Foetal Alcohol Spectrum Disorder
What is foetal alcohol spectrum disorder?
Foetal alcohol spectrum disorder (FASD) can affect the development of cells and organs, but the brain and nervous system are particularly vulnerable.
Foetal alcohol syndrome (FAS) and FASD
Foetal Alcohol Syndrome (FAS) is the most recognisable and severe presentation within the FASD spectrum, although many affected children do not have the characteristic facial features. It is a lifelong condition.
The condition affects the physical and mental development of the baby in the womb and continues to have a significant impact at school in the form of learning difficulties. It becomes apparent in many different aspects of a child’s life, including memory, attention and emotions, and because many of the symptoms overlap with autistic Spectrum Disorder (ASD) or attention deficit hyperactivity disorder (ADHD), it can sometimes be misdiagnosed or overlooked.
How common is FASD in the UK?
Current estimates say around 3 per cent of babies in UK are born with FASD of varying severity each year. The exact prevalence of FASD in the UK is unknown because many children remain undiagnosed or are diagnosed later in life. British Medical Association describes FASD as the most common non-genetic cause of learning disability in the UK.
A disproportionate number of vulnerable children, including those looked after by the local authority have been found to experience the impact of exposure to alcohol in the womb. Yet often there is little professional understanding in schools about the lasting impact FASD can have.
However, we don’t know the exact prevalence of FASD and the correlation between alcohol and FASD is not as straightforward as it might at first seem. Scientific studies are complicated by other factors, such as different populations studied, and the different diagnostic methods used.
Symptoms of foetal alcohol spectrum disorder
FASD can result in a range of difficulties affecting both physical and mental functioning.
Physical issues
Smaller head circumference
Heart problems
Limb and skeletal differences, especially affecting joints, limbs, and fingers
Kidney problems
Damage to the structure of the brain
Vision and hearing problems
Poor coordination and balance
Learning and cognitive difficulties
Poor short-term memory
Speech and language delays
Difficulty with processing information,
Hyperactivity
Poor concept of time
Problems staying on task
Difficulties with mathematics and abstract concepts
Poor concentration.
Behavioural and social difficulties
Impulsiveness and inattentiveness
Inability to think through consequences of actions
Poor social skills
Trouble adapting to change or switching from one task to another
Problems with behaviour
Sudden mood changes
Irritability and anger
Mental health problems
How can parents support a child with FASD?
Accentuate the positive. Children with FASD often have high energy levels and a gregarious and caring nature. Praise them for their kindness.
Many are skilled in visual arts, music and sports so look out for opportunities to develop these and their self-esteem in and out of school.
Children may be slow to process what you say, so keep everything simple – rules, routines, language, explanations and expectations.
Use concrete and positive language – for example, say ‘Walk’ rather than the negative ‘Don’t run’. Spell out precisely what you mean rather than an abstract instruction such as ‘Be careful’.
Provide a quiet place for homework to help them to concentrate. Encourage them to do their homework at a set time in a particular place and to put books and equipment away.
Teach strategies for remembering, such as making lists, repeating aloud, and using a homework diary.
Help children to put into words what they have to do. This will help them stay focused.
Work with your school – you will know best which developmental areas have been most affected by FASD, and what strategies are most effective.
How schools can support children with FASD
Children and adolescents with FASD can be immature and naïve and may trust too easily. Ask teachers to provide support both in the classroom and the playground, as children may struggle to relate to classmates. Teachers should also remember that a child with FASD may have a developmental age that is younger than their chronological age.
Ask the school to refer the child to clinicians who can help, such as speech and language therapists or occupational therapists.
In class:
The child should sit near the front of the classroom to avoid distractions
Learning needs to be as concrete as possible, with lots of examples – abstract words will confuse
Keep activities short and varied
Do not overload the child. Provide one instruction at a time and build up to longer sequences
Help them to sequence through the use of symbols and visual timetables
Teachers should encourage the child to repeat what they have said so that they focus and internalise instructions
Revise regularly to refresh knowledge before they forget it
Where can parents find help?
NHS – Fetal alcohol spectrum disorder NHS guidance on FASD
National Organisation for FASD – Resources for parents, schools and professionals National Organisation for FASD education resources
