In Most Countries Today,

it’s common knowledge that drinking while pregnant can harm the fetus. Modern doctors are quick to warn pregnant women against imbibing alcohol, even during the earliest weeks of pregnancy.

This wasn’t always the case. Up until the 1970s, many individuals were exposed to at least some amount of alcohol while in the
womb. Doctors weren’t as quick to steer pregnant women away from substance use, and many people were unaware of the
severity of alcohol-related symptoms in infants.

We now know that alcohol can have lasting effects on unborn children as they move into adulthood. Still, there are many adults living with fetal alcohol spectrum disorders (FASDs) today due to awareness and knowledge in years past.

Additionally, thousands of infants are born every year with an
FASD. Even with millions of pregnant women actively abstaining from alcohol, FASD is still a sizable problem in both third-world
and first-world countries.

In this guide, we’ll dive into the disorder, its causes, its symptoms, and its treatment. We’ll also share advice on preventing FASD
and supporting those diagnosed with a fetal alcohol disorder.

In Most Countries Today,

What is Fetal Alcohol
Spectrum Disorder?

Fetal alcohol spectrum disorder is a term that encompasses a wide range of symptoms caused by prenatal exposure to alcohol. Fetal alcohol syndrome is one of these disorders, but there are others that fall under this “umbrella” diagnosis.

Fetal alcohol spectrum disorder

Detecting and diagnosing FASD is difficult. Doctors are not able to use a test, but they can look for the key signs of fetal alcohol syndrome and other disorders. Generally, fetal alcohol disorders result in brain damage, growth problems, behavioral challenges, and some physical effects.

Fetal alcohol spectrum disorder can be triggered by both small and large amounts of drinking during pregnancy. At the time of this guide’s publication, there is no amount of alcohol that is 100% safe to consume while pregnant.

Fetal alcohol syndrome (FAS) and other FASDs were first brought into the public eye in 1973, when a group of pediatricians and psychiatrists at the University of Washington published an article in a British medical journal, The Lancet. Their findings indicated that prenatal alcohol exposure was tied to both pre-and post-natal growth deficiencies, physical abnormalities, and cognitive impairment.

Since then, research has continued to support these findings and delve
deeper into FASD and FAS.

Pregnancy Alcohol Use and FASD Statistics in the U.S.

In 2022, CDC researchers found that nearly 14% of pregnant women reported current drinking. Another 5% reported binge drinking within the last 30 days.

14%of pregnent woman

Researchers at Yale estimate that up to 54% of pregnancies that result in live births were exposed to at least 1 alcoholic beverage during gestation. Up to 13% are exposed to 5 or more drinks in just one week.

54%of pregnancies

Although we do not know exactly how many people have FASD, in-person assessments of
school-aged children report that up to 9 out of every 1,000 children have FAS.

9out of every 1000 children

It’s estimated that the FAS costs in the U.S. alone total at more than $4 billion annually.

$4Bannually

The Common Diagnoses of
Fetal Alcohol Spectrum Disorder

Prenatal exposure to alcohol can result in a range of intellectual and behavioral problems, many of which manifest during infancy and early childhood. However, some FASD and FAS cases are not diagnosed until later in life, especially if no physical symptoms are present.

Typically, FASD cases fall into one of the four categories below.

The Common Diagnoses of Fetal Alcohol Spectrum Disorder

01 Fetal Alcohol Syndrome (FAS)

This is the most severe fetal alcohol spectrum disorder and is estimated to occur in 0.5 to 2 births out of every 1,000. FAS can result in birth defects, neurodevelopmental disorders, and a wide range of spectrums including:

  • Problems with hearts, kidneys, and bones
  • Learning disabilities and low IQ levels
  • Memory and coordination difficulties
  • Hyperactivity and attention problems

As mentioned earlier, FAS is just one of the disorders that fall under the realm of FASD, but not all individuals with FASD meet the full criteria for FAS.

Unfortunately, FAS symptoms tend to worsen as the child ages, resulting in life-long consequences. Every individual tends to have slightly different fetal alcohol syndrome symptoms, but none are entirely reversible.

Fetal Alcohol Syndrome (FAS)

02 Alcohol-Related Neurodevelopmental Disorder (ARND)

Although not as severe as FAS, ARND is estimated to affect roughly 40,000 babies in just the United States each year. Individuals with alcohol-related neurodevelopmental disorders don’t have physical symptoms or growth problems, but they do struggle with brain and nervous system effects.

Most ARND cases involve:

  • Intellectual Disabilities
  • Behavioral Problems
  • Learning Difficulties
  • Nerve Abnormalities

Many children with ARND struggle to learn at the same pace as other children, and they will likely deal with neurocognitive development and behavior problems well into adulthood.

Alcohol-Related Neurodevelopmental Disorder (ARND)

03 Alcohol-Related Birth Defects (ARBD)

Infants born with alcohol-related birth defects will have visible symptoms of their disorder, such as improperly formed or functioning:

  • Hearts
  • Spines
  • Kidneys
  • Hearing Capablities
  • Bones
  • Vision

It is possible for individuals with ARBDs to fall under the other categories on this list. Many also experience the neurodevelopmental symptoms listed under ARND.

Alcohol-Related Birth Defects (ARBD)

04 Neurobehavioral Disorder Associated with Prenatal Alcohol Exposure (ND-PAE)

Lastly, there are ND-PAE diagnoses. Individuals with this disorder have impaired neurocognitive abilities, as well as difficulties with self-regulation and adaptive functioning. There is usually strong evidence of prenatal alcohol exposure, and most symptoms manifest early in childhood.

ND-PAE is a relatively new condition diagnosis and was first recognized by the Diagnostic and Statistical Manual 5 (DSM 5) of the American Psychiatric Association (APA) in 2013. Therefore, we have fewer statistics on the cases, but the diagnosis is helping healthcare providers better identify and care for alcohol-related behavioral problems in children.

Neurobehavioral Disorder Associated with Prenatal Alcohol Exposure (ND-PAE)

The Causes of Fetal Alcohol Spectrum Disorder

Fetal alcohol spectrum disorder occurs when a fetus is exposed to alcohol in the womb. Alcohol (and other harmful substances) can:

The Causes of Fetal Alcohol Spectrum Disorder

Reach the fetus via the placenta, resulting in high blood-alcohol concentrations

The Causes of Fetal Alcohol Spectrum Disorder

Interfere with the delivery of oxygen and nutrition to
the infant.

The Causes of Fetal Alcohol Spectrum Disorder

Harm the baby’s
developing tissues and
organs.

The Causes of Fetal Alcohol Spectrum Disorder

Potentially cause
permanent brain
damage.

The symptoms can vary from child to child, but defects caused by fetal alcohol syndrome or other fetal alcohol-related disorders can only be treated, not reversed. That is why there is no safe time to drink during pregnancy, nor is any amount of alcohol safe for developing fetuses.

How Common
is Fetal Alcohol Spectrum Disorder?

As our societies increasingly advocate for alcohol abstinence during pregnancy, most assume that FASD cases are becoming increasingly rare. Although FASD awareness is certainly helping with prevention efforts, fetal alcohol spectrum disorders are more common than many assume.

1 out of every 1,000 Children

Currently, the CDC estimates that 1 out of every 1,000 children is affected by FASD. However, some other studies put this number as high as every nine out of one thousand. The lack of a definitive FASD test makes it challenging to calculate a firm case number, even in the United States.

9 out of 100 U.S. children

Many researchers believe that FASD cases are widely unreported due to poor public awareness and misconceptions about what is “safe” to drink during pregnancy. Even research from 2018 indicates that as many as 9 out of 100 U.S. children could have at least some symptoms of FASD.

5% of the entire U.S. population,

In fact, it’s estimated that fetal alcohol spectrum disorder could affect up to 5% of the entire U.S. population, making this disorder equal to or more prevalent than other developmental disabilities such as autism. That’s why our team at Indiana Alliance focuses heavily on educating the public on FASD effects, prevention, and treatment.

Increased public awareness of FASD can help children with potentially unrecognized disabilities receive the treatment they need. Furthermore, it can contribute to fewer cases of alcohol use during pregnancy. Even light drinking can lead to serious problems in fetuses.

Fetal Alcohol Spectrum Disorder Symptoms

There are many FASD symptoms that can dramatically impact (and compromise) children’s abilities to navigate everyday life. The severity of the symptoms varies from case to case, with some children and adults experiencing more serious symptoms than others.

Generally, symptoms are grouped into three different categories. It is not uncommon for an individual with fetal alcohol spectrum disorder to experience:

Physical Deftects

Bodily defects (specifically in FAS cases, only) may include:

  • Distinctive facial features (small eyes, thin upper lip, short upturned nose, etc.)
  • Deformities of joints, limbs, and fingers
  • Vision or hearing difficulties
  • Small head circumference and brain size
  • Heart defects and problems with kidneys and/or bones

Furthermore, many FASD cases involve slow physical growth both before and after birth. Babies exposed to alcohol while in the womb may be born early or underweight and may grow slowly in comparison to other children.

Physical Deftects

Brain and Central Nervous System Issues

Problems with the brain and central nervous system
can include:

  • Poor coordination or balance
  • Intellectual disabilities
  • Delayed cognitive development
  • Poor memory and learning disorders
  • Attention problems
  • Challenges when processing information
  • Reasoning and problem-solving issues
  • Poor judgment skills
  • Hyperactivity
  • Quick and/or dramatic mood swings
Brain and Central Nervous System Issues

Social and Behavioral Problems

Social and behavioral problems associated with FASD may include:

  • Trouble getting along with others
  • Atypical or poor social skills
  • Problems switching from one task to another
  • Difficulties with controlled behavior and impulse control
  • Poor concept of time
  • Challenges with staying on task
Social and Behavioral Problems

What Are the Effects of Fetal Alcohol Spectrum Disorder?

When a child is diagnosed with a fetal alcohol spectrum disorder, they will likely face a range of challenges and effects for the rest of their life. Typically, their symptoms will be cataloged into two different categories: primary effects and long-term effects.

Primary effects are those that reflect underlying central nervous system damage from prenatal exposure to alcohol. These effects tend to present themselves at birth or early in life. On the other hand, long-term or “secondary” effects will manifest later in life.

What Are the Effects of Fetal Alcohol Spectrum Disorder

Primary Effects of FASD

Primary disabilities most directly reflect central nervous system damage, which leads to a range of cognitive disabilities. The most common primary effects of FASD tend to include:

  • Inconsistent memory
  • Challenges with recalling information
  • Difficulties filtering out environmental or emotional distractions
  • Lower levels of mental stamina
  • Difficulties interpreting and applying abstract concepts
  • Slow, inconsistent cognitive and auditory processing
  • Problems with impulse control and judgment
  • Resistance to changes (big and small)
  • Difficulties understanding other people’s perspectives and social cues

These early-detected effects are often noticeable in
the first years of schooling. Children with fetal alcohol spectrum disorder may struggle to connect with and understand their peers, and they may need
specialized attention during academic and social challenges.

Long-Term Outlook of FASD

Secondary effects of FASD tend to appear in an individual’s teen years or even in early adulthood. Many adults who were exposed to alcohol prenatally face life challenges such as:

  • Mental health problems
  • Substance use and/or problems with addiction
  • Disrupted schooling – often resulting in suspensions, expulsions, or dropping out
  • Trouble with the law or other authorities
  • Confinement (for mental health, substance abuse, or criminal behavior)
  • Sexually deviant behavior
  • Problems with employment and money
  • Low levels of maturity

Because of secondary effects such as these, many (if not most) individuals with fetal alcohol spectrum disorder are unable to live independently. Although every case varies significantly, it’s common for adults with FASD to require a high degree of support and
care from family members.

How Fetal Alcohol Syndrome is Diagnosed?

Diagnosing FASD is challenging because there is no specific test for the disorder. Typically, a diagnosis is made simply by a professional assessment of the child’s signs, symptoms, and potential exposure to alcohol in the womb.

Doctors tend to look for a series of clues that indicate the presence of fetal alcohol syndrome, such as:

How Fetal Alcohol Syndrome is Diagnosed

Abnormal Facial Features

Low Weight OR Height

Small Head Size

Hyperactivity

Attention Problems

Poor Coordination Skills

Even if prenatal exposure to alcohol is suspected, it is usually not possible to diagnose fetal alcohol syndrome or other disorders prior to the baby’s birth. Healthcare providers will need to assess physical and neurological symptoms in the child as it develops outside of the womb.

If no physical symptoms are present, diagnosing FASD is even more difficult – especially in adults. This is often the case in cases of fetal alcohol spectrum disorder that have gone unassessed and untreated for years.

How Can Fetal Alcohol Spectrum Disorder Be Treated

How Can Fetal Alcohol Spectrum Disorder
Be Treated?

There is no cure for FASD, but there are ways to treat and help manage the effects associated with the disorder. This is especially true in cases diagnosed early in childhood. The
sooner invention treatment is applied, the more customized and effective it can be.

Obtaining an FASD diagnosis during a child’s early years can help parents understand the challenges and create a more stable, loving home environment. They’ll also be able to take more advantage of social services and special education opportunities.

As individuals with fetal alcohol spectrum disorder age, treatments often include the use of:

Medications for
certain symptoms,

both physical and mental

1

Behavior therapy,

potentially with special education teachers and therapists

2

Counseling

from a trained
therapist

3

Educational assistance

in and outside of the
classroom

4

Parental or professional guidance

for help with life skills training

5

Support

for alcohol or substance abuse problems

6

Generally, though, treatment for fetal alcohol spectrum disorder falls heavily on the family. Coping assistance and community support can help treat the psychological and emotional problems associated with FASD.

Furthermore, parents and caregivers can seek guidance and resources from healthcare professionals, social workers, therapists, and associations like Indiana Alliance.

As parents and other family members care for children with FASD, it’s important to remember that early intervention and nurturing behavior is crucial. Learning to recognize the child’s strengths and limitations can help with the implementation of daily routines, as well as discipline.

When disciplining toddlers, children, or teens with FASD, understand that simple rules and language is often the most effective tactic. Individuals with FASD thrive in structured environments where positive reinforcement, loving support, and repetition are common.

The sooner parents and guardians can understand a child’s fetal alcohol spectrum disorder diagnosis, the more they can do to protect the child and prevent many of the secondary effects that they are at risk for later in life.

How Can Fetal Alcohol Spectrum Disorder Be Prevented?

Although FASD is a life-long condition, the good news is that fetal alcohol spectrum disorders are preventable with more societal awareness and healthcare interventions.

How Can Fetal Alcohol Spectrum Disorder Be Prevented

Alcohol-related damage can affect a fetus at any point during pregnancy. However, the effects of alcohol use can be the most serious during the first stages of fetal development. Considering that many women do not know they are pregnant for up to six weeks, it’s sometimes difficult to ensure they have stopped drinking before fetal development begins.

As a result, most healthcare professionals recommend that women avoid drinking alcoholic beverages:

  • If sexually active but not using any birth control
  • When trying to conceive
  • Throughout their pregnancies
  • While breastfeeding

Although alcohol levels in breastmilk are not directly linked to FASD diagnosis, research indicates that drinking while breastfeeding is unsafe for developing babies. If a woman does realize she has consumed alcohol while pregnant or breastfeeding, she should stop drinking immediately to minimize any possible effects.

Substance Abuse and Pregnancy

Alcohol isn’t the only dangerous substance used during pregnancy. Abuse of many drugs and medications can endanger the well-being of a fetus and lead to life-long effects after birth.

A 2021 study indicates that more than half of all pregnant women use prescription medications, nonprescription medications, social drugs (tobacco or alcohol), or illicit substances during some point in their pregnancy.

Unfortunately, it seems rates of substance use during pregnancy are actually increasing, despite increased awareness of FASD and other disorders. That’s why it’s important to understand that every substance a pregnant woman uses can affect the fetus in at least some capacity.

Let’s take a look at some of the most commonly used drugs that can be incredibly harmful to developing
fetuses while in the womb:

Opioids and Pregnancy

Opioids are a class of drugs used to treat and manage pain levels. They are often prescribed by medical professionals for injuries or after surgeries – but they are also used illicitly throughout the United States.

In 2020 alone, more than 68,000 deaths were attributed to
opioid-involved overdose deaths. This indicates a dramatic influx in the abuse and overuse of opioids in America. The most commonly abused opioids include heroin, fentanyl, methadone, naltrexone, and buprenorphine.

Sadly, opioid use disorder among pregnant women is becoming an increasingly significant public health concern in the United States. From the years 2010 to 2017, the number of women with
opioid-related diagnoses
documented at delivery increased by a staggering 131%.

Although the proper (and supervised) use of prescription opioids during pregnancy can be deemed safe, abuse of opioids during pregnancy can result in a number of effects on the fetus, including:

Substance Abuse and Pregnancy

Neonatal Abstinence Syndrome

NAS occurs when a baby is exposed to an addictive drug in the womb prior to birth, then goes through withdrawal after being delivered. This syndrome can cause serious problems for infants, including breathing difficulties, seizures, vomiting, fevers, and poor feeding abilities.

Neural Tube
Defects

The abuse of opioids during pregnancy can also result in birth defects involving the brain, spine, and spinal cord. Spina bifida is one of the most common neural tube defects, involving the malformation of a fetus’s spine and spinal cord.

Congenital Heart Defects

Opioid drugs have been found to raise the risk for several different types of heart defects in infants. Abusing opioids during pregnancy can affect the shape of the baby’s heart, how it works, or both.

Gastroschisis

Gastroschisis is a birth defect that affects the baby’s abdomen. The intestine will stick outside of the body through a hole beside the belly button, often as a result of malnutrition or the improper use of medications during pregnancy.

Miscarriage or Stillbirth

The improper use of opioids during pregnancy has also been associated with an increased risk of miscarriage (before 20 weeks of pregnancy) or stillbirth.

Preterm
Delivery

Opioids can cause a premature rupture of membranes during pregnancy. This is when the sac around the baby breaks before the woman goes into labor, which can result in premature birth before
37 weeks of pregnancy.

Stunted Growth

The use of opioids during pregnancy may also restrict the infant’s growth. When this happens, the baby may not gain the weight it should prior to its birth.

If you or someone you know is struggling with opioid addiction during pregnancy, immediate treatment is the best option. Contact your doctor or the free SAMHSA national helpline.

Amphetamines and Pregnancy

Like opioid medications, amphetamines can be legal or illegal depending on their production and use. They are legal when they are prescribed by a doctor to treat health problems, such as narcolepsy or ADHD.

However, amphetamines are illegal when they are used without a prescription to get high or improve performance. You’ve likely heard of the commonly used street amphetamine called “speed.”

Amphetamines and Pregnancy

Because amphetamines are stimulant drugs, they make users feel more alert and physically active. You may have heard of students using them to prepare for a test or an athlete turning to amphetamines to perform better.

Amphetamines also cause the brain to release dopamine, a
“feel-good” chemical that is involved with more positive moods, better thinking, and movement.

Unfortunately, the use of amphetamines during pregnancy can have serious effects on the fetus. Most often, using amphetamines while pregnant can lead to reduced blood flow to the placenta, which can cause the baby to be smaller at birth. It may also contribute to early labor and delivery or miscarriage/stillbirth.

The use of amphetamines during pregnancy has also been associated with a risk for:

Cleft Lip

Cleft Lip

A cleft lip is a birth defect that occurs when a baby’s lip or mouth does not form properly. This typically happens during early pregnancy, and can often be remedied through surgery after birth.

Cardiac Problems

Cardiac Problems

Prenatal alcohol exposure can result in cardiac defects to the atrioventricular valves, causing blood to flow backward into the atria. Ventricular septal defects – which is commonly referred to as a “hole in the heart” – may occur between the right and left ventricles; compromising the pumping chamber of the heart. This adds a risk of developing heart disease later in life.

Reduced Head Size

Reduced Head Size

Infants exposed to amphetamines in the womb have been noted to have smaller head circumferences, even when compared with other drug-exposed newborn infants. Research indicates that this may be the result of fetal serotonin depletion.

Biliary Atresia

Biliary Atresia

Biliary atresia is a blockage in the tubes that carry bile from the liver to the gallbladder. Typically, the
condition develops as a result of a fetus’s exposure to harmful chemicals, including amphetamines.

Systolic Murmur

Systolic Murmur

Because amphetamines can impact a fetus’s heart development, they are also tied to concerns such as heart murmurs. These are extra or abnormal sounds made when the blood flows through the heart. Although
some heart murmurs are not serious, they can be concerning when they happen at birth or during the first
sixth months of a baby’s life.

Undescended Testes

Undescended Testes

Cryptorchidism is a condition in which one or both of a baby boy’s testicles have not moved
down into their proper place. Undescended testicles move down on their own in most cases,
but if they don’t by the time a baby is six months old, they may require treatment to prevent
further medical problems.

Babies Born With Amphetamine

Babies Born With Amphetamine

Another risk of using amphetamine during pregnancy is that the baby will be born addicted to the
drug. If this happens, the baby will likely experience withdrawal after being born, which can lead to problems with feeding, agitation, irritability, and excessive drowsiness.

Whether a woman is taking amphetamine as prescribed or they are misusing it, there are risks. If
you or someone you know is using speed or another amphetamine while pregnant, seek help immediately.

It is recommended that women seek treatment for illicit amphetamine use as ceasing use
completely can lead to physical and psychological withdrawal symptoms, which can further harm
the fetus. Talk to a medical professional about the safest way to stop using the drug, both for the
mother and for the baby.

Marijuana and Pregnancy

Marijuana is the most widely used illegal drug during pregnancy in the U.S. As more people use marijuana, and the drug becomes legalized for recreational use in more states, the cases of marijuana-related fetal effects will likely increase.

Marijuana contains nearly 500 chemicals, including the
mind-altering compound tetrahydrocannabinol (THC). These can
pass through a woman’s placenta directly to the baby during pregnancy. Although further research is needed to understand the full effect of marijuana on pregnant women and developing fetuses, we know that some consequences are possible.

Potential effects of marijuana use on a developing baby include:

Marijuana and Pregnancy

Disrupted Brain Development
Before Birth

Research indicates that using marijuana during pregnancy could change how the baby’s brain cells are wired. In studies with mice, scientists found that the THC in smoked or digested marijuana interferes with the formation of connections between the nerve cells in the cerebral cortex – the area responsible for higher thinking skills and memory production.

Smaller Size at Birth

Researchers found that, on average, marijuana users gave birth to smaller babies – especially if the woman
used marijuana consistently throughout her pregnancy. These babies were roughly 5.5 ounces lighter than infants born to women who had not used marijuana while pregnant.

Higher Risk of Stillbirth

Many studies also indicate that using any illicit drug – including marijuana – is correlated with a much higher risk for stillbirth. Specifically, marijuana use during pregnancy is associated with a 2.8-fold increase in the likelihood of stillbirth.

Higher Chance of Early Birth

Babies born to women who were heavy cannabis users during pregnancy are more likely to have health problems, including premature birth and death within a year of birth. This is thought to be especially true when pregnant women use both marijuana and cigarettes during pregnancy.

Behavioral and Attention Problems

Other studies have found that prenatal marijuana use is significantly related to increased hyperactivity, impulsivity, and inattention symptoms in children. Although these symptoms may not be apparent in the first year of infancy, they may manifest as the child moves into toddlerhood and beyond.

Harm from Secondhand
Marijuana Smoke

We all know that tobacco smoke from cigarettes and cigarettes is harmful – but so is the secondhand smoke from marijuana. If pregnant woman is consistently around secondhand marijuana smoke, they can still jeopardize the development of their unborn fetus, even without smoking the drug themselves.

As marijuana use increases and more states legalize the drug, we could very well see an increase in fetal exposure to secondhand marijuana smoke. Further research is needed to understand the long-term effect of marijuana smoke on youth, young adults, and of course, developing babies in the womb.

Frequently Asked Questions

1. How early can FASD be diagnosed?

Fetal alcohol syndrome can be diagnosed at birth if the newborn is severely affected with noticeable symptoms, including facial abnormalities. However, other effects of FASD might not become obvious until at least eight months of age.

2. What are the risk factors of fetal alcohol spectrum disorder?

Although alcohol consumption during pregnancy is the cause of FASD, there are other risk factors associated with the presentation, severity, and complications of the disorder.

Maternal and child risk factors for fetal alcohol spectrum disorders can be grouped into four main factors:

1) The mother (her health, age diet, DMBI, nutrition, and other elements)
2) Alcohol exposure to the fetus (the quantity, frequency, and timing)
3) The maternal antenatal environment (socioeconomic status, prenatal care, etc.)
4) The child’s postnatal environment (parenting, stimulation, nutrition, support, etc.)

3. What is the life expectancy of a child with fetal alcohol spectrum disorder?

The sad truth is that the life expectancy of those with FAS and other serious alcohol fetal spectrum disorders tends to be lower than that of the general population. In a 2016 study, researchers found that the life expectancy at birth of people with FAS with 34 years, which is less than half of that of the general population.

That same study indicated the leading causes of death for people with FAS were actually external causes, not the disorder itself. Of these external causes, up to 15% involved suicide. Roughly 14% were accidents, and another 7% involved the use of illegal drugs or alcohol.

This is why it’s so crucial to foster public awareness of FASD and substance use during pregnancy. The more we know about FASD and its life-long effects, the more we can treat and support those living with the disorder.

4. What country has the highest rate of fetal alcohol spectrum disorder?

Currently, researchers estimate that South Africa has the highest prevalence of FASD cases. A 2017 study found that of the 187 countries surveyed, South Africa had the highest rates with about 111 FASD diagnoses per 1,000 members of the population.

Croatia came in second with about 53 diagnoses per 1,000 population, and Ireland ranked third with about 47 per 1,000.

5. How long do the effects of fetal alcohol spectrum disorder last?

The effects of fetal alcohol spectrum disorder are life-long. There is no cure, but that doesn’t mean there is no hope. Research does indicate that early intervention treatment services can improve a child’s development and a chance at a more normal life.

Adult treatment options may include medication to help with some symptoms, behavior and education therapy, and parent training.

6. Can someone with fetal alcohol spectrum disorder live a normal life?

Although we know the disabilities associated with FASDs are lifelong, we don’t have all that much firm research on the outcomes of FASD beyond childhood and adolescence. Some features may diminish or change over time, and secondary effects (such as unemployment or substance abuse problems) can possibly be prevented with proper care and guidance.

As an adult, proper support and treatment can allow an individual with FASD to participate in “normal” activities such as building a family, holding a job, getting involved with a community, and forming hobbies.

7. How do you discipline a child with fetal alcohol spectrum disorder?

As a parent with a child who has FASD, discipline, and structure can be difficult to maintain. The important thing to remember is that children with fetal alcohol spectrum disorder have a different brain. They often struggle with managing their temper and paying attention far more than other children.

Remember that the child will not just “grow out of” their neurological challenges. Rather than harshly reprimanding the child for mistakes, focus on accommodating their difficulties and rewarding them for good behavior. Praise them for achievements, explain what they have done well, and look for strengths as often as you can.

Parents with children who have FASD or fetal alcohol syndrome disorder will also need to use firm limits, clear consequences, and simple rules. Structure and repetition go a long way with children who struggle with abstract concepts and impulse control.

For more information on parenting children with FASD, please don’t hesitate to read through our Indiana Alliance resources.

8. What happens when someone with fetal alcohol spectrum disorder drinks?

Alcohol can impact individuals with FASD more intensely than the general population. When a person with FASD drinks one or two alcoholic beverages, they may feel as though they’ve had an entire bottle of wine.

This is one of the reasons why it’s so important to help guide and educate individuals with FASD on impulse control and understanding their limits. Many struggle with substance abuse, and that’s partially because substances affect them differently.

The Wrap: Next Steps to Take

If you or your child’s doctor believes there could be a problem related to prenatal alcohol exposure, we recommend seeking a referral to an FASD specialist. This could likely be a developmental pediatrician or a child psychologist.

You may also want to reach out to your state’s early intervention program if your child is under the age of three years. This is an excellent way to find a free evaluation and learn about services that can help the child receive necessary services.

If your child is already over the age of three, you may want to contact your local public school system to learn about their available resources. As we’ve discussed throughout this guide, understanding the ins and outs of fetal alcohol spectrum disorder is a crucial part of supporting children (and adults) through their challenges.

Next Steps to Take

About Indiana Alliance

At Indiana Alliance on Prenatal Substance Exposure, we work to prevent prenatal exposure to alcohol, drugs, and other substances that can harm fetal development. Our goal is to educate the public, advocate for resources, plan training events, and support families and individuals throughout the state of Indiana (and beyond).

If your child was exposed to alcohol prenatally, and you would like to connect with other parents dealing with FASD, we’d like to hear from you. This is your chance to share your story, ask questions, and seek support from others dealing with the effects of drinking while pregnant.

For more information on fetal alcohol spectrum disorder, please browse our resource library. You can also make a difference by donating to our FASD organization.