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Fetal Alcohol Spectrum Disorder

Assessing a child in your care:

There are a wide variety of symptoms that a caregiver might observe. Facial change can be observed if alcohol was used during the 1st trimester of pregnancy. These changes can include a difference in the width of eye, distance between the eyes, thin upper lip, palpepral fissure length, and flatness of the philtrum groove above the upper lip. This flatness can vary from absent to severe.

But not all FAS children have noticeable facial differences. Other indicators a caregiver might see will be behavioral. Soft signs of brain dysfunction can include poor memory, learning disabilities, language delay and poor social interaction. Each individual affected by FASD will have unique characteristics along a spectrum or possibilities.

Dr. Ann Streissguth, University of Washington, a leading researcher in the field of FAS, said that "The most outstanding characteristics of FAS are bad judgment and the inability to make the connection between an act and it consequences." … This is true even in the absence of the physical characteristics of the face and body. If behavior is a problem with a child, it is always wise to examine the background for possible alcohol abuse of the birth mother. (1)

For most people, good judgment comes from experience. But children with FAS have poor memory, are slow to learn new skills, and can be somewhat inattentive. They have trouble learning the consequences of their actions and often have trouble making sound decisions. Because of this, they don't seem to learn from the past and "grow in experience" at the rate other children do. They are also more apt to think in the concrete - unable to think in abstract. For all these reasons, their judgment is quite poor.

Many will also have poor social and adaptive skills and are open to victimization and trouble with lying and stealing. Relationships are one of the most important human demands, but brain dysfunction impairs ones ability manage relationships. Children suffering from FAS also experience delayed motor skills, poor concept of time, inability to organize, difficulty carrying out multi-tasks, and can easily get lost navigating from point A to point B. All this may mean that they might not be able to be left on their own, even as adults.

Primary Disabilities of FAS include learning problems, attention deficits, poor judgment, impulsiveness, memory problems, sleeping/eating disorders, distorted social perceptions, difficulty communicating/receptive language, and abstraction/ math problems.
A person with FAS might have difficulty with impulsivity, inability to plan or follow directions, and an inability to say no. They often get in trouble with the law. Suspect FAS when someone is passing tests but failing life.

Secondary Disabilities of FAS are defined as disabilities that a person is not born with which could be prevented or made less severe through better understanding and timely intervention. This could include mental health problems, disrupted school experience, trouble with the law, confinement, inappropriate sexual behavior, and alcohol and drug problems.

An acronym caregivers can use to remember the signs of FAS is the word "ALARMS," with the A - standing for adaptive behavior, L - language skills, A - attention difficulties, R - reasoning delays, M - memory lapses, and S - standing for sensory difficulties.

If you have questions concerning a child in your care or even an adult in your family, please consult your physician.

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1. Peggy Seo Oba, RDH, MPA, MBA, quoting from the August 1996 Final Report: Understanding the Occurrence of Secondary Disabilities in Clients with Fetal Alcohol Syndrome (FAS) and Fetal Alcohol Effects (FAE), Fetal Alcohol and Drug Unit, University of Washington, Seattle, Washington, <http://depts.washington.edu/fadu>

FASD resources

Contact us at
Christian Alliance for Indian Child Welfare

PO Box 253, Hillsboro, ND 58045 - 0253

writeus@caicw.org

WWW www.caicw.org