Foetal Alcohol Spectrum Disorder

Foetal Alcohol Spectrum Disorder (FASD) refers to a range of neurological problems resulting from exposure of an unborn child (fetus) to alcohol during pregnancy.

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Definition of Foetal Alcohol Spectrum Disorder

Foetal Alcohol Spectrum Disorder (FASD) refers to a range of neurological problems resulting from exposure of an unborn child (fetus) to alcohol during pregnancy.

The fetus cannot process alcohol hence it can damage brain cells, the spinal cord as well as other parts of their body and hinder their normal development in the womb. This disorder is a permanent, severe neurodevelopmental impairment and babies that survive the pregnancy, may be left with lifelong developmental problems (APA, 2013). 

 

Causes of FASD

Universally, it is estimated that alcohol is the principal cause of preventable birth defects and intellectual disability. FASD is associated with an array of birth defects and may also affect a child’s average life expectancy. If a pregnant woman drinks alcohol, the alcohol passes through the placenta from her blood into the unborn child’s bloodstream exposing the unborn child to the same alcohol concentrations as the mother.

The alcohol then inhibits the unborn child’s development of the foetal nervous system (including the brain) and may also trigger changes in facial development resulting in certain facial features.

The challenge sometimes is that at-risk children may not be identified in good time or a diagnosis may not be done promptly.

This results in many affected individuals not being effectively identified for timely intervention and appropriate support to be put in place (AMA, 2016; Centers for Disease Control and Prevention, 2021 & Shelton et al, 2018).

 

Types of FASD

There are three main types of Foetal Alcohol Spectrum Disorders (FASDs). There are: 

1. Foetal Alcohol Syndrome (FAS) – this usually represents the most involved end of the spectrum. Those with this type of FASD usually have growth problems, minor facial features and central nervous system problems. In most cases, those affected may have challenges with learning, attention span, communication, vision, hearing, memory, and getting along with others. 

2. Alcohol-Related Neurodevelopmental Disorder (ARND) – those with this type of FASD may exhibit intellectual disabilities resulting in poor performance in school and difficulties with math, memory, attention, judgement and impulse control. They may also have behavioural and learning problems. 

3. Alcohol-Related Birth Defects (ARBD) – those affected by this type of FASD might have heart, kidney, bone or hearing problems or a mix of these. 

(AMA, 2016; Centers for Disease Control and Prevention, 2021 & Shelton et al, 2018)

 

Symptoms of FASD

Those affected by FASDs usually exhibit various signs and symptoms broadly identified by certain facial features, developmental, as well as learning & behavioural challenges. 

Distinctive Facial features that may be a sign of FASD, including:

  • The horizontal length of the eye opening is short, from the inner corner to the outer corner of the eye
  • Philtrum that is smooth instead of ridged (this is the usually ridged skin area between the upper lip and the nose) 
  • A thin upper lip

Learning and behavioural problems that may indicate effects of FASD include:

  • Learning challenges or difficulties e.g. speech problems, problems with math and time keeping etc.
  • Challenges with memory.
  • Impulsiveness.
  • Short attention span (challenges concentrating or easily distracted and/or may be hyperactive).
  • Challenges connecting actions to consequences (poor reasoning and judgement skills).
  • Challenges in following instructions (able to verbally articulate/repeat instructions but not follow them).
  • Challenges with intellectual thinking (especially when dealing with math etc.).
  • Delayed cognitive processing (thinking)
  • Challenges in effectively handling social relationships.

Other signs of symptoms of FASD may include: 

  • Poor growth, where the baby is smaller than average at birth, have slow growth and be shorter-than-average height as an adult.
  • Poor coordination with problems in movement and balance.
  • Sleep and sucking problems as a baby.
  • Vision and/or hearing problems.
  • Problems with the heart, kidneys, bones or other organs.
  • Small head size.

(AMA, 2016; Centers for Disease Control and Prevention, 2021 & Shelton et al, 2018)

 

References

Australian Medical Association Limited (2016, August 24). Fetal Alcohol Spectrum Disorder (FASD) – 2016. AMA.

National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention (2021, May 21). Fetal Alcohol Spectrum Disorders (FASDs). Centers for Disease Control and Prevention.

Shelton, D., R., N., Till, H., and Moritz, K. (2018). Responding to fetal alcohol spectrum disorder in Australia. Journal of Pediatrics and Child Health, 54(10), 1121-1126.

Behaviour Help

If you are supporting an individual with this diagnosis, please refer to our services and resources. They aim to help children, adolescents and adults achieve better communication, social, emotional, behavioural and learning outcomes. So whether you are wanting guidance on parenting, teaching, supporting or providing therapy, Behaviour Help is at hand.

Note: This is not an exhaustive list of all the possible causes, symptoms and types but some general information that can be further explored. Based on what you have read if you have any concerns about an individual, please raise them with the individual/s. The caregiver can then raise these concerns with their local doctor who can provide a referral to the relevant professional (e.g. paediatrician, psychologist, psychiatrist, allied health professional and learning specialists) for diagnosis and treatment if appropriate.

Which resources are right for you?

Apps

Based on the Taking CHARGE of Rainbow of Emotions Workbook this app helps children of all ages develop emotional regulation skills. The app guides the child to firstly, identify and express their emotion in appropriate ways. Then the child is guided to use emotional management tool/s from the CHARGE tool kit to manage their emotions in a healthy way.

The acronym CHARGE stands for the different categories of emotional management tools – Chat tools, Helpful thinking tools, Amusement tools, Relaxation tools, Good routine tools and Exercise tools.

Behaviour Help App - Using the evidence-based approach of Positive Behaviour Support (PBS), the Behaviour Help web-based app allows people supporting individuals with emotional and behavioural difficulties to complete a Functional Behaviour Analysis and put together a comprehensive Behaviour Support Plan (BSP). The BSP can then be used by everyone interacting with the individual to manage and prevent challenging behaviours and ultimately improve their lives, and the lives of those who support them.

Books

If you want to learn more about emotional and behavioural difficulties then we have a great range of books you can read on your Kindle or order from Amazon.

Coaching

Personalised and practical one to one help tailored specifically to your family.

Online Courses

Access these online courses anytime online to learn about a range of diagnoses, practical skills and strategies to help develop the individual’s emotional regulation skills. Also learn to utilise the positive behaviour support framework to address anxiety, aggression, ADHD, ASD and ODD.

SEL Educational Videos

Minimise or eliminate the occurrence of challenging behaviours by teaching children of all ages appropriate ways of communicating, interacting, managing their emotions and behaviours.

The SEL curriculum uses video modelling to provide direct, explicit and systematic teaching of the various skills by discussing the importance of the skill, modelling the skill so the child learns what the skill looks like? sounds like? feels like? and learn the skill in staged situations that simulate real life scenarios.

Therapy

Personalised and practical behaviour therapy tailored specifically to your family.

Webinars

Webinars discuss a range of practical strategies to guide your child learn positive ways of behaving and managing their emotions.

Workshops

Attend our practical and interactive workshops to learn about a range of diagnoses, practical skills and strategies to help develop the individual’s emotions, behaviours, social and communication skills in your learning environment.

Ask Dolly

Since you’re here, you probably have questions and concerns. I am Dolly Bhargava, am here to help. I am a NDIS registered behaviour support practitioner and speech pathologist.

I have worked in a number of settings for over 21 years so, how can I help?

Please tell me what is worrying you right now and I will do my best to recommend resources and/or services that will be most useful to you in your situation.

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