What is Foetal Alcohol Spectrum Disorder (FASD?) Foetal Alcohol Spectrum Disorder (FASD) is the most common, non-genetic cause of learning disability in the UK (Plant, 1985; Plant et al., 1999; Autti-Ramo, 2002; British Medical Association, 2007; May and Gossage, 2001; Sampson et al., 1997). This condition is preventable. Research suggests that more than 7,000 babies are born every year in the UK with Foetal Alcohol Spectrum Disorder (The Telegraph 22/09/08). Some local authorities estimate that around 70% of the children needing adoptive families have drug/alcohol misuse in their background or have been exposed during pregnancy (Be My Parent 11/04/11 website). It costs an estimated £2.9 million per individual to raise a child with FASD across their lifespan (Peadon et al., 2008).
Of all the substances of abuse (marijuana, cocaine, and heroin) alcohol produces by far the most serious neuro-behavioural effects to the foetus. (IOM report to Congress 1996). Prenatal exposure is caused by alcohol crossing the placenta and within minutes, the level of alcohol in the foetus’ blood reaches maternal blood alcohol level. Alcohol is a teratogen which can cause any type of physical malformation and learning and behavioural challenges.
FASD, Foetal Alcohol Spectrum Disorders is an umbrella term for several diagnosis that are all related to prenatal exposure to alcohol. These are:
Foetal Alcohol Syndrome, FAS
Partial Foetal Alcohol Syndrome, PFAS
Alcohol Related Neuro-developmental Disorder, ARND
Alcohol Related Birth Defects, ARBD
FASD is a series of preventable birth defects caused by alcohol exposure during pregnancy, often even before a woman knows she's pregnant. These defects of the brain and the body exist only because of prenatal exposure to alcohol. Often the condition goes undiagnosed, or is misdiagnosed, for example as autism or ADHD, and this can lead to secondary disabilities. “A diagnosis before six years of age …. is a strong protective factor for all secondary disabilities except Mental Health Problems.” (Streissguth, Barr, Kogan and Bookstein in Streissguth and Kanter, [eds] The Challenge of Fetal Alcohol Syndrome – Overcoming Secondary Disabilities.,1997:35).
The Challenges No two children with FASD are exactly alike, either behaviourally or physically. Some of the co-occurring, behavioural, social and learning characteristics may include: - Attention problems or hyperactivity. (Morse, 1991; Nanson and Hiscock, 1990).* - Academic problems, including specific deficits in mathematics and memory skills. (Streissguth et al., 1993).* - Very specific language deficits e.g. poor receptive language (Abkarian, 1992).* - Problems with adaptive functioning that grows more significant with age. (Lemoine & Lemoine, 1992; Streissguth & Randels, 1989).* - Behavioural challenges. - Social or relationship challenges including difficulty making or sustaining friendships. - Sensory impairments such as vision or hearing. - Sensory integration challenges including auditory, visual and tactile processing.
All of the above issues are expanded upon in Lasser, 1999, Challenges and Opportunities, p.p.19-23). *(1-4 cited by Stratton et al., eds., 1996). - Inconsistent performance - Poor regulation of emotion - Poor working/short term memory issues. - Lack of abstract reasoning - Failure to predict - Do not understand cause and effect - Fails to generalise - Tendency to be oppositional - Poor sense of self - Difficulty with money, time and maths concepts - Difficulty with transitions - Appears unmotivated
Secondary Disabilities Defensive behaviours develop when there is a poor fit between the person with FASD and their world. These behaviours can be lessened or prevented with diagnosis and appropriate support. If support and intervention does not take place these disabilities can include: - Mental Health Problems - Disrupted school experience - Trouble with the law - Confinement - prison/treatment centre - Inappropriate Sexual Behaviour - Alcohol /Drug Problems - Dependent Living - Problems with Employment (Streissguth, Barr, Kogan and Bookstein in Streissguth and Kanter, eds.,1997:pp33,34).
Skills & Qualities One of the important things to remember is that people diagnosed with FASD will also have strengths so it is important to find out what the person does well and have them do that regardless of their behaviour. Some common skill areas include: - Trusting - Caring - Friendly - Persistent - Musical - Artistic - Articulate - Creative - Great with their hands Let us reiterate that FASD is largely preventable and when you consider the challenges that young people with FASD face, then we need to consider how we as a society can do more to prevent other children having to face a life filled with these difficult challenges.