women abstain from alcohol consumption • According to American Pregnancy Association: • 2-4 drinks, frequently, can lead to FAE • 5-6 drinks, frequently, can lead to FAS • According to Fetal Alcohol Syndrome (Institute of Medicine; National Academies Press: 1996, p. 68) • Effects of mild alcohol intake are controversial • Existing research suggests alcohol bingeing related to FAS

  18. Protective Factors • Early diagnosis • Special education • Social services • Nurturing environment • Absence of violence (National Center on Birth Defects and Developmental Disabilities)

  19. Early Intervention

  20. Common Issues Among FAS Babies • Sleep disturbances • Poor sucking response • Crying • Underdevelopment • Toilet training challenges • Distractibility, difficulty following directions • Disobedience Source: Teresa Kellerman, Coordinator, FAS Resource Center

  21. Screening • In September 2012, American Academy of Pediatrics recommended all children be screened for Fetal Alcohol Syndrome • At Emory University, Experts Try New Approach to Treating Fetal Alcohol Syndrome (CBS Atlanta, September 2012)

  22. Affected Individuals • Randy (ARND) • Matt (FAS) • Stefanie (FAS) • Sinja (FAS; English child living in Germany) • The Story of Iyal (YouTube, 3:49)

  23. FAS: Real People Fetal Alcohol Syndrome: A Biological Basis (Youtube.com)

  24. Resources • Fetal Alcohol Syndrome Diagnostic and Prevention Network (UW), 206-598-0555 • National Organization on Fetal Alcohol Syndrome Washington State (Mill Creek), 206-940-2832 • Fetal Alcohol Drug Unit (UW), 206-543-7155

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