Foetal Alcohol Spectrum Disorder (FASD)

What is Foetal Alcohol Spectrum Disorder (FASD)?

FASD stands for Foetal Alcohol Spectrum Disorder. It is caused by alcohol exposure in pregnancy.  It can affect the developing brain and body of an individual before they were born.

It is now known that alcohol is a toxic substance that easily crosses from the mother to the foetus throughout the pregnancy.  This disrupts a baby’s development. A developing foetus does not have a fully developed liver.  It cannot filter out the toxins from the alcohol and this causes harm. It is now known that there is no safe time, no safe type, no safe amount of alcohol to drink when pregnant.

5 cartoon figures of people of different ethnic origins.  one is in a wheelchair, one is wearing glasses

 

 

 

FASD is a life-long neurodevelopmental condition.  It causes cognitive, emotional and behavioural challenges.  It is often referred to as a hidden disability. FASD affects each person in different ways. There are over 400 disorders associated with FASD. It has both strengths and difficulties. Those with FASD and their families need support to learn FASD-informed strategies.  These can help support them in their daily lives.

There is no cure for FASD. Adults with FASD have the same problems they had when they were younger. Many need on-going support and help throughout their life. With the right support from a young age, children can learn to work with and to understand FASD.  It can help them to have more positive life outcomes.

Key Facts

FASD is the most common yet unrecognised neurodevelopment condition in the world.

It is the most common known cause of neurodevelopmental conditions and birth defects in the western world.

In the UK, 1 in 20 people could have FASD compared to 1 in 94 with Autism.

FASD is thought to affect 3-5% of the population.  This makes it more common than Autism or ADHD.

ADHD and autism have many common symptoms with FASD. This can result in misdiagnoses and/or missed diagnosis of FASD. 

FASD is known as a hidden disability.  It affects the brain and body. You cannot tell just by looking at someone if they have the condition.

Around 10% of people with FASD have specific facial features associated with the condition.

How to get a diagnosis

There is not currently a clear pathway for an FASD diagnosis in Sheffield.  

Speak to your GP or Health Visitor if you have any concerns about your child's development. You can talk to them about the NICE guidelines.

For any FASD diagnosis your GP/Health visitor will ask about the following:

  • any proof you have about alcohol use during pregnancy (in writing where possible)
  • any proof from school or other professionals about developmental challenges.

Your GP will be able to refer you to a paediatrician for multidisciplinary team assessment.  There are also cases where a diagnosis has been given through Community Paediatrics and CAMHS.

The 3 facial features of FASD (the sentinel facial features)

Less than 10% of people with FASD have differences in their facial features. These are:

  • a thin upper lip
  • smooth philtrum (the crease between nose and mouth)
  • short palpebral fissures (this is to do with the space between the bottom and upper eyelids)

With these facial features, Health professionals may be able to diagnose without proof of alcohol use in pregnancy. 

How they diagnose FASD

  • Confirmation alcohol used in pregnancy. Sometimes this will involve a review of medical and maternity records by professionals.
  • Related symptoms.  A diagnosis of FASD is only made when there is evidence of a long-standing brain dysfunction. This would be a severe impairment in three or more of the 10 brain domains.

5 cartoon figures of people of different ethnic origins.  one is in a wheelchair, one is wearing glasses

The 10 Brain Domains

There are potentially 10 brain domains (or functions) that can be affected by alcohol use in pregnancy.  No two people with FASD will be affected in the same way.  Each face different challenges and have different strengths.

  • planning
  • problem solving
  • transitions
  • time management
  • following instructions
  • long and short term memory
  • daily routines
  • understanding social cues
  • understanding personal boundaries
  • emotional age
  • empathy
  • managing and expressing emotions
  • adaptability
  • attention
  • planning learning
  • organisation
  • co-ordination
  • writing
  • reactions to sensory input - sight, smell, hearing, taste, and touch
  • reaching developmental milestones
  • expressive language.  This could be verbal or non-verbal
  • receptive language.  This is understanding language
  • sitting still
  • focusing on a task
  • impulse control. Difficulty controlling actions or reactions
  • brain and head size may be small.  This is known as microcephaly

Challenges with:

  • maths
  • reading
  • time
  • money
  • comprehnsion

Talking to health and educational professionals who may have limited knowledge of FASD

The FASD Network have resources to help you to speak about FASD to professionals who have limited knowledge.  The FASD Network and the National Organisation for FASD have training for professionals.