Fetal Alcohol Disorder
Prenatal exposure to alcohol can cause a range of disorders, known as fetal alcohol spectrum disorders (FASDs). Fetal alcohol spectrum disorders (FASD) is the new term used to describe anyone who has been affected by prenatal alcohol exposure, including fetal alcohol spectrum (FAS).One of the most severe effects of drinking during pregnancy is fetal alcohol syndrome.
Fetal alcohol spectrum disorders (FASDs) is an umbrella term describing the range of effects that can occur in an individual whose mother drank alcohol during pregnancy. These effects include physical, mental, behavioral, and/or learning disabilities with possible lifelong implications. The term FASDs is not intended for use as a clinical diagnosis. These problems often lead to difficulties in school and problems getting along with others. FASDs include fetal alcohol syndrome (FAS) as well as other conditions in which individuals have some, but not all, of the clinical signs of FAS.
Partial Fetal Alcohol Syndrome (PFAS) - children with PFAS have faces that look different and one of the following: growth problems, unexplained learning or behavioral problems.
Fetal Alcohol Effects (FAE) - The term FAE has been used to describe behavioral and cognitive problems in children who were exposed to alcohol during prenatal stage, but who do not have all of the typical diagnostic features of FAS. These traits include behavioral or cognitive abnormalities or a combination of both. They do not have the facial features seen in FAS. Although this term is still used, the Institute of Medicine has replaced this term with ARBD and ARND.
Alcohol-Related Neuro-developmental Disorder (ARND) - children with ARND have learning and/or behavioral problems that are associated with prenatal alcohol exposure but do not have the typical facial differences or growth problems.
Alcohol-Related Birth Defects (ARBD)—children with ARBD have confirmed prenatal alcohol exposure and alcohol related birth defects. Children with ARBD might have problems with the heart, kidneys, bones, and/or hearing.
Fetal Alcohol Syndrome (FAS) - is one of the leading known preventable causes of mental retardation and birth defects. FAS is characterized by abnormal facial features, growth deficiencies, and central nervous system problems.
Symptoms of Fetal Alcohol Spectrum
Fetal alcohol syndrome (FAS) is a permanent condition. It affects every aspect of an individual’s life and the lives of his or her family. The effects of drinking alcohol during pregnancy can vary widely. Some children may have little or no problems. Others may be severely affected. FAS is at the severe end of the spectrum, effects of the mother drinking alcohol during her pregnancy. Fetal death is the most extreme outcome.
FAS is a disorder characterized by abnormal facial features, growth and central nervous system (CNS) problems. Children with FASDs might have the following characteristics or exhibit the following behaviors:
• Small size for gestational age or smaller heads and brains
• Facial abnormalities such as small eye openings
• Poor coordination
• Hyperactive behavior
• Learning disabilities
• Developmental disabilities (e.g., speech and language delays)
• Mental retardation or low IQ
• Problems with daily living
• Poor reasoning and judgment skills
• Sleep and sucking disturbances in infancy
• Miscarriage or stillbirth
• Premature delivery
• A baby with malformation of the heart or other vital organs
• Malformations of the eyes, nose, or mouth
• Memory, attention span, communication, vision, hearing, or a combination of these
If a person has one or two of these findings, they will not get a diagnosis of FAS. There are other terms used to describe persons affected by alcohol, who do not have FAS. These terms are not actual diagnoses. However, you may hear or read these terms used as you do more research. All FASDs are 100% preventable, if a woman does not drink alcohol while she is pregnant.
Risk Factors
Lots of factors play a role in how alcohol will affect the baby in the womb. One of the main factors is the amount of alcohol that the mother drank while she was pregnant. As a rule, the more the mother drinks, the greater the chance that the alcohol may harm the baby. Another major factor is the time during the pregnancy in which the mother drinks. The first trimester (the first 12 weeks) is a critical period in the baby’s growth. During this time, the baby’s organs, limbs, and face are developing. Drinking alcohol during the first trimester can cause serious defects in these organs. During the second trimester, the baby is growing bigger. Alcohol can slow the baby’s growth, making the baby smaller than expected. Also, the brain still develops during the 2nd and 3rd trimesters.
The brain is the organ that is most affected by alcohol before the baby is born. In most cases, the brain will not look different, but the alcohol can damage parts of the brain that cannot be seen. It’s not known why, but alcohol damages parts of the brain that gives us our memory, self-control, coordination and judgment. As a result, children with FAS tend to have problems learning, poor attention spans, problems with behavior, and problems trying to do things like grasp an object or brush their teeth (we call these “fine motor skills”). These children can be hyperactive, have seizures, or develop slowly.
Alcohol can lead to problems with the forming of the brain and with the way it functions. Alcohol disrupts normal brain development. Alcohol includes beer, wine, and liquor. Other factors that can change the effects of FAS are the way in which a mother’s body handles alcohol, the genetic make-up of the baby and other drugs or medicines that the mother may take.
The reported rates of FAS vary widely. These different rates depend on the population studied and the surveillance methods used. CDC studies show rates for fetal alcohol spectrum disorders (FASDs) affects one out of every 100 babies that are born. That’s 40,000 babies every year who are born with some amount of problems due to prenatal alcohol exposure! About one out of every 1000 babies is born with full-blown FAS.
Causes of Fetal Alcohol Spectrum Disorders
If a woman drinks alcohol during her pregnancy, her baby can be born with fetal alcohol spectrum disorder, a lifelong condition that causes physical and mental disabilities. Inside the mother, a fetus is fed through the placenta. Alcohol ingested by a pregnant woman passes easily through the placenta, every time the mother drinks alcohol, the developing fetus gets a dose of alcohol. Because of this, drinking alcohol can adversely affect the development of the baby. Consumption of alcohol by a pregnant woman may be the first indicator of potential fetal alcohol syndrome.Timing of alcohol use during pregnancy is also of importance. Alcohol use during the first trimester is more damaging than during the second trimester, which is, in turn, more damaging than use in the third trimester. A pregnant woman who drinks any amount of alcohol is at risk, since a "safe" level of alcohol ingestion during pregnancy has not been established. However, larger amounts appear to cause increased problems. Multiple birth defects associated with "classical" fetal alcohol syndrome are more commonly associated with heavy alcohol use or alcoholism.
Education and Fetal Alcohol Syndrome
School is difficult for many children, but it can be especially so for children with FAS. Their learning differences and behavioral problems make it difficult for these children to succeed in school. Often their behavioral problems are not understood, and the children are seen as trouble makers. Without special help, these children often get frustrated with their school work and develop poor self esteem.
Children with FAS often need special educational services to help them overcome their learning and behavioral problems in order to succeed in school. All public schools and most private schools provide such services to children who qualify to receive them. It is a good for parents to work closely with their child’s teachers and other school staff. This will allow the parents and teachers to work as a team, gathering the resources that will best help the child.
Several laws have been made that require that special education has to be given to children with learning disabilities and other mental handicaps. The Individuals with Disabilities Education Act (IDEA) is a very important federal law that explains how students with possible learning disabilities are to be assessed and educated. Under IDEA, any student who may have a learning disability or mental handicap must be properly tested (assessed) to determine his/her learning abilities and needs. An individualized Education Plan (IEP) is then created based on the results of the tests.
Outcomes of Fetal Alcohol Syndrome
The outcome for infants with fetal alcohol syndrome is variable depending on the extent of symptoms, but almost none are normal when it comes to brain development. The problems of the infant and child with fetal alcohol syndrome are diverse and difficult to manage. Those with cardiac defects may necessitate surgery. Furthermore, there is no effective therapy for mental retardation.
Children with FASDs are at risk for psychiatric problems, criminal behavior, unemployment, and incomplete education. A child who is diagnosed early in life can be placed in appropriate educational classes and given access to social services that can help the child and his or her family. Children with FASDs who receive special education are more likely to achieve their developmental and educational potential.
In addition, children with FASDs need a loving, nurturing, and stable home life to avoid disruptions, transient lifestyles, or harmful relationships. Children with FASDs who live in abusive or unstable homes or who become involved in youth violence are much more likely than those who do not have such negative experiences to develop secondary conditions.
There is no cure for FAS. Likewise, the effects of prenatal alcohol exposure are life-long and cannot be corrected. However, the effects of prenatal alcohol exposure can be lessened when the symptoms of FAS are recognized early and the child receives the appropriate care.
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