Fetal alcohol spectrum disorders (FASDs) is a term that encompasses the range of conditions that can occur in a person whose mother drank alcohol during pregnancy. These effects can include physical, mental, behavioral and/or learning problems. Often, a person with an FASD has a combination of these problems.Types of FASDs
Different terms are used to describe FASDs, depending on the type of symptoms.Fetal Alcohol Syndrome (FAS):
FAS represents the most involved end of the FASD spectrum. Strict criteria, including all of these following findings, define this diagnosis:
Partial FAS (pFAS):
- Three specific facial abnormalities (smooth philtrum, thin vermillion border, and small palpebral fissures)
- Growth deficits (e.g. lower‐than‐average height, weight, or both)
- Central nervous system (CNS) abnormalities (structural, neurological, functional or a combination)
When a person does not meet the full diagnostic criteria for FAS but has a history of prenatal alcohol exposure, some of the facial abnormalities as well as a growth problem or CNS abnormalities.
Alcohol‐Related Neurodevelopmental Disorder (ARND):
People with ARND might have intellectual disabilities and problems with behavior and learning.
Alcohol‐Related Birth Defects (ARBD):
People with ARBD might have problems with the heart, kidneys, and/or bones, as well as with hearing and/or vision.
Many children with FASDs remain undetected because there is a lack of accurate, routine screening in prenatal clinics and pediatric settings. Thus, current prevalence figures underestimate the magnitude of these disorders because of inconsistent documentation of prenatal exposures or symptoms characteristic of prenatal alcohol exposure. But studies do show that children in foster care have an increased likelihood of having an FASD.*Diagnosing FASDsDiagnosing FASDs
can be difficult because there is no specific biologic medical test and a broad range of symptoms and signs are included under the FASD umbrella. Greater awareness and consistent screening are needed to be effective in identifying and diagnosing FASDs.
Pediatricians should consider FASDs when evaluating children with developmental problems, behavioral concerns, or school failure. These diagnoses should particularly be considered for children in foster care, especially if drug or alcohol use by a parent was a contributing factor. Like other children with complex medical or behavioral disabilities, children with FASD need a pediatric medical home to provide and coordinate care and ensure necessary medical, behavioral, social, and educational services.**Treatments
FASDs last a lifetime. There is no cure for FASDs, but research shows that early intervention and treatment can improve an affected child’s development. Proper care coordination between specialists and the medical home, educational support, and mental health support are key to any successful treatment plan. There are many types of treatment options, including medication
, behavior and education therapy, parent training, and other alternative approaches.
No one treatment is right for every child. Good treatment plans will include close monitoring, follow‐up care, and changes as needed. Evidence‐based interventions for children with an FASD are available. For information visit the Centers for Disease Control and Prevention Web site
The Fetal Alcohol Spectrum Disorders
Web page of the Centers for Disease Control and Prevention is a nationally recognized site that provides a variety of information and resources.Download the FASD Fact Sheet in PDF format.
References:* Astley et al., Journal of Pediatrics, 2002
** Gahagan et al. Pediatrics, 2006