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Frequently Asked Questions (FAQ) about FASD

1. WHAT IS FASD?
2. WHAT CRITERIA DEFINE THE FAS DIAGNOSIS?
3. WHAT ARE THE COGNITIVE AND SOCIAL IMPLICATIONS OF FAS?
4. IS THERE NEUROLOGICAL DAMAGE FROM PRENATAL ALCOHOL EXPOSURE?
5. DON’T PHYSICIANS ADVISE PATIENTS ABOUT ALCOHOL DURING PREGNANCY?
6. SO WHY WON’T PREGNANT WOMEN TALK TO PRIMARY CARE PROVIDERS ABOUT THEIR ALCOHOL USE?
7. WHAT CAN BE DONE TO COUNTERACT PUNITIVE POLICIES THAT DRIVE PREGNANT WOMEN FROM PRENATAL CARE?
8. ARE ALCOHOL RELATED PROBLEMS IN PREGNANCY PREVENTABLE?
9. HOW CAN THE BARRIERS TO SCREENING PREGNANT WOMEN FOR ALCOHOL BE REDUCED?

1. WHAT IS FASD?

The term Fetal Alcohol Spectrum Disorders (FASD) recently was conceived as an umbrella term to describe the broad range of physical, mental, behavioral and learning problems that can occur in the offspring of women who drink alcohol during pregnancy.

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2. WHAT CRITERIA DEFINE THE FAS DIAGNOSIS?

The diagnosis of FAS is based on three criteria: prenatal and/or postnatal growth retardation, central nervous system impairment and facial dysmorphology.  Alcohol-related birth defects (ARBD) and alcohol-related neurodevelopmental disorders (ARND) occur three to four times more frequently than diagnosed cases of FAS.

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3. WHAT ARE THE COGNITIVE AND SOCIAL IMPLICATIONS OF FAS?

Adolescents and adults with FAS have IQs ranging from 20 to 105 with a mean of 68. Alcohol-exposed children have difficulty with behavioral regulation, impulsivity, and poor judgment. As the child ages and the social environment expands in complexity, the FAS child is susceptible to victimization, poor self-esteem, social isolation, inappropriate peer group affiliation, drug and alcohol use, abuse, sexual promiscuity and depression.

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4. IS THERE NEUROLOGICAL DAMAGE FROM PRENATAL ALCOHOL EXPOSURE?

Yes, there is neurological basis to the cognitive and behavioral deficits found in children with prenatal alcohol exposure. Those areas of the brain vital to executive function and behavioral regulation appear to be most vulnerable. Due to impairment of the attention and executive function domains of memory, inhibition, planning and organization among others, the individual is not able to think ahead in order to self-direct behavior, integrate multiple bits of information, stay on task, problem solve or place information into memory for later use.

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5. DON’T PHYSICIANS ADVISE PATIENTS ABOUT ALCOHOL DURING PREGNANCY?

In a study conducted by the American College of Obstetricians and Gynecologists, although 97% of obstetricians asked patients about their alcohol use, 80% responded that “a little alcohol” does not pose a threat to the pregnancy or fetus. However, one study documented that any alcohol use in pregnancy places the child at more than three times increased risk for delinquent behavior.

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6. SO WHY WON’T PREGNANT WOMEN TALK TO PRIMARY CARE PROVIDERS ABOUT THEIR ALCOHOL USE?

Most pregnant women fear prosecution or loss of their baby to the child protection system.

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7. WHAT CAN BE DONE TO COUNTERACT PUNITIVE POLICIES THAT DRIVE PREGNANT WOMEN FROM PRENATAL CARE?

Screening, via a structured questionnaire needs to take place within the context of primary prenatal care. Furthermore, an integrated system of screening, assessment, referral, and treatment can link universal prevention and early intervention regarding alcohol use during pregnancy.

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8. ARE ALCOHOL RELATED PROBLEMS IN PREGNANCY PREVENTABLE?

Yes, if women cease drinking prior to becoming pregnant and when supported by early identification and referral. Infants whose alcoholic mothers enter treatment and become alcohol free by the third trimester have substantially improved outcomes at birth.

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9. HOW CAN THE BARRIERS TO SCREENING PREGNANT WOMEN FOR ALCOHOL BE REDUCED?

Children’s Research Triangle has identified four issues that motivate physicians and other primary care providers to screen for alcohol use among pregnant women:

• Educational and training issues – increase knowledge about alcoholism and addiction, alcohol’s impact on pregnancy, and more effective screening and referral options.
• Practice issues – provide adequate screening instrument, prompting in the medical chart, and follow through protocols for referrals.
• Policy issues – support comprehensive community care, view addiction as a health as well as a social concern, and screen the general (not targeted) population within the prenatal clinic.
• Cultural and linguistic issues – use family systems to support abstinence, increase access to health care among racially or ethnically diverse families, translate screening instruments, and ensure open communication between the pregnant woman and the provider.

 

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