A Parent and Caregiver Guide to Fetal Alcohol Spectrum Disorder

According to data published by the Centers for Disease Control and Prevention (CDC), fetal alcohol spectrum disorders (FASDs) affect an estimated 1 to 5 percent of school-aged children in the United States. For many families, receiving an FASD diagnosis can raise questions about what the condition means and what support may be available moving forward.

While every child's experience is different, understanding FASDs can help parents make informed decisions and connect with services that support their child's development.

What Are Fetal Alcohol Spectrum Disorders?

Fetal alcohol spectrum disorders are the name for a range of disorders that can occur when a baby is exposed to alcohol before birth. During pregnancy, consumed alcohol passes through the umbilical cord and can interfere with normal fetal development.

Because everything a woman eats, drinks, or consumes can pass to the baby, there is no known safe amount of alcohol use during pregnancy. Alcohol exposure can affect development at any stage of pregnancy, so healthcare professionals recommend avoiding alcohol throughout pregnancy.

Prenatal alcohol exposure can affect the developing brain and other parts of the body. As a result, children can be affected in different ways. For example, some children may experience physical differences, while others face challenges related to learning, attention, or behavior. The disorders are diagnosed depending upon the features a child exhibits:

• Fetal Alcohol Syndrome (FAS)

• Partial Fetal Alcohol Syndrome (pFAS)

• Alcohol-Related Neurodevelopment Disorder (ARND)

• Alcohol-Related Birth Defects (ARBD)

• Neurobehavioral disorder associated with prenatal alcohol exposure (ND-PAE)

Fetal Alcohol Syndrome (FAS) is the most widely recognized diagnosis within the spectrum. However, not every child with an FASD has FAS. The effects of prenatal alcohol exposure can vary significantly from one individual to another. 

What Signs May Lead to a Diagnosis?

A child with FASD may exhibit some common physical signs.  

Physical signs may include:

• Smaller-than-average height or weight

• Slower growth before or after birth

• Smaller head size

• A smooth ridge between the nose and upper lip

• A thin upper lip

• Shorter eye openings

Many of the challenges associated with FASDs involve brain development and nervous system functioning. While some children may show physical signs, others may display developmental, cognitive, or behavioral signs, which may include:

• Delays in reaching developmental milestones

• Learning disabilities

• Difficulty understanding new concepts

• Memory problems

• Difficulty focusing or paying attention

• Delayed speech and language development

• Challenges with planning and problem-solving

• Difficulty regulating emotions

• Challenges adapting to changes in routine

• Difficulty understanding social cues

Not all symptoms will be present, and some concerns may be more notable when a child enters school and begins to experience difficulty. 

How Are Fetal Alcohol Spectrum Disorders Diagnosed?

There is no single medical test that can diagnose all fetal alcohol spectrum disorders. Instead, healthcare providers conduct a thorough evaluation that examines a child's development and overall functioning.

The diagnostic process may evaluate the following:

• growth patterns before and after birth

• facial features associated with FADs

• brain function and nervous system development

• learning abilities and attention

• medical history

• known prenatal alcohol exposure when information is available

Diagnosis may involve multiple healthcare professionals working together to assess a child's needs. Depending on the situation, families may work with pediatricians, developmental specialists, psychologists, or other providers.

Moving Forward with Support

While an FASD diagnosis can bring uncertainty, it can also provide answers. Understanding a child's needs allows families to seek services that support healthy development and long-term success.

An FASD diagnosis does not define a child's future. Early intervention can play an important role in improving outcomes for children with FASDs, and parents do not have to navigate this journey alone. 

Sacramento County Behavioral Health provides support resources and screenings to help families navigate care both during and after pregnancy. We are here to offer compassionate care, free of judgment.