Indiana Prevention Resource Center (IPRC)

Focus on Fetal Alcohol Syndrome Disorders (FASDs)

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Published on January 21, 2016

Part 1:  What it is, Causes, Consequences, Responses

During January we remember the too frequently devastating results of drinking during pregnancy -- outcomes that, if the mother avoids alcohol consumption, are 100% preventable.  The CDC defines fetal alcohol spectrum disorders (FASDs) as “a group of conditions that can occur in a person whose mother drank alcohol during pregnancy.”  (CDC, April 2015 – Facts about FASDs)  Problems can include physical, behavioral and learning issues and often involves a combination. 
FASD may manifest itself in the following ways:  abnormal facial features, small head circumference, shortened height, low weight, poor coordination, hyperactivity, attention deficit, poor memory, problems in school (particularly with math), learning disabilities, delays and difficulties in speech and language, lower IQ, poor reasoning/judgement, sleep disorder, vision or hearing problems, heart, kidney or bone problems.   (CDC, Apr, 2015)  Part 1 of this article summarizes information presented on the CDC’s web site (http://www.cdc.gov/ncbddd/fasd/facts.html) on Fetal Alcohol Syndrome Disorders (FASDs).    

Source: http://www.dfw.org.uk/news-events/seminar-adoption-focus-foetal-alcohol-syndrome-disorder

The cause is simple:  drinking alcohol during pregnancy.   Alcohol passes to the fetus via the umbilical cord.  No amount of alcohol is known to be safe while pregnant or while attempting to become pregnant.  There is no safe time, place, circumstance, or type of alcohol.   The only way to prevent FAS and FASD is by not drinking at all.   Unfortunately, one in 10 pregnant women report alcohol use.  Annually an estimated 120,000 newborns in the U.S. are born with a birth defect, and among these FASD is one of the most common. 

Based on their symptoms, three different terms are used to describe alcohol-related fetal damage.  The 2nd and 3rd terms were adopted by the Institute of Medicine (IOM) in 1996, replacing the term Fetal Alcohol Effects (FAE) for conditions affecting intelligence, behavior and learning consequent to the mother drinking during pregnancy.

• Fetal Alcohol Syndrome (FAS), the most extreme presentation of the spectrum in the form of death or manifestation of the above effects, including physical abnormalities in facial features, problems with growth and in their central nervous system
• Alcohol-Related Neurodevelopmental Disorder (ARND describes people whose intellectual abilities have been affected, resulting in behavioral and learning problems.
• Alcohol-Related Birth Defects (ARBD) refers to persons suffering heart, kidney, bone, or hearing problems or a combination thereof.

The solution is for women to not drink at all while attempting to become pregnant and throughout the entire pregnancy.   Treatment is in the form of intervention as early as possible, for the mother to stop drinking at any point for the duration of the pregnancy, and after birth to improve child development.   There are medications to address some FASD symptoms.   There are therapies to help with behavior and learning.   Parents can be trained in child-rearing techniques that provide structure and help with discipline.   The FASDs will not go away, will not be out grown, but will endure for the person’s lifetime.  Protective factors can be enhanced to help the individual reach her/his potential.   Contributions to protection include:  being diagnosed before age 6; having a home environment that is stable, loving, and nurturing; not experiencing or witnessing violence; and the opportunity to participate in special education and social services. 

Part 2:  What Can Be Done To Prevent FASDs – Community Action Steps

Three approaches that can be taken by communities to prevent Fetal Alcohol Syndrome Disorders (FASDs) have been recommended  by the Substance Abuse and Mental Health Services Administration (SAMSHA) in their publication “Preventing FASD” (2007):

• To increase public knowledge about FASD through general education, public service announcements, media attention, alcohol warning labels, posters, pamphlets and billboards.
• Target women at risk by screening pregnant women and women of childbearing age for alcohol use, and by providing interventions with pregnant women who drink and with women who drink and do not use birth control.   Screening and brief interventions  such as motivational interviewing may be effective at reducing risk.
• Target women at highest risk through treatment of alcohol problems and strategies to encourage pregnancy prevention.   Women at risk include those who abuse alcohol while pregnant or who are at risk of becoming pregnant, particularly women who have already given birth to a child with an FASD. 

Of primary interest and assistance to communities in this effort are the resources of the FASD Center for Excellence of SAMHSA (www.fasdcenter.samhsa.gov/) ; the FASD website of the CDC (www.cdc.gov/ncbddd/fasd/; and the National Organization on Fetal Alcohol Syndrome (www.nofas.org).    The National Birth Defects Prevention Network, in collaboration with the CDC and others, created a 2016 National Birth Defects Prevention Month packet to help raise awareness and offer actionable steps that community groups can take.   You can download the entire packet at http://www.nbdpn.org/bdpm2016.php.   It includes sample proclamations, sample news releases, fact sheets for policy makers, a social media toolkit, and much more. 

The IPRC HOME Library offers over 100 resources related to fetal alcohol syndrome, with 25 published since 2012.   These include materials about the effect of a Screening, Brief Intervention and Referral to Treatment intervention,  YouTube videos on the topic from the ATTC and others,  research articles from the CDC and others,  diagnostic tests in the adolescent years, personal stories about living with FASD, the history of the syndrome, FASD and mental health treatment, a longitudinal study from the NIAAA on the long-term consequences , moderate prenatal drinking tied to lower child IQ,  and heavy prenatal drinking linked to childhood brain development. 

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