Fetal Alcohol Spectrum
Disorders (FASD), Fetal Alcohol Syndrome
(FAS), Fetal Alcohol Effects (FAE),
Partial Fetal Alcohol Syndrome (pFAS),
Alcohol Related Neurodevelopmental
Disorders (ARND), Static Encephalopathy
Alcohol Exposed (SEAE) and Alcohol
Related Birth Defects (ARBD) are all
names for a spectrum of disorders caused
when a pregnant woman consumes alcohol.
FASD is 100% preventable. If
you are pregnant or plan to become
pregnant, don't drink any beverage
alcohol. There is no known safe level.
is funded through voluntary donations.
We depend on you for being
able to continue our services. FASlink
serves more than 400,000 people annually
through this website and the Discussion
Forum. The FASlink Archives
provide access to more than 130,000
documents on FASD related issues.
the FASlink Collection - more
than 200 MB of information in a
Collection is an extensive compilation
of key articles about FASD. It is
available for download as a Thank You
for a donation of $20.00 or more to
FASlink. Click on the image above or click here to donate.
it quacks like a duck ....
by Bruce Ritchie
incidence of FASD exceeds
10% of our
children. FASD is the full
spectrum of disorders caused
by prenatal exposure to
alcohol. The incidence of
Fetal Alcohol Syndrome (with
the classic facial features)
is about 1%. Facial features
are determined around the
third week of pregnancy, so if
the mother was not drinking at
that time, the facial features
can be quite normal, but the
neurological damage can be as
Statistics Canada's "Canadian
Community Health Survey" and
their Birth and Population
statistics for the concurrent
period, It is likely that 37%
of babies have been exposed to
multiple episodes of binge
drinking (5+ drinks per
session) during pregnancy. An
have been multiply exposed to
1 to 4 drinks per session
alcohol exposure has been
linked to more than 60
disease conditions, birth
defects and disabilities.
Damage is a diverse continuum
from mild intellectual and
behavioural issues to profound
disabilities or premature
death. Prenatal alcohol damage
varies due to volume ingested,
timing during pregnancy, peak
blood alcohol levels, genetics
and environmental factors.
Ethanol interacts with
more than 1000 different genes
and cell events, including
cell signalling, transport and
suppression causes loss of
neurons and glia, inducing
excessive cell death during
normal programmed death
(apoptosis) or triggering
apoptosis at inappropriate
times leading to smaller or
abnormal brain structures with
fewer connections between
brain cells, leading to fewer
cells for dopamine production,
leading to problems with
addiction, memory, attention
and problem solving, and more
pronounced conditions such as
of Canadian school age
children are receiving special
education services, most for
conditions of types known to
be caused by prenatal alcohol
As FASD is a
diverse continuum, issues
range from almost
imperceptible to profound. It
is somewhere in the middle
that the issues attract the
attention of parents,
educators, medical and social
work professionals, and
eventually the justice system.
Most of the issues that
attract sufficient attention
are behavioural and
probable that 10% to 15% of
children are significantly
enough affected by prenatal
alcohol exposure to require
As they become adults, FASD
does not disappear but the
issues of youth translate into
ongoing problems in family
mental health and justice
conflicts. The cost to the
individuals affected, their
families and society are
enormous and as a society, we
cannot afford to ignore them.
Presentation to the
Legislative Assembly of Ontario,
Standing Committee on Social Policy,
Bill 118, Accessibility for Ontarians
with Disabilities Act
Disabilities - An
individualís place, and success, in
society is almost entirely determined
by neurological functioning. A child
with a brain injury is unable to meet
the expectations of parents, family,
peers, school, and career and can
endure a lifetime of failures. The
largest cause of brain injury in
children is prenatal exposure to
alcohol. Often the neurological damage
goes undiagnosed, but not unpunished.
strategies that can work to help the
child with FASD compensate for some
difficulties. Early diagnosis and
intensive intervention and tutoring
can do wonders, but the need for a
supportive structure is permanent.
to Fetal Alcohol Spectrum Disorders
(PDF) Document prepared for the above
PowerPoint FASD Presentation
provides an overview of FASD. 8 MB
intoxicated is defined as a Blood
Alcohol Level of .08%. A
100 lb (45 kg) female consuming 5
standard drinks will reach a BAL
of .25% - three times the
legal limit. BAL reduces
.01% per hour.
About 50% of
pregnancies are unplanned. "If you
drink, don't have sex. If you have sex,
don't drink. Prevent Fetal Alcohol
Spectrum Disorders (FASD)Ē
Most girls are 2
to 3 months pregnant before they find
out and the baby may well have been to
many parties before the pregnancy is
This link shows
on Windows Media Player an ultrasound
recording of a fetus responding to
damage to the fetus
occurs over a wide and diverse
continuum. Damage varies due to volume
ingested, timing during pregnancy, peak
blood alcohol levels, genetics and
FASD is not a
threshold condition. It is a diverse
continuum ranging from mild intellectual
and behavioural issues to the extreme
that often leads to profound
disabilities or premature death.
At the mild end,
damage may be the loss of some
intellectual functioning (IQ), visual
problems and higher than normal pain
tolerance. At the severe end, damage may
be severe loss of intellectual
potential, severe vision problems,
dyslexia, serious maxilo-facial
deformities, dental abnormalities, heart
defects, immune system malfunctioning,
behavioral problems, attention deficit
disorders, hyper-activity, extreme
impulsiveness, poor judgment, little or
no retained memory, deafness, little or
no capacity for moral judgment or
interpersonal empathy, sociopathic
behaviour, epilepsy, tremors, cerebral
palsy, renal failure, heart failure,
ask my child to fly
Don't ask my child to fly,
for he has not wings.
Don't ask my child to see
the glint on the eagle's beak,
for his vision has been diminished.
Don't ask my child to remain
calm amid the din,
for her ability to screen out the noises
has been taken away.
Don't ask my child to be
careful with "strangers",
for he is affectionate with everyone and
prey for the unscrupulous.
Don't ask my child to
for the clock which works for you and I,
does not exist for her.
Don't ask my child to not
play with the toys of others,
for he has no concept of property.
Donít ask my child to
remember you tomorrow,
although you met today.
Don't ask my child to heal
for her hands cannot hold a scalpel or
Don't ask my child to meet
the challenges set by society,
for you have denied her the tools.
Don't ask my child to
forgive you for standing idly by,
while he was in trouble in his mother's
for he will,
but He may not.
I wonít do it right, because
I will find success, watch me.
I will not feel a thing when
it hurts, because I canít.
I will see tomorrow as a new, bright
I wonít see what I did as
wrong, because I canít.
I will stand up and make you see me as a
I wonít ask again, because I
I will not be ashamed to try over and
I wonít say yes when what I
mean is no, because I canít.
I will shout from the rooftops, ďIím
I wonít feel bad about
myself, but I do.
I will look in that mirror and smile.
I wonít try to feel that I
need to be perfect, but I do.
I will only do what I can.
I wonít say that Iím broken,
but I am.
I will find the pieces and put them back
Today is your day, my day,
Today we will change the world, shape it
and recreate it
To make it fit in our lives.
We are different, but we will stand and together we
Feel free to be you, them, and me.
There is no safe
level of alcohol consumption during pregnancy. Fetal
Alcohol Spectrum Disorders are 100% preventable. If
you are pregnant or planning on becoming pregnant, don't
drink any alcohol at all.
Maternal prenatal alcohol
at low levels is adversely related to child behavior.
The effect was observed at average exposure levels as
low as 1 drink per week.
Even brief exposures
to small amounts of alcohol may kill brain cells in
a developing fetus. A study carried out by John
Olney, M.D., at the Washington School of Medicine
in St. Louis showed that just two drinks consumed during
pregnancy may be enough to kill some developing brain
cells, leading to permanent brain damage.
The Canadian Paediatric
Society states: "Fetal alcohol syndrome (FAS) is a common
yet under-recognized condition resulting from maternal
consumption of alcohol during pregnancy. While preventable,
FAS is also disabling." "Health care providers play
an important role in identifying babies or children
with FAS. They should become familiar with the screening
tools that are available to diagnose the condition in
children at various ages." ďFAS diagnostic and treatment
services require a multidisciplinary approach, involving
physicians, psychologists, early childhood educators,
teachers, social service professionals, family therapists,
nurses and community support circles.Ē
Search the Main Faslink Website
Bruce Ritchie, President/Moderator
Who are we? Our roots go back to 1991 as the
Fetal Alcohol Support Network, formed by a group of
parents who were struggling with the lack of professional
knowledge and supports in the FASD field. FASlink online
began as a FASD discussion forum in 1995, founded by
Val Surbey and the Canadian Centre for Substance Abuse
(CCSA). In 1999 CCSA ceased to fund the discussion
forum. FASlink was merged with the FASN website under
the direction of Bruce Ritchie and the combined name
became FASlink Fetal Alcohol Disorders Society. FASlink's
website contains more than 130,000 searchable FASD related
documents. The FASlink
Discussion Forum, with more than 700 members, compiles
the papers and discussions into the FASlink Archives. Our membership
is worldwide but most are in Canada and the USA, from
the most remote locations to urban centers. You can
the FASlink Discussions.(.....more)
opportunity in Central and Southwestern
Ontario for children and youth with FASD
and other Special Needs.
Annieís Havens Specialized
Foster Care (Licensed by the Ontario Government),
is an agency caring for many children and youth with
FASD and other Special Needs, including medically
fragile, autism, ADHD etc. The agency has a wonderful
history and is very unique in the province because
in-home staffing, clinical supports and therapies
are provided to their foster parents.
See their website at www.annieshavens.ca , especially if you feel you
might have something to offer these wonderful children,
and at the same time enjoy financial advantages for
your home. Bruce Ritchie is a consultant, advisor
and trainer for Annieís Havens.
"Kalee" by SanGia
Family Caregivers Unite!
with host Dr. Gordon Atherley and
Young adults, Mental Health
and the Justice System
Aired September 27, 2011
about the advice thatís given to family caregivers
Dr. Dave Travland
and Bruce Ritchie
Originally broadcast August 10, 2010.
Caregivers and Fetal Alcohol Spectrum Disorder
Teresa Kellerman and Bruce Ritchie
Originally broadcast April 13, 2010.
Money Management of Disability
This is a reply to a discussion on
the FASlink Discussion Forum
My son (now age 23) was diagnosed with FAS as an infant
with a long menu of issues. He was part of the Infant
Parent Program at Chedoke Hospital in Hamilton until
age 2. At age 2, we obtained Special Services at Home
(after a battle) and he had a worker come to the house
15 hours/week (9 AM until noon) until he started Grade
1 full time. In JK and SK he had Special Education supports
as well as throughout elementary and high school. He
was in a regular classroom throughout. He graduated
high school as an Ontario Scholar with the Principal's
Gold Honour Award. He did a full Grade 12 and then returned
to Grade 12 to add more courses of interest in a second
year. The end results justify the monumental battles
we had with bureaucracies to get the supports to which
he was entitled. It was as tough as any business I have
owned and operated. The extra year in Grade 12 also
helped with his maturation process.
He continued his education, first as an online student
at Athabasca University and then as a 60% full time
student at Lambton College. 60% course load qualifies
as a full time for a student with disabilities. At age
18, David gave me full Power of Attorney. It has been
critical in helping to manage his life. In Ontario,
he qualified for Assistance for Children with Severe
Disabilities (formerly the Handicapped Children's Benefit)
until age 18. That was for a maximum $435/month. At
age 18 (about 60 days before his 18th birthday) we applied
for ODSP, the Ontario Disability Support Program and
he qualified for the full amount, just over $1,000/month.
He has his own apartment with lease but I entirely manage
his funds. He does receive an allowance weekly and can
earn additional funds. As long as he is classed as a
full time student, what he earns is not deducted from
We often grocery shop together, but that is a huge challenge
as impulse buying is still a problem. He does have good
survival skills as we have camped since his childhood.
When school was out for the summer, he accompanied me
on the Great FASD Horseback Ride and Trek across Canada
in 2007 (Sarnia, ON to Victoria, BC portion). It was
an incredible experience for him.
As a student with permanent disabilities, he qualifies
for the Canada Studies Grant and the Bursary for Students
with Permanent Disabilities. All available grants are
automatically considered by OSAP (Ontario Student Assistance
Program) for students attending full time (60%+) in
a post secondary education program (college, university,
and trades programs). The funds are entirely in grants,
not loans. They only become loans if he withdraws from
a course part way through. To stay as a grant, he has
to pass or fail, not quit. He has Spec Ed supports,
particularly a quiet environment and extra time for
exams. He would never be able to navigate all the forms
and battles required for ODSP, college application,
financial supports, etc. on his own, and he knows it.
He doesn't want the aggravation. That is my job.
He has been taking targeted courses that will help him
to become self-employed in the future - English, Accounting,
Math, Psychology, Marketing, etc. His "choices" with
my strong influence. I take care of his car insurance
as an occasional driver on my van and his grandmother's
car. That is far less expensive than stand-alone insurance
for a single male under age 25. When he wants to go
to a special event, such as Fan Expo in Toronto, he
has a small group of highly reliable friends to travel
with and I arrange the tickets, travel, hotel, food,
spending money, etc.
Last Fall, we started the Artists Co-op and rented a
store front in the Cultural District in downtown Sarnia.
It is a practical lesson in starting and operating a
small business. I have been an entrepreneur for more
than 40 years. It has been an excellent experience for
him as well as a challenge for me as we have locked
horns frequently in the process, as normal. In spite
of having an excellent group of outstanding artists,
sales did not justified the overhead and we closed the
store. Again, an excellent practical lesson. He has
been involved every step of the way. In the words of
Kenny Rogers' "The Gambler", "You have to know when
to hold 'em and know when to fold 'em, know when to
walk away, and know when to run." We have re-focused
in another location and continue to serve our customers.
He is learning how to sell and imprint images on T-shirts,
ceramic coffee mugs, water bottles, and sheet aluminum
(plaques, awards, certificates, portraits, signage,
etc.) A key benefit has been his interactions with customers
and local businesses, in an environment where "the boss",
me, won't fire him for the odd screw-up. He will learn
as an adult he can make mistakes, take ownership of
them, learn from them, and deal with the consequences,
without the world falling apart. He is getting a crash
course in small business, something no school can give.
Hopefully, the lessons will be positive and stay with
him for a lifetime.
He loves to feel he is independent, but wants me to
sweat the details. :-) Working together has its
challenges, but they are well worthwhile. I am age 69
now and will not live forever. I will probably retire
when they stuff me in an urn. I only have a short time
to pass on what I have learned in 40+ years of running
We have developed a different adult/adult relationship
that still has vestiges of parent/young adult. I treat
him with respect, but I am the elder and know where
the landmines are planted and how things work. I can
help him avoid those landmines. He should make his own
mistakes, not repeat mine. So far, it is working.
When he really gets obnoxious and unrealistic about
money, I offer to turn everything over to him, including
managing the challenges of ODSP, college, car insurance
and repairs and maintenance, leases, etc. We go over
the budget costs of the standard of living and benefits
he currently enjoys with the realities of fully managing
his own life. That has a very sobering effect. He has
taken accounting at college and the math shows the standard
of living on ODSP really sucks. Without cost and affecting
his ODSP, he has free access to resources that might
otherwise be unavailable. It is a delicate balancing
act. The trick is learning how to squeeze a nickel until
the beaver poops. I can only hope I can keep up with
the challenges and keep the lines of communication open.
FASD and Academic Achievement
and intensive, appropriate intervention can make an
enormous difference in the prognosis for children with
Here are some
thoughts about my journey with David over the 21 years
since his birth. More.....
The Faces of Hidden Fetal Alcohol
Spectrum Disorders (FASD)
Great FASD Horseback Ride Across Canada
The Great FASD Horseback Ride
Across Canada 2007 trekked from Halifax,
NS to Victoria, BC and covered some 22,000 km round
trip over 4 months. There were many organized public
and private events and hundreds of teaching moments
on the trek. more ....
Margaret Sprenger and
Ritchie received the St. Michael's Hospital
"Award for Pioneer Work in the Area of Fetal Alcohol
Mary Cunningham, Ernie Parsons MPP, Margaret
Sprenger, Bruce Ritchie
Michael's Hospital, Fetal Alcohol Spectrum Disorder
Clinic is pleased to support the work of FASlink. St.
Michael's FASD Clinic views FASlink as an essential
service for our clients. We are fortunate to partner
with FASlink in our attempt to improve the lives of
individuals and their families with FASD. Dr. Brenda
Stade, St. Michael's FASD Clinic" St. Michael's Hospital
is a teaching hospital affiliated with The University
FASD Diagnostic Clinic - Booking Office: (416) 867-3655
a raw egg (without breaking
the yolk) into a clear glass.
Add a 1 ounce shot glass of
alcohol. With a swizzle stick,
gently stir some of the
alcohol into the egg white.
Watch the effects on the egg
white. White streaks will form
in the clear portion. Alcohol
literally cooks the cells.
ďHere is your baby's brain on