1. Fetal Alcohol Spectrum Disorders
Fetal Alcohol Syndrome
Fetal Alcohol Effects
Alcohol-Related Neurodevelopmental Disorder
Alcohol-Related Birth Defects

2. Fetal Alcohol Spectrum Disorders
“ (FASD) is an umbrella term describing the range of effects that can occur in an individual whose mother drank alcohol during pregnancy. These effects may include physical, mental, behavioral, and/or learning disabilities with possible lifelong implications.”
National Organization on Fetal Alcohol Syndrome terminology, 2004

3. FASD History
Thoughts and concerns regarding alcohol consumption’s effects on procreation or pregnancy are not new (centuries old), though reportedly different1,2
First ‘official’ documentation in 1899
Breakthrough in 1960’s and 1970’s:
In 1968 Dr. Paul Lemoine studied 127 children with features and symptoms related to prenatal alcohol exposure
In 1970’s further study in Seattle termed the condition “fetal alcohol syndrome”
1Source: Clarren, Sterling K. Recognition of Fetal Alcohol Syndrome. JAMA. 1981;245(23): doi: /jama
2Abel, Ernest L.. "Was the Fetal Alcohol Syndrome Recognized by the Greeks and Romans?." Alcohol and Alcoholism 34.6 (1999): Was the Fetal Alcohol Syndrome Recognized by the Greeks and Romans?. Web. 20 Feb

4. FASD Prevalence Morgan Fawcett (YouTube, 0-1:55)
Approximated
Among United States births:
< 10 in 100,000 born with HIV
1.5 in 1000 born with Down Syndrome
6 in 1000 born with Fetal Alcohol Spectrum Disorder
Morgan Fawcett (YouTube, 0-1:55)
Source: Centers for Disease Control

5. Fetal Alcohol Syndrome (FAS)
Affects babies per 1000 (CDC)
FAS is the leading cause of intellectual delay
FAS is the leading cause of birth defects
Caused by a mother’s heavy drinking during pregnancy
Central nervous system (brain, spinal cord) damage
Untreated, this primary disability can lead to secondary disabilities
Environmental issues complicate the condition
Many FAS-affected children in foster care
Prevalence: 60 out of 1000*
FAS is irreversible
*Lange, Shannon, Kevin Shield, Jurgen Rehm, and Svetlana Popova. "Prevalence of Fetal Alcohol Spectrum Disorders in Child Care Settings: A Meta-analysis." Pediatrics (2013): e980-e995. Pediatrics.org. Web. 7 Nov

6. Four Fetal Alcohol Syndrome Criteria
Growth problems
Specific facial features
Central nervous system damage or dysfunction
Prenatal alcohol exposure
4-Digit Diagnostic Code (WA State Diagnostic & Prevention Network)

7. Growth Problems Growth retardation
Bone growth - prenatally and postnatally
Height
Weight
Head circumference
Heart malformations

8. Low Birth Weight Source: Clinical Advisor
Low Birth Weight Source: Clinical Advisor. Fetal Alcohol Spectrum Disorders.

9. Low Birth Weight (example only; not due to FASD) Source: Beginbeforebirth.org

10. FAS Physical Characteristics
Facial characteristics
Small head
Small eyes
Large cheeks
Thin upper lip
Flat nose
Clinical presentation (AAFP, 2005)

11. Vision Issues Source: Clinical Advisor
Vision Issues Source: Clinical Advisor. Fetal Alcohol Spectrum Disorders.

12. Fetal Alcohol Syndrome (FAS) Cognitive Characteristics
Learning differences
Visual-spatial learning
Objects on table (remembered, not placed correctly)
Slower reaction times (eye movements - geometric patterns)
Difficulty planning, organizing
Difficulty letting go of problem-solving strategies, even when they do not work
Memory deficits
Early stages, rather than recall (different from Down’s Syndrome)
Attention deficits
May be misdiagnosed ADHD
May focus and maintain attention well, but shift attention poorly
Source: NIAAA, Alcohol Alert, December 2000

13. Brain Size Source: The Clinical Advisor
Brain Size Source: The Clinical Advisor. Fetal Alcohol Spectrum Disorders.

14. Fetal Alcohol Syndrome
Vignettes (Fetal Alcohol Syndrome, National Academies Press:1996. Page 54)

15. Fetal Alcohol Effects (FAE)
Those affected with prenatal alcohol exposure
Those without all the symptoms of FAS
Growth deficiencies
Behavior problems
Substance abuse
Cognitive deficits
Some facial features
FAE now known as two diagnoses: Alcohol-Related Neurodevelopmental Disorder, Alcohol-Related Birth Defects

16. Alcohol-Related Neurodevelopmental Disorder
Issues related to nervous system:
Communication problems
Memory problems
Learning differences
Visual & spatial skill problems
Problems with motor skills

17. Alcohol-Related Birth Defects
Defects in major organ systems:
Abnormal development
Underdevelopment
Heart
Kidneys
Eyes, ears
Skeleton

18. Is Any Amount of Alcohol Considered Safe?
There is no “safe” amount of alcohol consumption (Chart: MN Department of Health)
Most physicians will recommend pregnant women abstain from alcohol consumption
According to American Pregnancy Association:
2-4 drinks, frequently, can lead to FAE
5-6 drinks, frequently, can lead to FAS
According to Fetal Alcohol Syndrome (Institute of Medicine; National Academies Press: 1996, p. 68)
Effects of mild alcohol intake are controversial
Existing research suggests alcohol bingeing related to FAS
Experiment in Alaska bars (NBC, 2014)

19. Protective Factors Early diagnosis Special education Social services
Nurturing environment
Absence of violence
(National Center on Birth Defects and Developmental Disabilities)

20. Early Intervention

21. Common Issues Among FAS Babies
Sleep disturbances
Poor sucking response
Crying
Underdevelopment
Toilet training challenges
Distractibility, difficulty following directions
Disobedience
Source: Teresa Kellerman, Coordinator, FAS Resource Center

22. Screening
In September 2012, American Academy of Pediatrics recommended all children be screened for Fetal Alcohol Syndrome
At Emory University, Experts Try New Approach to Treating Fetal Alcohol Syndrome (CBS Atlanta, September 2012)

23. Affected Individuals Randy (ARND) Matt (FAS) Stefanie (FAS)
Sinja (FAS; English child living in Germany)
The Story of Iyal (YouTube, 3:49)

24. Fetal Alcohol Syndrome: A Biological Basis (Youtube.com)
FAS: Real People
Fetal Alcohol Syndrome: A Biological Basis (Youtube.com)

25. Resources
Fetal Alcohol Syndrome Diagnostic and Prevention Network (UW),
National Organization on Fetal Alcohol Syndrome Washington State (Mill Creek),
Fetal Alcohol Drug Unit (UW),