ABOUT FASD
Fetal Alcohol Spectrum Disorder
Information on diagnoses, intervention, support, and prevention
Fetal Alcohol Spectrum Disorder (FASD):
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caused solely by prenatal alcohol exposure (when pregnant people use other substances, alcohol is one of the most common co-substances)
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the number one cause of intellectual disabilities and birth defects in the U.S, up to 1/20 school-aged children has an FASD
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although parents with a substance use disorder have a higher likelihood of having a child with an FASD,
most children with FASDs are born to parents who do not have a substance use disorder
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Maternal choline supplementation is effective in mitigating the effects of prenatal alcohol exposure
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Early childhood choline supplementation shows promise in the treatment of FASD
FASD is an umbrella term describing the broad range of birth defects and disabilities caused by alcohol exposure in utero. Alcohol is a teratogen - like thalidomide, rubella, mercury, lead - which means it causes birth defects. These effects may include physical, neurological, behavioral, and developmental disabilities with lifelong implications. It is particularly destructive to the brain of the fetus, causing damage to the structures, function, neurochemistry, and the brain's ability to grow and repair. Studies show there is no safe level of prenatal alcohol exposure.
Some characteristics of FASD may include:
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Hearing or vision problems - strabismus, auditory processing disorder, ear infections
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Low birth weight or short stature (height)
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Speech and language delays
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Dental issues - malocclusion, delay of permanent teeth, cleft palate, etc.
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Difficulty understanding abstract concepts - metaphor, sarcasm, managing time or money
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Facial abnormalities - approximately 10% of individuals with FASD have facial abnormalities such as smaller eye openings, flattened groove above upper lip, thin upper lip
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Skeletal abnormalities - Permanent curving of the fifth finger (clinodactyly), permanent flexion contracture of a finger or toe (camptodactyly)
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Hyperactive behavior - for which ADHD medications may not be effective
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Impulsivity, poor judgment, difficulty learning from mistakes or generalizing knowledge
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Poor social skills, developmentally younger than their peers, lower than expected adaptive intelligence
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Poor coordination
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Organization, planning, and memory issues, difficulty with multi-tasking
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Difficulty in school despite average IQ, especially with abstract concepts like math
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Heart, kidney abnormalities, autoimmune, seizure disorder, sleep disorder
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Sensory processing disorder - sensitivity to light, sound, touch, smells, taste and food texture, over and under-sensitivity to pain
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Poor self-management - may have tantrums "out of nowhere", tantrums may persist past early childhood, easily overwhelmed or overstimulated by environment
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Here's the good news - we also know that when we understand the brain injury of prenatal alcohol exposure and appreciate the brain differences of FASD, we can more effectively support individuals with FASD. This support includes protective factors* such as:
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caregiver support and training
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stable nurturing home environment
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These protective factors help individuals with FASD to build on their strengths and interests, to learn new skills to help them accommodate their weaknesses, and reach their developmental and educational potential.
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Basic Facts:
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FASD is the number one cause of intellectual disability and birth defects in the U.S. It is currently estimated that FASD affects up to 5% of school-aged children - more common than autism, cerebral palsy, and Trisomy 21 combined. ​
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FASD is as common as asthma.
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The prevalence of FASD is much higher among adopted and foster children.
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FASD is largely preventable. Given that approximately half of all pregnancies in the United States are not planned, the U.S. Surgeon General recommends that women who are pregnant, might be pregnant, or consider becoming pregnant should abstain from alcohol.
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Screening and support: OB/GYN Providers Pediatric Providers Clinicians
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One in seven pregnant adults in the U.S. report drinking alcohol in the last thirty days. Of those who reported using alcohol, 5.2% binge drank. In a 2017 study, of those pregnant women who used opioids non-medically, 51.2% binge drank alcohol. Polysubstance use is common whenever substances are used, including in pregnancy.​​
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Alcohol is eliminated from the amniotic fluid at 3 - 4% the rate of the mother.
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This creates a prolonged alcohol exposure for the developing fetus.
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Changes in the fetus in the second trimester,(eliminating and swallowing) further prolong this exposure.
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According to the most recent CDC statistics:
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35.3% of Maine women aged 18-44 who drink, binge drink (4 or more drinks on one occasion)
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Overall, one in nine (11.3%) pregnant women in Maine reported drinking in the last trimester. Six of Maine's sixteen counties have a rate of 10% or greater, Cumberland County, 1/6.*
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​Every year, from 2012-2023, 600-1000 Maine newborns were reported substance exposed**
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Every year since 2014, at least 50% of Maine child removals has involved a factor of parental substance use. *2014- 2020 CDC PRAMS Data **2024- Maine Child Welfare Annual Report ​​​
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Only 10% of individuals with FASD have facial abnormalities.
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Facial abnormalities (and the co-occurring brain injury) such as smaller eye openings and a thin upper lip, occur when the fetus is exposed to alcohol in the third week of development, when many people do not yet know they are pregnant.
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The nutritional supplement choline shows promise in the treatment of children with FASD.
Dr. Jeff Wozniak MD NOFAS Webinar - Choline Study
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​Maternal choline supplementation has been shown effective in mitigating effects of prenatal alcohol exposure.
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FASD Diagnosis
Early assessment and diagnosis of an FASD can reduce the risk, incidence, and impact of secondary and co-occurring conditions such as learning disabilities, mental illness, addiction, school failure, and social deficits.
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Diagnoses under the FASD umbrella:
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FAS - Fetal Alcohol Syndrome
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pFAS - Partial Fetal Alcohol Syndrome
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ARND - Alcohol related neurodevelopmental disorder
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ND-PAE - Neurodevelopmental Disorder Associated with Prenatal Alcohol Exposure DSM 5 Diagnosis for FASD
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DSM 5 Criteria here
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Free AAP FASD Live Webinar Training for AAP Members and Staff
For more information on the FASD Champions Network or to schedule a training session at your site, contact Josh Benke, Program Manager, FASDs, at jbenke@aap.org or 630-626-6081.
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University of Minnesota FASD Program
"The University of Minnesota FASD program was created in 1978 and today brings together pediatricians, neuropsychologists and occupational therapists to help make recommendations to teachers, social workers and others to provide you and your child with comprehensive, coordinated care.
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FASD Intervention
Families Moving Forward (FMF) "...is based on the idea that children with FASD have brain-based difficulties - neurological impairments - that are the underlying cause of many learning and behavioral problems. Caregivers learn Positive Behavior Support, Motivational Interviewing, and other evidence-based techniques. 'Reframing' and 'accommodations' help them change their own attitudes and how they manage the child, which leads to improvements in the child's behavior. Remote Training is available for mental health professionals and agencies."
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For More Information Go to Resources/Providers​​​​​​​​​​​​​​
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FASD Support
National FASD Collaborative Project Support Group Calendar
​FASD organizations from around the U.S. joined forces under the notion that if we each "give a little," we can create more dynamic FASD systems of care nationally. These support groups are run by a range of leading organizations and experts in the field of FASD.
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FASD United (Formerly NOFAS National Organization on Fetal Alcohol Syndrome
FASD United is the leading voice and resource of the Fetal Alcohol Spectrum Disorders (FASD) community. Founded in 1990, it is the only international, non-profit organization committed solely to the prevention of prenatal exposure to alcohol, drugs, and other substances known to harm fetal development.
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"Welcome to the Circle of Hope (COH)! The COH was founded in 2004 by NOFAS Vice President Kathy Mitchell. It is a network of women who have consumed alcohol during pregnancy and may have a child or children with Fetal Alcohol Spectrum Disorders."
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FAFASD Families Affected by Fetal Alcohol Spectrum Disorder
FAFASD provides trainings about caring for, living with, working with, and supporting people with FASDs using the neurobehavioral (brain-based) model.
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​FAFASD Always Remember the Brain: 30 Strategies for Parents of Children with a Fetal Alcohol Spectrum Disorder
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PROOF Alliance "You're not alone"
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FASD Support Network of Saskatchewan FASD Tips for Parents and Caregivers Resource for parents, caregivers, teachers, and therapists
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Brief Videos on Understanding FASD​
The Provincial Outreach Program for Fetal Alcohol Spectrum Disorder (POPFASD) is funded by the British Columbia Ministry of Education and has been in existence since 2006. The mandate of our program is to increase educators’ capacity to meet the learning needs of students with Fetal Alcohol Spectrum Disorder.
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FASD United (Formerly National Organization on Fetal Alcohol Syndrome NOFAS)
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The Myth of Light Drinking During Pregnancy Doctors, psychologists, epidemiologists, and researchers speak to the risk of prenatal alcohol exposure at any level.
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PROOF Alliance
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Prevention
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American College of Obstetrics and Gynecology (ACOG) Fetal Alcohol Spectrum Disorders Prevention Program
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