What is Fetal Alcohol Syndrome?

Fetal Alcohol Syndrome (FAS) is a specific pattern of abnormalities seen in some children of women who drank heavily during pregnancy, and it is the only cause of mental retardation that is truly preventable. FAS is now recognized by many as the leading known cause of mental retardation in the U.S.

It is estimated that one in every 750 live births is a child with FAS.

Although FAS is a medical diagnosis, many inconsistencies exist in its assessment, diagnosis, and intervention. Clinical geneticists and dysmorphologists generally base their assessments on the following four criteria:

1. growth deficiency
2. central nervous system effects
3. specific facial dysmorphology
4. a history of prenatal alcohol exposure

An individual with growth deficiency is typically defined as falling below the tenth percentile for height and weight. Central nervous system effects range from learning disabilities to mental retardation. The constellation of specific facial features includes short palpebral fissures (narrow eye openings), indistinct philtrum (flattened area between the nose and the upper lip), and a thin upper lip.

Unfortunately, no laboratory tests are available that can establish or rule out the diagnosis of FAS. If an individual has effects in some, but not all of the four categories specified by the Institute of Medicine, an individual may be diagnosed as having a related condition such as Partial FAS (pFAS), alcohol-related neurodevelopmental disorder (ARND), or alcohol-related birth defects (ARBD). Although these are not necessarily less severe forms, they are not as easy to recognize and distinguish from other conditions. Collectively, all of the conditions associated with prenatal alcohol exposure are often referred to as Fetal Alcohol Spectrum Disorders (FASD). This is a descriptive term, and not meant to be used as a diagnosis. For additional diagnostic information, please go here

The range of Impairments of Fetal Alcohol Syndrome vary tremendously between individuals. Ann Streissguth, PhD (University of Washington-Seattle) reported IQ's ranging from 29 to 120 for individuals with FAS, and 42 to 142 for individuals with FAE. Ann Stressguth and Sterling M. Clarren MD, also of the University of Washington-Seattle reported the following adaptive living deficits seen in individuals with FAS or FAE with an average chronological age of 17: an average overall level of adaptive functioning of age 7, performance at an average age of 9 years old in daily living skills based on the Vineland Adaptive Behavior Scale (VABS), performance at an average 6-year-old level in socialization skills, and significant communication deficits. Streissguth also reports

"even patients with FAS or fetal alcohol effects (FAE) who were not technically retarded were frequently characterized on the VABS as failing to consider consequences of their actions, lacking appropriate initiative, being unresponsive to subtle cues, and lacking reciprocal friendships." *

Other effects of FASD that need to be addressed are the inconsistent learning patterns and the spotty memory that can be exhibited by many individuals with this diagnosis. Difficulties with learning may be associated with organizational and processing deficits in the areas of information input, output, integration, and memory. Although a task may appear to be mastered one day, the following day, or the following week, that same task may very well need to be re-taught. This is a re-occurring pattern.

* REFERENCE: Streissguth, A.P. (1994). A Long-Term Perspective of FAS. Alcohol, Health & Research World, 18 (1) pp 74-81