About fetal alcohol spectrum disorder (FASD)

What is fetal alcohol spectrum disorder (FASD)?

Fetal alcohol spectrum disorder (FASD) is a medical condition caused by prenatal alcohol exposure. This can cause developmental problems for the child.

FASD can happen when alcohol in the mother’s blood passes to her baby through the placenta. Because alcohol can impact everything that is happening in the womb during pregnancy, the symptoms and presentations depend on a complex mix of timing, frequency, genetics and other factors, and will be different for every person.

It is a neurodevelopmental condition that can cause lifelong cognitive, emotional and behavioural challenges.

The National Organisation for FASD state that between 2% and 4% of children are affected by FASD, increasing to 27% for those in care.

Symptoms of FASD and how it presents

Symptoms of FASD vary from child to child. What presents depends on timing, genetics and other factors.

FASD is defined by severe impairment in 3 or more neurodevelopmental areas, which could be:

• motor skills (controlling and coordinating body movements)
• mental processing, such as learning or memory skills
• memory
• academic achievement
• language
• attention
• executive function, including impulse control and hyperactivity
• social skills

For the vast majority of children with FASD, there is no outward sign of the condition. What will be noticed is that they will struggle to cope, behave and learn as their friends and peers do.

There are more than 400 often better-known medical conditions associated with FASD. People with the condition will often receive multiple diagnoses, such as ADHD and autism. People who have FASD can also present with physical abnormalities.

Changes over time

As a child with FASD gets older, symptoms can also change as the child’s nervous system develops. Developmental gaps will become more apparent as a child gets older. It is often noticed at the transition to secondary school at age 11.

What to do if you think your child has FASD

Speak to your GP about getting a referral to a pediatrician for an assessment for FASD.

The GP or pediatrician may want further information from you about why you think the child may be affected by FASD, such as any evidence you have of alcohol consumption in pregnancy.

Find out more about getting a diagnosis of FASD on the National Organisation for FASD’s website.

Understanding and managing FASD

As a carer of someone with FASD, it can be useful to know that:

• the brain of someone with FASD reacts impulsively without being able to process what has happened or what is needed sufficiently quickly
• children with FASD often struggle to process everything that they hear or take a long time to process a piece of information: they may need a whole minute or more to work out how to tackle a single instruction
• children’s behaviour may seem childish, but should be thought of as a developmental stage that is around half of their actual age
• people with FASD have great strengths and with the right support and guidance, can achieve a lot and lead positive lives

FASD and processing instructions

As parents and carers, you may try to help by repeating an instruction or giving helpful advice, but this can confuse a child with FASD as the brain tries to process another instruction over the top of what it was already working on.

Too many good parenting prompts can then lead to a complete freeze as the child with FASD cannot work out what they need to do.

Responding to behaviours in a child with FASD

It can be helpful to reframe expectations of a child to take into account the impact of their FASD on the child’s brain and their behaviours.

Reframing expectations of a child with FASD might be remembering that when they are:

• acting like a child – they are a child
• they won’t do something – they can’t
• they are fussy/demanding – they are hypersensitive
• they seem not to care – they struggle to understand feelings
• refusing to sit still – they are overstimulated/need contact
• not getting something obvious – they do not learn from experience

Children with FASD need their carers to be calm and patient, and help them make sense of what is often a confusing world. If you need help with managing challenging behaviour linked to FASD, there’s also a guide and training workshop around this topic.

Get support

There are a range of organisations and groups that support people with FASD and their carers.

Support from Kinship

Here at Kinship, we offer a range of free support for all kinship carers, including  workshops, online advice and information, and support groups.

To find services, information and support in your local area, including information about your local children’s services, use our Kinship Compass tool.

You can also contact the Kinship advice team for free, non-judgmental advice and information if you live in England or Wales.