What are Fetal Alcohol Spectrum Disorders (FASD)?

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What is Fetal Alcohol Syndrome? (first in a series)

Fetal Alcohol Spectrum Disorder (FASD) is a global term used to refer to the multitude of birth defects that can be caused by prenatal exposure to alcohol.

In this day and age, most women have heard at some point that drinking while they’re pregnant can hurt their baby, but many don’t understand how severe the problems can be, or what forms they can take.

Specific, targeted research into the effects of prenatal alcohol exposure has really only begun in the latter half of the 20th century, as awareness within the scientific community and the population at large began to grow.  Now, experts disagree on what amount might be too much, whether a small drink now and then can cause great harm, but the fact remains that there is no clear answer to that question. This has led many if not most public health professionals to advise mothers to abstain as completely as possible as soon as they know or suspect they might be pregnant, under the maxim “better safe than sorry.”

One of the reasons it has taken so long for Fetal Alcohol Spectrum Disorder to be recognized, researched, and treated is the sheer variety of ways it can present in children. FASD is called a spectrum disorder for this very reason: depending on a multitude of factors including the amount, timing, and pattern of the alcohol exposure (eg. binge drinking vs. regular smaller amounts), various complications can occur, and each case is unique. Some of these complications are hard to detect, and it is widely suspected that many cases of milder FASDs are often misdiagnosed (as ADHD, for example). This will be discussed further in a later article.

In classic, or full Fetal Alcohol Syndrome (FAS), characteristic physical malformations, especially to the face and head, can present; see http://pubs.niaaa.nih.gov/publications/Social/Module10KFetaExposure/Module10K_12.jpg for a selection of pictures.  However, serious problems often lurk behind a totally ‘normal’ exterior – malformations in the brain and central nervous system which can cause serious neurological and behavioural problems.

The reasons for the variety of presentations are easy to understand.  As children develop in the womb, different parts of their bodies and nervous systems are developing at different rates and at different times. Therefore, if for example a large amount of alcohol was ingested at a time when the eyes were particularly vulnerable, one might expect to see more effects in that area, but later in the pregnancy, the teeth might be more vulnerable. See the chart at http://embryology.med.unsw.edu.au/Medicine/images/hcriticaldev.gif for a good overview of how teratogens (agents causing birth defects, such as alcohol) can affect a baby in utero at different stages of gestation. It’s worth pointing out that the brain and central nervous system remain vulnerable throughout pregnancy.

The series of posts to follow will concentrate on the various subtypes/divisions within the spectrum, from Alcohol-Related Birth Defects to ‘full’ Fetal Alcohol Syndrome; physical characteristics; neurological effects; behavioral and psychological challenges of FASD; speech and language implications; strategies for helping children with FASD; challenges to diagnosis and treatment; and further resources to learn more about FASD.

I welcome your comments to add to and further inform this article and those to follow, and your questions or recommendations for the later articles!

**Note: much of the content of this and the articles to follow was originally gathered for a neurolinguistics term paper I submitted in Fall 2006. I will cite sources as much as possible, but any mistakes are my own. I am not an expert, but I have done quite a lot of reading and research. If you have any concerns or wish to learn more than a general knowledge overview, please contact a medical professional.**

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