Fetal Alcohol Spectrum Disorder (FASD) is the term used to describe the range of effects caused by drinking alcohol during pregnancy. These effects may include physical, mental, behavioural and/or learning disabilities with possible lifelong implications.
Prenatal exposure to alcohol is a leading cause of preventable birth defects and along with Spina Bifida and Down Syndrome, one of the top three known causes of developmental delay in children in Canada. Health Canada estimates that approximately 9 in every 1,000 infants are born with FASD. In North America, FASD was first identified as a medical condition in 1973.
Fetal Alcohol Spectrum Disorder (FASD), Fetal Alcohol Syndrome (FAS), Alcohol-Related Birth Defects (ARBD), Fetal Alcohol Effects (FAE), and Alcohol-Related Neurological Disorders (ARND) are the most commonly used terms to refer to the various forms of impact, resulting from exposure to prenatal alcohol.
FASD Damage is Irreversible
Some children with FASD have physical disabilities, but many of the effects are not visible and may include problems with learning, memory, attention, problem solving, behaviour, vision and hearing. They may not understand social situations and their behaviour is often interpreted as problematic, rather than a symptom of an underlying condition. Children with FASD do best when their individual strengths are recognized and built upon in a supportive environment adapted to meet their needs.
In terms of FASD, growth deficiency is defined as significantly below average height, weight or both due to prenatal alcohol exposure. Deficiencies are documented when height or weight falls at or below the 10th percentile of standardized growth charts appropriate to the patient's population.
The Central Nervous System and FASD
Central nervous system (CNS) damage is the primary key feature of any FASD diagnosis. Prenatal alcohol exposure can damage the brain across a continuum of gross to subtle impairments, depending on the amount, timing, and frequency of the exposure as well as genetic predispositions of the fetus and mother. Structural abnormalities of the brain are observable, physical damage to the brain or brain structures caused by prenatal alcohol exposure. Structural impairments may include microcephaly (small head size) of two or more standard deviations below the average, or other abnormalities in brain structure (e.g., agenesis of the corpus callosum, cerebellar hypoplasia).
When structural impairments are not observable or do not exist, neurological impairments are assessed. In the context of FASD, neurological impairments are caused by prenatal alcohol exposure which causes general neurological damage to the central nervous system (CNS), the peripheral nervous system, or the autonomic nervous system.
Neurological problems are expressed as either hard signs, or diagnosable disorders, such as epilepsy or other seizure disorders, or soft signs. Soft signs are broader, nonspecific neurological impairments, or symptoms, such as impaired fine motor skills, neurosensory hearing loss, poor gait, clumsiness, poor eye-hand coordination, or sensory integration dysfunction. Many soft signs have norm-referenced criteria, while others are determined through clinical judgment.
Prenatal alcohol exposure risk may be assessed by a qualified physician, psychologist, social worker, or chemical health counselor. These professionals work together as a team to assess and interpret data of each key feature for assessment and develop an integrative, multi-disciplinary report.
Amount, frequency, and timing of prenatal alcohol use can dramatically impact the key features of FASD. Most individuals with deficits resulting from prenatal alcohol exposure do not express all features of FAS and fall into other FASD conditions. Since research has not been able to confirm a safe level of alcohol on an unborn child, a woman should not drink when she is pregnant.
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