Fetal Alcohol Spectrum Disorders

Minnesota Organization on Fetal Alcohol Syndrome

Fetal Alcohol Spectrum Disorders (FASD) is a term that describes the range of problems that can occur in an individual whose mother drank alcohol during pregnancy. A child born with an FASD may have lifelong struggles with behavior and learning and there may be physical problems as well.

Alcohol quickly and easily crosses the placenta. If you drink alcohol during pregnancy your baby's blood alcohol content will closely match yours. Alcohol is a teratogen which means it is a substance that is toxic to baby's developing cells, and brain cells are especially vulnerable. We have learned in recent years through the use of MRI and other brain imaging methods that the damage to the developing baby's brain can be quite extensive. Sometimes cells migrate to the wrong location during development, sometimes parts of the brain fail to develop at all (for example, corpus callosum). This brain damage cannot be fixed, it is permanent.

In addition to brain damage, there can be physical differences in babies who were exposed to alcohol in the womb. If you drink alcohol during the early weeks of pregnancy when your baby's face is developing, your child may have certain facial features characteristic of Fetal Alcohol Syndrome. If you drink alcohol during the time that the heart is developing, your child can have an alcohol-related birth defect of the heart. So much depends on what is developing in the baby at the time alcohol is consumed and the individual characteristics of the mother and fetus, that it is impossible to say how much alcohol is safe during pregnancy. The message must continue to be that there is no safe amount, no safe time and no safe kind of alcohol to use during pregnancy.

Some people with Fetal Alcohol Spectrum Disorders will have IQs that are low enough to qualify them for special services, but most people with FASD have IQs that are within the average range. Most people with FASD look completely normal as well. They may, however, struggle with impulse control, attention, learning, hyperactivity or have sensory processing disorders, memory deficits, problems making and keeping friends, difficulty understanding cause and effect, trouble regulating their emotions and other problems that make it hard for them to live independently or keep a job when they are older. There are strategies that can help people with FASD be more successful and it is important for parents of children prenatally exposed to alcohol to find resources and learn about this disability so they can best help and advocate for their children.

FASD in infants may include:

• Easily over-stimulated - baby may not tolerate being held or rocked while being fed
• Poor habituation - easily distracted and aroused by the environment
• Irregular sleeping patterns
• Lack of "stranger anxiety"
• Sensitivity to touch
• Weak suck, feeding is difficult
• Motor delays
• Fussiness
• Failure to thrive or problems with growth

FASD in toddlers may include:

• Hyperactivity
• Language and speech delay
• Motor problems
• Sleep problems
• No understanding of safety issues
• Cognitive deficits
• Overly tactile
• Tantrums

FASD in preschoolers may include:

• Language and speech delays
• Small motor problems (learning to write and use scissors may be difficult)
• Coordination and balance problems
• Difficulty learning social skills (biting, poking friends)
• Night terrors and sleep problems
• Distractibility
• Difficulty completing tasks
• Easily frustrated (tantrums)
• Delays in toilet training

Tips for helping a child with FASD:

• Early diagnosis and intervention have been found to increase success - talk to your child's pediatrician about any concerns
• Adapt the environment to meet your child's needs. Reduce noise and clutter
• Simple, concrete directions and consistent rules
• Meal and bedtime routines
• Preschool or early socializing and learning opportunities
• Stability in the home