Myth #1: It’s safe to have a regular glass of wine or other alcoholic beverages during pregnancy.
Fact: Wine, beer, spritzers, hard liquor - any form of alcohol - is unsafe to drink during pregnancy. Alcohol is a teratogen. All teratogens, such as thalidomide and lead, cause birth defects. Alcohol is a teratogen that is particularly damaging to the brain of the fetus, but also causes damage to other parts of the body including the kidneys, heart, skeletal system, immune system, visual and auditory systems. Any amount of alcohol at any time during pregnancy can cause permanent irreversible brain damage to the child.
Myth #2: Drinking in moderation will not cause FASD.
Fact: There is no known safe threshold of alcohol exposure for the fetus. Twin studies have shown that the same amount of prenatal alcohol exposure can produce different outcomes - one twin born with full FAS, the other with ND-AE. Damage to the fetus from alcohol exposure is determined by many factors such as the genetic vulnerability of the fetus or the nutritional status of the mother. Damage is not determined only by the amount or timing of fetal alcohol exposure.
Myth #3: Every person with FASD has facial abnormalities.
Fact: Only 10% of individuals with FASD have facial abnormalities. Facial abnormalities occur when the prenatal alcohol exposure occurs very early in the first trimester. The absence of facial abnormalities does not rule out FASD; 90% of individuals with FASD do not have facial abnormalities.
Chasnoff Ira J., et al. Misdiagnosis and Missed Diagnoses in Foster and Adopted Children with Prenatal Alcohol Exposure. Pediatrics. 2015; 135(2):264-270
Khazan, Olga.When ADHD Isn't What It Seems. The Atlantic. January 15, 2015
(Dr. Ira Chasnoff interview)
Myth #4: Children outgrow FASD.
Fact: Many of the effects of prenatal alcohol exposure cannot be cured and have lifelong implications. This includes permanent birth defects, brain injury, and/or disabilities. Although FASD cannot be cured, research shows that early diagnosis by an FASD informed provider, intervention, and treatment, as well as family support and training can improve a child’s development, identify and build on their many strengths, and improve overall quality of life.
Myth #5: A person with FASD has a low IQ.
Fact: Each individual with FASD is unique, and no two people with FASD will have the same strengths or challenges. Some individuals with FASD have an average or high average overall IQ, and some have a low or borderline IQ. When assessing the disability of FASD, one needs to consider all areas of this complex brain injury, such as adaptive function, auditory and sensory processing, and developmental deficits. The nature of the disabilities of those affected depends not only on the IQ, but on the parts of the brain or body that have been affected by prenatal alcohol exposure.
Hagan, Joseph, F. et al. Neurobehavioral Disorder Associated With Prenatal Alcohol Exposure.Pediatrics.2016;138(4)
Myth #6: "People with FASD could do better, they just need to try harder!"
Fact: Individuals with a Fetal Alcohol Spectrum Disorder, no matter where they fall on the spectrum, have a moderate to severe brain injury.
Prenatal alcohol exposure can cause diffuse permanent brain damage to the fetus - damage to the structures, function, neurochemistry, and the brain's ability to grow and repair. This damage affects the child's ability to manage everyday life and learning - memory, executive function, attention, auditory processing, ability to grasp cause and effect, emotional self-regulation, understanding social cues, non-verbal communication, and judgment. Individuals with FASD demonstrate great resilience and perseverance, facing these challenges everyday.
When we parents, teachers, and providers learn about the cause of the challenges, we can then take responsibility to accommodate, support and more effectively care for our loved ones. With our support, these children and adults then have a much greater chance at a better quality of life and an opportunity to make the most of their many talents and abilities.
Petrenko, Christine PhD., et al. The Association Between Parental Attributions of Misbehavior and Parenting Practices in Caregivers Raising Children with Prenatal Alcohol Exposure: A Mixed-Methods Study. Res Dev Disabil. 2016 Dec; 59: 255–267
Myth #7: Adults cannot be diagnosed with FASD.
Fact: FASD informed providers diagnose adult individuals with FASD.
Although FASD is typically encountered during childhood, the clinical manifestations persist into adulthood. Due to the lack of FASD informed providers, the belief that a person with any FASD must have facial abnormalities(very rare, about 10%) and the lack of support for individuals with FASD, delay in diagnosis or misdiagnosis is unfortunately the norm. Without early diagnosis and support, secondary disabilities can develop:
Problems with employment
Inappropriate sexual behavior
Disrupted school experience
History of confinement in jail, prison, residential drug treatment, psychiatric unit
However, we also know the protective factors for FASD that allow individuals with FASD to grow into healthy adults, making the most of their neurodiversity, many skills, and talents:
FASD-informed providers - AAP FASD Toolkit, AAP FASD live webinar training, Families Moving Forward Training (FMF) for Clinicians
FASD diagnosis before age six - Evaluations including neuropsych, PT, OT, auditory and sensory processing
Early intervention - parent training in supporting the child's social/emotional skills, self-regulation skills, adaptive skills as well as caregiver support and respite (FASCETS)
Peer support groups, find talents/strengths
Stable long-term home environment
FASD trained/informed - parents/caregivers, support group
FASD-informed teachers, school psychologists, social workers
FASD-informed foster care system
FASD-informed adult support services
FASD-informed law enforcement and court system
*Huggins, Janet E., et al. Suicide Attempts Among Adults with Fetal Alcohol Spectrum Disorders: Clinical Considerations. Mental Health Aspects of Developmental Disabilities. 2008;11(2):33-41
Petrenko, Christie L.M., Ph.D, et al. Prevention of Secondary Conditions in Fetal Alcohol Spectrum Disorders: Identification of Systems-Level Barriers. Matern Child Health J. 2014 August ; 18(6):1496–1505
Grant, T. M., Novick Brown, N., Graham, J. C., Whitney, N., Dubovsky, D., & Nelson, L. A. (2013). Screening in treatment programs for Fetal Alcohol Spectrum Disorders that could affect therapeutic progress. The International Journal of Alcohol and Drug Research. 2(3):37-49. https://doi.org/10.7895/ijadr.v2i3.116
NIH/NIAAA Current Research on Adults with FASD
Principal Investigators: Claire Coles, Ph.D. (Emory University, Atlanta, Georgia), Therese Grant Ph.D. (University of Washington, Seattle, Washington)