FASD – Rffada

Understanding FASD

Fetal Alcohol Spectrum Disorder (FASD) is a diagnostic term used to describe the risks to the brain and body of individuals prenatally exposed to alcohol. FASD is a lifelong disability.

Individuals living with FASD will experience some challenges in their daily living, and need support with motor skills, physical health, learning, memory, attention, communication, emotional regulation, and social skills to reach their full potential. Success is possible.

Each individual with FASD is unique and has areas of both strengths and challenges. FASD is a serious public health and social issue affecting hundreds of families in Australia and FASD occurs wherever alcohol is consumed. There is a critical lack of services with staff who have been trained to appropriately support families and individuals living with the symptoms of this condition.

Individuals living with FASD (diagnosed or not) can struggle with learning at school, find it difficult to follow instructions, to make and keep friends, and may be in constant trouble with friends and peers. Social and age structured expectations cannot be met and over the lifespan, FASD can present as socially unacceptable and sometimes unusual behaviour.

In the absence of appropriate interventions and support, challenges across the lifespan can lead to difficulties in employment, experience trouble with the police, mental health problems, substance misuse, and other equally serious complications.

Guide to the FASD diagnosis

Bower C, Elliott EJ 2016, on behalf of the Steering Group. Report to the Australian Government Department of Health: “Australian Guide to the diagnosis of Fetal Alcohol Spectrum Disorder (FASD)” (ISBN. 978-0-6481297-4-5).

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5658660/

The parts of the brain most commonly affected are:

More typical characteristics of FASD

If you suspect that an individual in your care or who you support, regardless of their age, may be living with undiagnosed FASD, gather all the information you can find and take it to your GP. A diagnosis can only be made by your doctor or a team of specialists.

Unique to each individual, some or all of the following will be experienced.

If you are a service provider / medical professional, find out as much as possible about FASD. Without knowing and understanding this condition you might be making life more difficult by referring your client/patient to programs/specialists which are inappropriate in expectations. Rather, it is environmental changes which lead to success.

Dysmaturity

Behaviour is symptomatic and skills to meet expectations set by others is noted to be younger than chronological age. Some argue that functioning could be at a level that is half the age of an individual. Consequently, the individual living with FASD may struggle in social relationships – with personal boundaries and be over-friendly or withdrawn. Often there is difficulty in understanding social cues and laughter or tears at inappropriate times can occur. To make friends, attention seeking can happen. With few friends a common experience, vulnerability to manipulation by others can be problematic.

Adaptive skills

Managing daily life tasks including personal hygiene, home management, financial management.

Motor Skills

These are the specific movements of the body’s muscles to perform small or large tasks and can include writing, picking up small items or walking, running or riding a bike (balance). The brain and muscles have to work together.

Sensory systems

Linked to flight or fight response, there may be hyperarousal (over sensitive and reactive to light, sound, temperature, touch or smell) or it’s opposite.

Nutrition

Adverse reactions to different food types.

Communication and processing pace

Dependent on how fast the brain processes information, the individual living with FASD may talk excessively and quickly; interrupt others; find it difficult to join in topics of conversation; seem opinionated; make inappropriate comments or comments not in context with conversation; and repeat statements frequently.

Learning and memory

There is difficulty and inconsistency in remembering the details of some tasks and/or translating to different situations. A struggle to learn new skills can be common and often instructions need to be continually repeated. There is difficulty in learning from mistakes and in linking cause and effect.

Abstract thinking

difficulty organising and managing daily tasks; struggles to manage money or time and follow through on multi-step instructions.

Executive functioning

Unable to plan and follow through with task and difficulty is more evident with more complex tasks. Concrete thinking is evident.

Strengths:

Behaviour is mislabelled and not understood as symptomatic of brain difference. Regulation of actions can be difficult

Poor anger management
Fearless in the face of danger
Impulsive and compulsive
Perseverative
Inattentive [often diagnosed or mis-diagnosed as ADHD | ADD
Unusual activity level [high or low]
Lying
Stealing
Unusual reactivity to sound, touch, light
Fidgety, cannot sit still

Physical and Facial Appearance

It is estimated that approximately 10% of children exposed to alcohol during pregnancy will have physical signs of FASD. Such individuals may be shorter and/or thinner than other children the same age, in effect, a smaller stature for age. They may have wide-spaced eyes with slanted or droopy eyelids; and the distance between the upper lip and nose may be long and/or there may be a smooth space (philtrum) with a thin vermillion border (upper lip).