Fetal Alcohol Spectrum Disorder (FASD) represents a spectrum of neurodevelopmental and physical impairments that can result from exposure to alcohol during pregnancy. These impairments are usually lifelong and can include difficulties including:
- executive functioning;
- social functioning;
- adaptive behaviour;
- emotion regulation;
- motor skills;
- and language.
FASD is also linked to an array of secondary outcomes (e.g. trouble with the law) and comorbid psychiatric (e.g. ADHD) and medical diagnoses, (e.g. hearing problems and sleeping difficulties). FASD is often labelled an invisible disability, affecting individuals from all socioeconomic backgrounds.
Often individuals with FASD are labelled as ‘lazy’ or ‘disobedient’, however, their behaviour is a manifestation of their brain-based disability as their actual functioning is much lower than their developmental age. The gap between individuals with FASD and typically developing individuals continues to widen with age, particularly as individuals with FASD become more vulnerable to developing secondary conditions.
Youth and adults with FASD are more likely to have substance use issues, difficulty finding employment, and are more likely to have had contact with the justice system. As such, early identification and management of FASD is vital and has the potential to improve long-term outcomes.
One of the key barriers to diagnosis is limited awareness among health professionals and the community, as well as a lack of appropriately trained clinicians for diagnosis. There continues to be limited pathways for diagnosis and therapy in Australia and internationally. Providing a diagnosis of FASD can help individuals make sense of themselves and can assist with providing more tailored intervention plans.
Missing FASD as a diagnosis also has the potential to influence the effectiveness of interventions. For example, individuals with FASD do not respond as well to behavioural interventions and certain medications. Individuals with FASD and their families have emphasised the importance of having a FASD-informed management team, ranging from teachers to health professionals.
We must continue to build community awareness around the impact of alcohol use during pregnancy to prevent FASD. The current NHMRC guidelines in Australia indicate that no alcohol during pregnancy and breastfeeding is the safest option, however, there continues to be unclear messaging about the impact of drinking – particularly low levels of alcohol – during pregnancy.
Additionally, while research suggests that FASD is growing in recognition as a diagnostic term, community members, justice personnel and school and health professionals are less clear on the typical behaviours associated with FASD. Consequently, it is important that we continue to build community awareness around the potential impact of prenatal alcohol exposure and the lifelong impact of FASD.
Upskilling multidisciplinary clinicians and the wider community on FASD will help to improve and sustain prevention, screening, assessment, diagnosis and management efforts going forward. FASD has significant impacts on the individual and their family, and therefore early detection and intervention is essential.
Find out more about UWA’s micro-credentials on FASD-related topics.