Pregnancy and Alcohol - issues related to women, alcohol, drug addiction, and pregnancy - Pregnancy Prevention, fetal alcohol, children, FASD

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Did You Know?
Nearly 62% of Wisconsin women of childbearing age drink alcohol, and almost 25% are frequent or binge drinkers (4 or more per occasion).

What are FASDs?

Fetal alcohol spectrum disorders (FASD) is an umbrella term used to describe the range of effects associated with prenatal alcohol exposure-it is not a diagnosis. In 1980, the Fetal Alcohol Study Group of the Research Society on Alcoholism first described the wide range of effects that can occur due to prenatal alcohol exposure. In 1996, the federal Institute of Medicine (IOM) published five clinical diagnostic categories that can result from prenatal alcohol exposure. In 2005, Dr. Eugene Hoyme and other authors proposed modifications to the IOM guidelines- making the diagnostic criteria more specific. Learn more about the diagnostic criteria.

Fetal alcohol syndrome (FAS) is a specific pattern of abnormalities seen in some children of women who drank heavily during pregnancy. FAS is a leading cause of mental retardation and other intellectual disabilities in the U.S. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) estimates that FAS occurs in about 1 in 1,000 births. Although FAS is a medical diagnosis, many inconsistencies exist in its assessment, diagnosis, and intervention. Unfortunately, no laboratory tests are available that can establish or rule out an FASD diagnosis. Clinical geneticists and dysmorphologists, as well as the Institutes of Medicine (IOM) generally base their assessments on the following four criteria:

Growth deficiency
Central nervous system
History of prenatal alcohol exposure

Growth deficits associated with prenatal exposure to alcohol include prenatal growth retardation; birth weight, length, and head circumference below the 10th percentile; and postnatal growth retardation. An individual with FAS typically falls below the tenth percentile for height and weight.

Central nervous system (CNS) deficits associated with prenatal exposure to alcohol include poor fine and gross motor coordination and a range of cognitive disabilities including learning disabilities, mental retardation, developmental disabilities, speech and language deficits, memory and processing problems, and attention problems. Individuals with FAS typically have CNS effects ranging from learning disabilities to mental retardation.

Facial changes associated with prenatal exposure to alcohol include narrow eye openings (short palpebral fissures), a flattened ridge

between the nose and upper lip (indistinct philtrum), and a thin upper lip (vermilion).

If an individual has effects in some, but not all of the four categories specified by the Institute of Medicine, an individual may be diagnosed as having a related condition such as Partial FAS (pFAS), alcohol-related neurodevelopmental disorder (ARND), or alcohol-related birth defects (ARBD). These conditions are not necessarily less severe forms of FAS, and they are not easy to recognize or distinguish from other conditions. Collectively, all of the conditions associated with prenatal alcohol exposure are referred to as fetal alcohol spectrum disorders (FASD). This is a descriptive term, and not meant to be used as a diagnosis.

The range of Impairments caused by prenatal alcohol exposure varies tremendously between individuals. Reported IQ scores for individuals with FAS ranges from 29 to 120 , and for individuals with other FASDs ranges from 42 to 142 (Ann Streissguth, PhD). A long-term study on FASD (Understanding the Occurrence of Secondary Disabilities in Clients with FAS and FAE, 1996) reported the following adaptive living deficits among individuals with FASD with an average chronological age of 17: average overall level of adaptive functioning of age 7, performance at an average age of 9 years old in daily living skills based on the Vineland Adaptive Behavior Scale (VABS), performance at an average 6-year-old level in socialization skills, and significant communication deficits.

Other effects of FASD that need to be addressed are the inconsistent learning patterns and the spotty memory that can be exhibited by many individuals with this diagnosis. Difficulties with learning may be associated with organizational and processing deficits in the areas of information input, output, integration, and memory. Although a task may appear to be mastered one day, the following day, or the following week, that same task may very well need to be re-taught. This is a re-occurring pattern.

Additional Information

Diagnosis of an FASD