Fetal Alcohol Spectrum Disorders

An individual’s place, and success, in society is almost entirely determined by neurological functioning.

A neurologically injured child is unable to meet the expectations of parents, family, peers, school, career and can endure a lifetime of failures. The largest cause of neurological damage in children is prenatal exposure to alcohol. These children grow up to become adults. Often the neurological damage goes undiagnosed, but not unpunished.

They can become the forgotten kids - the children that have nearly invisible disabilities. They have their arms and legs, can see and hear, run, play, etc., but most have never been to a birthday party or a sleepover.. they are last to be chosen to play, and first to be blamed. Their illnesses aren't fatal, but a small part of their hearts and souls die with every rejection. Their behaviors may seem odd or unpredictable to themselves as much as society.

Fetal Alcohol Syndrome (FAS), Fetal Alcohol Effects (FAE), Partial Fetal Alcohol Syndrome (pFAS), Alcohol Related Neurodevelopmental Disorders (ARND), Static Encephalopathy (alcohol exposed) (SE) or Alcohol Related Birth Defects (ARBD) are all names for a spectrum of disorders caused when a pregnant woman consumes alcohol.

More than 20% of children have been exposed to high levels of alcohol in utero. All will suffer varying degrees of effects, ranging from mild learning disabilities to major physical, mental and intellectual impairment. It takes very little alcohol to cause serious damage. Research has shown that even a single exposure to high levels of alcohol can cause significant brain damage in the infant.

Six week-old baby brains

Normal FAS

Alcohol is toxic at all concentrations. Alcohol damage to the fetus occurs over a wide continuum. Damage varies due to volume ingested, timing during pregnancy, peak blood alcohol levels, genetics and environmental factors.

FAS/E is a lifetime disability. It is not curable. A child does not "grow out of it". However, early diagnosis and intensive, and appropriate, intervention can make an enormous difference in the prognosis for the child. There is a small window of opportunity, up to about age 10 or 12, to achieve the greatest potential for an alcohol affected child. That period is when the greatest development of fixed neural pathways occurs. That is when alternative "coping" pathways are most easily built as "work-arounds" to damaged areas of the brain. Time is of the essence.

In utero alcohol damage can include:
Attention deficit disorders - ADD/ADHD Mild to severe vision problems Higher than normal to dangerously high pain tolerance
Loss of intellectual functioning (IQ) Severe loss of intellectual potential
Mental Retardation
Serious maxilo-facial deformities Dental abnormalities Cleft palate
Bi-polar Behavioral problems Dyslexia
Immune system malfunctioning Extreme impulsiveness Poor judgement
Little or no retained memory Deafness Little or no capacity for moral judgement
Little or no capacity for interpersonal empathy Sociopathic behaviour Epilepsy
Tremors Cerebral palsy Renal (liver) failure
Asthma Complex seizure disorder Developmental speech and language disorder
Developmental delay Height and weight deficiencies Tight hamstrings
Cognitive perseveration Echolalia Autistic traits
Rigidity Sleep disorder Developmental coordination disorder
Adaptive esotropia Tourette's traits Central auditory processing disorder
Night terrors Precocious puberty Social problems
Depression Reactive outbursts Suicide
Heart defects Heart failure Death

The brain's Frontal Lobes control judgement, inhibition, concentration, self-control, conscience, personality and emotional traits as well as cognition and memory, motor speech and movement skills.

The Left Hemisphere deals with language based memory - logical interpretation of language, mathematics, abstraction and reasoning, facts and rules (such as safety and social).

The Right Hemisphere deals with holistic functioning - processing of images, sound, touch, for a "holistic" picture. Memory here is visual, auditory and spatial. So, the Left side is logic, facts, rules. The Right side is sensory input and reactive.

The Corpus Callosum connects right and left sides to allow communication between the hemispheres. The Right side senses input, checks with the Left side to see if there are rules to deal with this pattern of input, integrates the stored information and reacts in a modified way. Damage to any of these systems causes very poor, inappropriate response. For example, if the Corpus Callosum cannot access the appropriate information, quickly enough (or at all), then reaction to stimulae will be completely spontaneous, impulsive, based solely on instinct, (if any). Alcohol seriously damages the physical structures, "wiring" and brain chemistry.

FAS (Fetal Alcohol Syndrome) individuals may have a distinctive physical appearance and lower IQs, but have lower crime and addiction rates than FAE individuals as they get earlier diagnosis and can be better protected by society and their parents.

While FAE (Fetal Alcohol Effects) individuals may lack the outward physical appearance of alcohol damage, and generally have higher IQ's, the internal damage to the brain and other organs can be just as serious as full FAS. IQ measures convergent fact based thinking. Life skills require divergent adaptive thinking that in FAE individuals will be substantially lower than their IQ. However, because FAE individuals "look normal" they are expected to perform normally. These issues lead to secondary disabilities. Primary disabilities are those the child is born with. Secondary disabilities are those that develop as a result of failure to properly deal with the primary disabilities.

"The girls get knocked up and the boys get locked up." They are followers, easily misled, with little or no appreciation of consequences. Without intervention, many ride the justice system merry-go-round or become "homeless street people". They are required to compete in society but have been denied the tools to do so.

Of FAE individuals between the ages of 12 and 51:

  • 95% will have mental health problems;
  • 60% will have "disrupted school experience";
  • 60% will experience trouble with the law;
  • 55% will be confined in prison, drug or alcohol treatment centre or mental institution;
  • 52% will exhibit inappropriate sexual behaviour.

Of FAE individuals between 21 and 51:

  • more than 50% of males and 70% of females will have alcohol and drug problems;
  • 82% will not be able to live independently;
  • 70% will have problems with employment


Early diagnosis can help prevent secondary disabilities such as mental health problems, dropping out of school, trouble with the law and substance abuse. After diagnosis, parents often find that their ability to cope with the child's behavior changes dramatically when they understand that the problems are most likely based on organic brain damage, rather than the child's choice to be inattentive or uncooperative.


Costs of FASD

On average, each FASD individual costs the taxpayer more than $3 million in his or her lifetime (health problems, special education, psychotherapy and counseling, welfare, crime, and the justice system).

More than 60% of prisoners are likely affected by alcohol in utero. It costs approximately $120,000/year to "house" a Young Offender and $82,000 for an adult offender. Punishment does not cure neurological damage.

Add on:

  • the FAS/E individual's own lifetime loss of income;
  • the high costs to the families (foster, adoptive or biological) who raise and care for FAS/E children and adults;
  • the lost income of a parent who must care for the exceptionally high needs of an FAS/E child;
  • the costs to families whose FAS/E child is permanently dependent upon them;
  • the costs of legal services for defending their child in the courts;
  • the cost of stress caused divorce, etc.

Don't Ask My Child to Fly

Bruce Ritchie 1997

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 "settle down",
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.

Don’t ask my child to remember you tomorrow,
although you met today.

Don't ask my child to heal your wounds,
for her hands cannot hold a scalpel or sutures.

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 being tortured in his mother's womb,

for he will,

but He may not.