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. 

It is estimated that 7.7 out of 1,000 children globally will be born with FASD. It is estimated that 32.4 children will have FASD per 1000 children in the United Kingdom (Lange et al., 2017).

The cost of not accurately diagnosing FASD is estimated to be £600,000 per case.

“FASD is a diagnostic term used to describe impacts on the brain and body of individuals prenatally exposed to alcohol.

FASD is a lifelong disability. People with FASD will experience some degree of challenges in their daily living, and need support with motor skills, physical health, learning, memory, attention, communication, emotional regulation, and social skills to reach their full potential. Each person with FASD is unique and has areas of both strengths and challenges.” (Harding, Flannigan & McFarlane, 2019).

 

How is FASD caused?

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 result in changes to the brain and body of the individual as they are developing in utero.

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 co-ordination
  • 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.

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.