FASD Overview

FASD: The Facts

  • Foetal Alcohol Spectrum Disorders (FASD) are brain-based, neurodevelopmental disorders that require appropriate diagnosis, assessment and support across the lifespan.
  • Alcohol can cause more damage to an unborn baby than any other drug.
  • Alcohol-free pregnancy is the healthiest and safest option.
  • There is no known safe amount of alcohol during pregnancy.
  • More awareness of the risks of alcoholic pregnancy is needed. There are many reasons women might drink alcohol during pregnancy. Often, they don’t know they are pregnant or do not understand the risks involved. Older, more educated women are more likely to drink in pregnancy according to some research.
  • It is important to move beyond stigma and help identify alcohol-exposed pregnancies so mum can get appropriate support and so the child’s possible future needs can be identified as soon as possible.
  • Early diagnosis and support can change trajectories and contribute toward happier families.
  • Adults with FASD deserve access to diagnosis, support and benefits.

Foetal* Alcohol Spectrum Disorders (FASD) are caused by prenatal alcohol exposure. FASD is an umbrella term that covers Foetal Alcohol Syndrome (FAS), Alcohol-Related Neurodevelopmental Disorder (ARND), Alcohol-Related Birth Defects (ARBD), Foetal Alcohol Effects (FAE) and partial Foetal Alcohol Syndrome (pFAS). (In Scotland’s new SIGN guidance they are adopting simplified diagnostic terms – ‘FASD’ with and without ‘sentinel facial features’.) The Department of Health has asked NICE to explore whether these may be used in England.

Alcohol is a teratogen – a substance that crosses the placenta and causes malformations in a foetus and interferes with its development. When a pregnant woman drinks, the alcohol in her bloodstream passes freely through the placenta into the foetus’ blood. Because the foetus does not have a fully developed liver, it cannot filter out the toxins from the alcohol as the mother can. Instead, the alcohol circulates in the foetus’ blood system which can harm brain cells and damage the nervous system of the developing baby throughout the entire nine months of pregnancy.

FASD may not be detected at birth but sometimes becomes apparent later in life and carries lifelong implications. Its effects are diverse and range from cognitive and sensory processing issues and Attention Deficit Disorder to heart problems and concerns with bones and organs. Quite often people with FASD have multiple diagnoses. One study listed more than 400 co-occurring conditions. Every person with FASD is affected differently. A common ‘old-school’ misconception persists that someone has to have specific facial features to have a diagnosis. This is incorrect. By some estimates, it is less than 10% of those on the FASD spectrum who have these distinctive facial features.

All too often, people with FASD are undiagnosed or misdiagnosed. FASD, especially if unrecognised and unsupported, can contribute to serious social and behavioural problems.

The good news is that there are known strategies that can help someone with FASD to build upon their many strengths and to lead happy and fulfilling lives. FASD is often called a ‘hidden disability.’

Adults with FASD are leading efforts to raise awareness of FASD and to help others understand the importance of access to diagnosis and appropriate support.

How many people are affected?

The incidence of FASD in the UK and internationally is not accurately known. Many children born with FASD are not diagnosed, or do not receive a correct diagnosis, which makes calculating the prevalence of the condition extremely difficult.

The first UK-based screening prevalence study, conducted by researchers at Bristol and Cardiff Universities, was released at the end of 2018. This indicated more than 6% of the population might be affected. There is an urgent need for UK-based active case ascertainment studies to get a better understanding of just how many have FASD. The UK has the 4th highest rate of drinking alcohol during pregnancy in the world.