Fetal Alcohol Spectrum Disorder describes a group of conditions that can develop when someone has been exposed to alcohol in the womb. The spectrum includes diagnoses such as ‘Fetal Alcohol Spectrum Disorder with Sentinel Facial Features’ and ‘Fetal Alcohol Spectrum Disorder without Sentinel Facial Features. ​​​​​​​

The history of FASD

Fetal Alcohol Syndrome was first reported by Jones and Smith in 1973. Prior to that Lemoine published a series of 127 cases in France highlighting the presentation of people exposed to alcohol whilst pregnant.

Fetal Alcohol Spectrum Disorder with Sentinel Facial Features is characterised by central nervous system impairments, confirmation of prenatal alcohol exposure, and the 3 sentinel facial features. Fetal Alcohol Spectrum Disorder without Sentinel Facial Features is characterised by impaired central nervous system impairments, confirmation of prenatal alcohol exposure, and 2 or less sentinel facial features.

Only a small percentage of people with FASD have all 3 sentinel facial features and having them does not necessarily imply a more severe form of FASD or greater impairment. Sentinel facial features include short palpebral fissures (the opening between a person’s eyelids), a flat or smooth philtrum (the ridge between our upper lip and nose) and thin upper lip vermilion. 

 

What we do

Our aims:

  • To clarify the diagnosis and wider neurodevelopmental profile of FASD
  • To offer guidance to local services on strategies to manage behaviours

Our referral criteria:

  • To have a diagnosis of FASD, there should be a history or a strong suspicion of alcohol exposure during pregnancy
  • We also ask for genetic tests to be completed to rule out other disorders or factors that may contribute to the symptoms the person is exhibiting.
  • Due to the nature of the assessments used in the clinic, the individual being assessed must be over the age of 6 years old.

Diagnosis

To diagnose FASD in the UK, we use the NICE guidance, which has adopted the SIGN-156 (Scottish) guidance. There are four key areas that are looked at, to be diagnosed with FASD.  These are:

Causes of FASD

If a woman drinks alcohol during pregnancy the toxins in her blood pass to the foetus through the umbilical cord. This exposure to alcohol can cause physical, mental or behavioural damage to the baby.

Signs of FASD

A person with FASD may experience the following:

  • Abnormal facial features such as a smooth ridge between the nose and upper lip
  • Small head size
  • Below average height
  • Low body weight
  • Poor coordination
  • Hyperactive behaviour
  • Poor memory
  • Difficulty with attention
  • Learning disabilities
  • Speech and language delays
  • Poor reasoning or judgement skills
  • Vision or hearing problems
  • Problems with the heart, kidneys or bones

Treatment

There is no cure for FASD but research shows that early intervention can improve a child’s development. Medication can help some symptoms and behaviour and education therapy can provide management techniques for other symptoms.