What is Fetal Alcohol Spectrum Disorder (FASD)?
Fetal Alcohol Spectrum Disorders (FASD) is an umbrella term used to describe the range of effects that can occur in an individual whose mother consumed alcohol during pregnancy.
When a woman drinks alcohol while pregnant, her fetus is exposed directly to alcohol through her bloodstream. Alcohol can interfere with the growth and development of all fetal body systems; however, the developing central nervous system (the brain and spinal cord) is especially vulnerable to the damaging effects of alcohol. These effects, which can vary from mild to severe, may include physical, mental, behavioral, and/or learning disabilities with possible lifelong implications.
FASD affects individuals from ALL socioeconomic and ethnic backgrounds.
There are three diagnostic categories that fall under the FASD umbrella:
Fetal Alcohol Syndrome (FAS) is the most severe and visibly identifiable form of FASD, and it is the leading known cause of preventable developmental disabilities in the Western World. The criteria for the diagnosis of FAS are:
- Growth deficits (height or weight at or below the 10th percentile),
- A unique cluster of facial anomalies (small narrow eyes, smooth grooze above the upper lip, and a thin upper lip),
- Damage to the central nervous system, which can lead to a wide range of cognitive, behavioural and other problems. These include small brain, seizures, problems with coordination, visual motor difficulties, decreased IQ, significant developmental delays, attention deficit and hyperactivity problems, and
- Confirmed or unconfirmed prenatal alcohol exposure.
Partial FAS (pFAS) is a diagnostic categorization for individuals who present with:
- Most, but not all, of the growth deficits and/or facial features of FAS,
- Damage to the central nervous system (see above), and
- Confirmed prenatal alcohol exposure.
Alcohol Related Neurodevelopmental Disorders (ARND) is a diagnostic categorization for individuals who present with:
- Damage to the central nervous system (see above), and
- Confirmed prenatal alcohol exposure.
ARND is far more prevalent than FAS or pFAS.
What are the symptoms of fetal alcohol spectrum disorders (FASD)?
While every individual with FASD has a unique set of strengths and weaknesses, an individual with any diagnosis within the FASD spectrum has some brain dysfunction as a result of prenatal alcohol exposure.
The signs and symptoms of FASD are most commonly broken down into primary and secondary disabilities. However, remembering that not all individuals are alike, it must be noted that not all primary and secondary disabilities listed below will apply to all individuals, rather the lists are reflective of the disabilities commonly observed among this unique population.
The primary disabilities of FASD are those that most directly reflect the underlying central nervous system damage caused by prenatal exposure to alcohol. This damage manifests in a range of difficulties with adaptive behaviour, attention, cognition, executive functioning, and memory. As a result, individuals with FASD may have trouble with abstract reasoning, organization, planning, understanding or recalling a sequence of events, connecting cause and effect relationships, and/or regulating their own behaviours and emotions.
Typical brain-based, primary disabilities of FASD include:
- Inconsistent memory and recall
- Inability to filter out environmental or emotional distractions and sensory stimuli
- Slow and inconsistent cognitive and auditory processing
- Decreased mental stamina
- Difficulty interpreting, and applying abstract concepts (for example, managing money and time)
- Impulsivity and poor judgment
- Inability to predict outcomes (of their own or others' actions)
- Difficulty shifting from one context to another
- Resistant to change
- Inability to see another person's perspective
- Inability to recognize indirect social cues
Another common characteristic of individuals diagnosed with FASD is dysmaturity. Dysmaturity is a term used to refer to widely varying levels of maturity in different areas of development, such as expressive language and language comprehension, social and self care skills, and awareness and regulation of emotions. Individuals with FASD do not have the ability to meet many of society’s age based social and academic expectations. Given that FASD is not usually outwardly visible, the effects of their dysmaturity can be confusing and frustrating to themselves and to those around them.
Alcohol is toxic and can affect any organ or system of the fetus. Individuals with FASD can also have permanent vision and hearing problems; poorly developed bones, limbs and fingers; and damage to the heart, kidney, liver and other organs.
Secondary disabilities are those not present at birth, but occur later in life as a result of the primary disabilities associated with FASD. They include:
- Mental health problems
- Disrupted school experience (suspension, expulsion, and/or drop-out)
- Involvement with the law (trouble with authorities, charged and/or convicted of a crime)
- Confinement (inpatient treatment for mental health and/or alcohol/drug problems, or incarceration for crime)
- Alcohol and/or drug problems
- Poor academic achievement and school failure
- Sexually deviant behaviour
- Problems with employment
- Dependent living
When combined with individuals’ primary disabilities, these secondary disabilities increase the complexity of care and result in significant social and economic costs to society.
What are the types of treatments for FASD?
There is no cure for FASD. However, if FASD is diagnosed early, interventions may be able to lessen its impact and prevent secondary disabilities.
Many types of treatments are available for individuals with FASD:
- Medical care/specialists (for example, speech-language pathology, occupational therapy, physical therapy, mental health care, etc.)
- Medication to help lessen some of the symptoms of FASD
- Behavioural and educational therapy
- Parent training
- Alternative approaches (auditory training, creative art therapy, meditation, etc.)
An individual with FASD can be assisted by special programs with their learning and behaviour. Such assistance can enable a person with FASD to maximize their independence and achievements.
Some protective factors can help reduce the effects of FASD and help individuals with these conditions reach their full potential:
- Early diagnosis
- Involvement in special education and social services
- Loving, nuturing, and stable home environment
- Absence of violence
Can FASD be prevented?
FASD is preventable! There is NO safe amount, type of alcoholic beverage, or time to drink alcohol during pregnancy. Make a safe choice for your child – do not drink ANY alcohol during pregnancy and/or when you are trying to get pregnant.
General information on FASD and its prevention can be found in the brochure “Alcohol and Pregnancy: Protect Your Child” (PDF)
Where can I find help, treatment and support for FASD?
- If you drank alcohol before you knew you were pregnant, stop drinking now and talk to your health care provider. When a pregnant woman stops drinking at any time during pregnancy, she decreases the risk of harm to her child.
- If you cannot stop drinking or someone you know cannot stop drinking alcohol, help is available at CAMH’s Alcohol Research and Treatment Clinic (ARTC). No referral is required. ARTC provides a comprehensive assessment by an interprofessional team that includes both a psychosocial and a medical component.
Call 416 535-8501 ext. 36019 to book an assessment.
Location: CAMH, Bell Gateway Building, 100 Stokes Street, 3rd
Floor, Toronto, ON M6J 1H4
- If you are worried about your child, there are a number of diagnostic clinics in Canada.
- NWC Alberta FASD Services Network Clinic: 780 674-4141
- Alberta Children’s Hospital, FASD Clinic: 403 943-7231
- MediGene Services Inc., FASD Diagnostic Clinic: 403 571-0450
- Renfrew Educational Services, FASD Assessment and Diagnostic Clinic: 403 291-5038 ext. 1615
- Cold Lake
- Lakeland Centre for Fetal Alcohol Spectrum Disorder: 780 594-9905
- Glenrose Rehabilitation Hospital, FASD Clinical Services: 780 735-8278
- Accredited Supportive Living Services Ltd.: 780 332-4183 ext. 112
- High Level
- Northwest Regional FASD Society: 780 326-6535
- High Prairie
- Northern Association for FASD: 780 523-3699
- Medicine Hat
- Bridges Family Programs: 403 526-7473
- Northwest Alberta
- Northwest Alberta FASD Service Network: 780 841-3253
- Siksika Health and Wellness Centre, Seven Stars Children Clinic: firstname.lastname@example.org
- Sunny Hill Health Centre for Children (PHSA): 604 875-2000 ext. 8325
- Vancouver Island Health Authority, Complex Developmental Behavioral Clinic: email@example.com
- Centre for Disease Control, Complex Developmental Behavioral Conditions Clinic: 250 753-0251 ext. 228
- Prince George, Terrace, Smithers, Burns Lake, Prince Rupert, Fort St. John, and Dawson Creek
- Complex Developmental Behavioral Clinics: 250 565-5827
- Interior Health Children’s Assessment Network: 250-712-0416
- Maple Ridge
- The Asante Centre: 604 467-7101
- New Westminster
- Fraser Developmental Clinic (Private): 604 522-7979
- Fraser Health Assessment Network:
- Children’s Hospital, Manitoba FASD Centre: 204 787-1822
- New Brunswick FASD Centre of Excellence: firstname.lastname@example.org
- Durham Region:
- Grandview Children’s Centre: 1 800 304-6180
- Resources for Exceptional Children and Youth: 905 427-8862 ext. 401
- Hotel Dieu Hospital Child Development Centre: 613 544-3400
- FASD London Region Assessment Clinic: 519 679-7250 ext. 155
- Medical Genetics Program of Southwestern Ontario: 519 685-8453 or 1 800-243-8416
- Children’s Hospital of Eastern Ontario: 613 737-2275
- Peel FASD Clinical Service: 905 507-9360 ext. 326
- Health Sciences North: 705 523-7100 ext. 1526
- Thunder Bay:
- NorWest Community Health Centres: 807 626-8485
- Anishnawbe Health Toronto: 416 360-0486 ext. 234
- Mothercraft (Breaking the Cycle) FASD Diagnostic Clinic: 416 364-7373
- Motherisk Program, Hospital for Sick Children: 1 877 FAS-INFO
- St. Michael’s Hospital Fetal Alcohol Spectrum Disorder Diagnostic Clinic: 416 867-3655
- Surrey Place Centre FASD Adult Diagnostic Clinic: 416 925-5141 (for individuals 18+ years of age)
- Waterloo Region FASD Diagnostic Clinic: 519 749-8740 ext. 272
- Kinsmen Children’s Centre, Alvin Buckwold Child Development Program (for children 0-18 years of age): 306 655-1096
- Royal University Hospital, Clinical Teratology/Genetics Clinic (for adults only)
- Regina Community Clinic, The FASD Clinic: 306 543-7880 ext. 268
- The Regina Child and Youth Services: 306 766-6700
- Wascana Rehabilitation Centre, Children’s Program: 306 766-5765
- Prince Albert
- Child & Youth Development Clinic: 306 765-6589
- Children & Youth FASD Diagnostic and Support Teams: 867 456-8193
- Fetal Alcohol Syndrome Society of the Yukon Adult Clinic: 867 393-4948
- Yellowknife Stanton Hospital, FASD Clinic & Community Support: 867 669-4111