Fetal alcohol syndrome (FAS) is a condition that results from alcohol exposure during pregnancy. Problems that may be caused by fetal alcohol syndrome include physical deformities, intellectual disability, learning disorders, and behavioral problems. The problems caused by fetal alcohol syndrome vary from child to child, but defects caused by fetal alcohol syndrome are irreversible and are life-long – patients do not “outgrow” the manifestations of the disease by age 18.
When alcohol crosses the placenta into the baby’s blood there is no alteration in its concentration. The delicate developing embryo/fetus cannot readily eliminate the alcohol. The drug stays in the system of the embryo/fetus longer than in the mother’s. In this sce-nario alcohol is toxic or poisonous to the developing child, especially in the first trimester when essential organs are formed and crucial brain development occurs. Although there is no “safe” amount of alcohol during pregnancy, researchers show that “binge” consump-tion of alcohol is the most dangerous scenario. Alcohol has worse effects on the fetus/embryo than any “street” drug combo.
Fetal alcohol syndrome isn’t a single birth defect and cannot be diagnosed via a lab or genetic test. It’s a cluster of related problems and the most severe of a group of consequences of prenatal alcohol exposure. Collectively, the range of disorders is known as fetal alcohol spectrum disorders (FASDs). FASD represents a state of mal-adaptation. For example, In normal adaptation, one has to have a relative stable temperament and mood, processes information from all senses, make sense of verbal and non verbal cues, be able to reason logically most of the time, and have a stable environment which includes good health, age appropriate educational experi-ences, safe housing, and a loving and supportive family. Alcohol is a neuro-toxin that literally changes the brain’s chemistry in a global way including – brainstem (regulation of automatic functions like breathing, vision and hearing), cerebellum (balance and coordina-tion), limbic system (attention), cerebrum (speech/language, cognition, and memory). Hence children with FASD are frequently diag-nosed with ADHD, ODD, Depression, Anxiety, Attachment Disorder, and PTSD in addition to having low IQ scores.
A child does not have to have specific physical characteristics to be diagnosed with FASD. Because there is no particular lab test or imaging test that makes the diagnosis – instead the diagnosis is made by having 1/ a positive history of any alcohol consumption dur-ing pregnancy and 2/ a cluster of maladaptive behaviors and/or developmental and intellectual disabilities. FASDs are the leading cause of preventable intellectual disability in the general population.
In the practice of Medicine, the thought is that if professionals treat the mental health diagnosis, (therapy, medications) the symptoms will improve, and in the practice of Social Work the thought is that if professionals offer services to treat the environment (parenting classes, stable housing, and drug and alcohol treatment) the symptoms will improve. Alas, that is not always the case for FASDs . Nev-ertheless protective services are always important:
Early intervention services
By helping children from birth to 3 years obtain speech, language and sensory processing therapy early on, children with FASD will be more likely to participate in a classroom environment successfully by the time they are in kindergarten.
Involvement in special education and social services Children who receive special education geared towards their specific needs and learning style when school aged are more likely to reach their full potential. In addition, families of children with FASDs who receive social services, such as counseling and respite care have more positive experiences than families who do not receive such services.
Provide a loving, nurturing, and stable home environment
These supports can help prevent secondary conditions, such as criminal behavior, unemployment, and incomplete education.
Absence of violence Children with FASDs like all children, need to be taught acceptable ways of showing their anger or frustration, and parents and caregiv-ers must be patient, because it will take a lot longer with children with FASDs compared to more typically developing children.