Alcohol Spectrum Disorders
Sheet for Personnel in Law Enforcement
by Teresa Kellerman, Director, FAS Community Resource Center, Tucson,
What is FASD? Fetal
Alcohol Syndrome Disorders (FASD) are a spectrum of lifelong physical,
mental and neurobehavioral birth defects associated with alcohol
consumption during pregnancy. FASD ranges from full Fetal Alcohol
Syndrome (FAS) to Prenatal Exposure to Alcohol (PEA). Other terms
for FASD include Fetal Alcohol Effects (FAE), Alcohol Related Neurodevelopmental
Disorder (ARND), and Alcohol Related Birth Defects (ARBD).
What is the incidence
of FASD? The incidence of all FAS disorders is
approximately 10 per1,000. The incidence of full FAS is approximately
2 per 1,000.
What are the symptoms
of FASD? Individuals with full FAS may have short
stature, small eyes, smooth upper lip, and some developmental delays.
Most individuals with FASD do not have any physical symptoms. Almost
all individuals with FASD have learning disabilities, memory deficits,
stunted social development, and behavior problems.
Are individuals with
FASD mental retarded? FAS is the leading known
cause of mental retardation, but most individuals with full FAS
have IQ in the normal range. They have good expressive language
skills, but poor comprehension. They can read, but have trouble
writing. They seem to have insights and understanding, but actually
have problems with abstract concepts like time and money. Their
ability to function in life is well below their IQ. Their emotional
level of development is well below their chronological age. They
may appear to be smarter than they actually are, and tend to be
naïve and gullible.
Do persons with FASD
have other disorders? Many persons with FASD have
more than one disorder. Other disorders that may occur along with
FASD include: Attention deficit disorder (ADD/ADHD), depression,
Reactive Attachment Disorder (RAD), Bipolar disorder, Obsessive
Compulsive disorder (OCD), pervasive developmental disorder (PDD),
Asperger syndrome (mild autism), Tourette Syndrome, mental retardation,
or developmental delays.
What does a person
with FASD look like? These individuals may have
apparently normal physical characteristics. Even a person with full
FAS may not look unusual. The average untrained person will not
recognize a person with FASD just by looking at him or her.
How does a person
with FASD act? Not all individuals with FASD will
behave in the same manner. Some may withdraw and shut down, others
may become aggressive and belligerent. Most individuals with FASD
have poor impulse control, are emotionally immature, and show
poor judgment. This is due to dysfunction of parts of the brain
that were damaged by prenatal exposure to alcohol, particularly
the frontal lobes, which affect ability to make decisions and control
How does a person
with FASD feel? Individuals with FASD are overly
sensitive to environmental stimulation. They have difficulty coping
with sensory stimulation like noise, crowds, being pushed or shoved.
When they feel overwhelmed, they may withdraw and shutdown, or they
may act in an aggressive manner. Most individuals with FASD are
for the most part undiagnosed, misdiagnosed, or otherwise not recognized
as having FASD, and are therefore at high risk of developing secondary
conditions during adolescence and adulthood.
How well do individuals
with FASD function? Most individuals with FASD
have mental health issues, have disrupted school experience, have
trouble with the law, and often exhibit inappropriate social and
sexual behaviors. These individuals are at high risk of developing
addiction to alcohol and other drugs, and are at risk of developing
depression and suicidal tendencies. Those at higher risk are the
ones without a diagnosis, with an IQ in the normal range. Because
their disorder is not recognized, their actions and motives are
misunderstood. Others have unrealistic expectations that cause stress,
frustration, and anger.
Factors to Consider
When Confronting an Individual with FASD:
behaviors have a basis in organic brain dysfunction, over which
the individual has little control. Destructive and/or dangerous
behaviors are reinforced in a maladaptive environment.
Arrested social development:
Studies show that regardless of age, regardless
of IQ, the person with FASD may have stunted social development,
about that of a 4 to 6 year old child.
deficits: Their ability to comprehend may be lower
than would be expected, and their inability to read social cues
accurately may interfere with their ability to understand the expectations
of others. They may understand rules and consequences, but still
may not understand why they are in trouble. The ability to process
information is sporadic and unpredictable.
Symptoms of co-ocurring disorders mentioned earlier
may mask those of the underlying FAS Disorder. Most will present
with some attention deficit disorder (ADHD) and have problems processing
information, understanding instructions, and controlling behavior.
Disorder: Persons with FASD might be extra sensitive
to external stimuli like sound and touch. They may feel overwhelmed
by being arrested, jostled with other prisoners, noise and lights,
and may feel the need to push back or lash out in defense, even
if not seen as reasonable to others.
Individuals with FAS are generally immature, have
a grandiose sense of themselves, but have an unrealistic view of
the world. They have difficulty handling everyday stress, may have
trouble controlling their temper, and may be self-abusive. They
may be unable to assess risk or danger, but may have unreasonable
fears. They may have difficulty accepting the limitations of their
individuals with FASD are helped by medications, including stimulants,
anti-depressants, and antipsychotics. If medications are withheld
or not taken, they may be increase of symptoms and decrease of control
Individuals with FASD are at risk of being victims
of sexual abuse and may also become perpetrators themselves, due
to the combination of normal hormone influence with lack of impulse
control and poor judgment. Emotional immaturity leads to peer interaction
with younger individuals.
person with FAS/ARND requires guidance, mentoring, structure, and
supervision. Even in the best of circumstances, with good role modeling,
effective medications, verbal and visual cues, and a supportive
environment, when the person with FAS is left on his or her own,
eventually there will be failure due to poor judgment and they will
act on impulse without regard for the consequences. The high risk
of making the same mistakes over and over require close monitoring
24 hours a day, 7 days a week.
The individual with
FASD will need:
by all personnel of the nature of the FAS disability.
· Advocacy by a
competent adult who knows and understands the individual and the
· Reasonable expectations
that match his/her functional abilities (6 year old level).
· Facts explained
in simple, concrete terms, which may need to be repeated.
· Assistance in
carrying out instructions given by the court/judge/officer.
· Protection from
predators due to emotional immaturity and social naivety.
· Assessments to
determine functional ability (IQ and Adaptive Behavior).
· Long-term support
services in order to function successfully in the community.
in the Court System
Sources of above
information: National Organization on Fetal Alcohol Syndrome; studies
by Anne Streissguth, PhD, Fetal Alcohol and Drug Unit, University
of Washington; studies by Edward Riley, PhD, San Diego State University,
Chair of the National Task Force on FAS; and Robin LaDue, PhD, Fetal
Alcohol and Drug Unit, University of Washington. More information
on FASD can be found at http://www.fasstar.com/