Fetal Alcohol Syndrome

Published on June 26th, 2013

Fetal Alcohol Syndrome Defined

picture of a bottle next to a sign

Source | Fetal Alcohol Syndrome

In 2004, a meeting organized by the National Organization on Fetal Alcohol Syndrome (NOFAS), which included experts from the Center of Disease Control and Prevention (CDC), the National Institute on Alcohol Abuse and Alcoholism (NIAAA), the Substance Abuse and Mental Health Service Administration (SAMHSA), and others, in order to offer a clear definition of Fetal Alcohol Syndrome and its inherent effects. The term Fetal Alcohol Spectrum Disorders was coined to describe the effects of maternal alcohol consumption during pregnancy (“Fetal Alcohol Spectrum Disorders, Handbook”, p.11).

Fetal Alcohol Syndrome was first studied in the U.S. in 1973 by David W. Smith and Kenneth L. Jones, pediatricians who specialized in dysmorphology (the study of congenital abnormalities during development) at the University of Washington Medical School. Organizations such as the March of Dimes, founded in 1938 to combat polio, helped shine a light on fetal and early childhood development within the U.S..

Drs. Smith and Jones first studied a group of eight children who displayed similar abnormalities and determined that, of the eight, four of the children were born to alcoholic mothers. Smith and Jones surmised that within fetal development, alcohol acted as a teratogen and was responsible for the defects they observed.

The abnormalities observed during the study and eventually attributed to Fetal Alcohol Syndrome included: “pre- and post-natal growth deficiencies, minor facial abnormalities, and damage to the developing brain that can result in behavioral, learning, and cognitive abnormalities”(O’Neil).

During this period Jones contacted French pediatrician Paul Lemoine who had conducted a study of 127 children of 69 French families in which one or the other was diagnosed with alcoholism. The separate studies seemed to reach the same conclusions; heavy drinking during pregnancy was harmful to the fetus and resulted in various behavioral and cognitive throughout the life of the offspring. Alarmingly, Lemoine’s continued study found that of the 127 children, 105 had been institutionalized as a result of their handicaps attributed to Fetal Alcohol Syndrome.

Characteristics of Fetal Alcohol Syndrome

picture of a baby with fetal alcohol syndrome

Source | Fetal Alcohol Syndrome Traits

According to the Fetal Alcohol Spectrum Disorders Handbook developed by the Sanford School of Medicine of the University of South Dakota Pediatrics department, characteristics of Fetal Alcohol Spectrum Disorder include:

Growth Deficiency

  • In Height
  • In Weight
  • In Both Height and Weight
  • Pre-natal and Post-natal

Facial Characteristics

  • Smooth or Long Philtrum (Ridges between nose and mouth.)
  • Short Palpebral Fissures (Eye Slits)
  • Thin Upper Lip
  • Minor Anomalies May Include:
  • Flat Midface
  • Short Upturned Nose

Central Nervous System Dysfuntion

  • Michrocephaly (Small Brain Size)
  • Tremors
  • Seizures
  • Hyperactivity
  • Fine Motor Difficulties
  • Gross Motor Difficulties
  • Attention Deficits
  • Learning Disabilities
  • Mental Retardation
  • Developmental Delays
  • Intellectual Disabilities (“Fetal Alcohol”, p. 8,9)

*Not every individual diagnosed with Fetal Alcohol Syndrome will exhibit all of the above characteristics.

Characteristics of those with Fetal Alcohol Syndrome are studied within different developmental stages as the individual ages. The developmental stages are defined by researchers as: Characteristics often seen in Newborns or Infants, Characteristics often seen in Preschool Aged Children, Characteristics often seen in Elementary School Aged Children, and Characteristics often seen in Adolescents and Young Adults.

Chronological Developmental Stages

The Fetal Alcohol Spectrum Disorder Handbook lists the ongoing characteristics within chronological developmental stages as:

Newborns or Infants

  • Difficulty Sleeping – Unpredictable Sleep/wake Cycles
  • Electroencephalogram (EEG) Abnormalities
  • Failure to Thrive
  • Feeding Difficulties including Weak Sucking Reflex
  • Heart Defects, Kidney Problems or Skeletal Anomalies
  • Increased Sensitivity to Light and Sound – Easily Overstimulated
  • Neurological Dysfunctions
  • Small Size
  • Poor Fine Motor Skills
  • Poor Gross Motor Skills
  • Susceptibility to Infections

Preschool Aged Children  

  • Emotional Overreaction and Tantrums
  • Hyperactivity
  • Lack of Impulse Control
  • Mental Retardation
  • Poor Eye-hand and Physical Coordination
  • Poor Judgment (Not Afraid of Strangers, Children may be Over-friendly)
  • Small Size
  • Speech Delays (May Include Poor Articulation, Slow Vocabulary or Grammar Development, or Perseverative Speech)

Elementary School Aged Children 

  • Attention Deficits
  • Hyperactivity
  • Language Difficulties (Delayed development or difficulties with expressive or receptive language)
  • Learning or Cognitive Disabilities
  • Memory Difficulties
  • Poor Impulse Control (Often seen as lying, stealing, or defiant Acts)
  • Small Size
  • Social Difficulties (May include over friendly, immaturity, easily influenced and difficulty with choices.)

Adolescents and Young Adults

  • Difficulties in Abstract Reasoning
  • Difficulty Anticipating Consequences
  • Low Academic Achievement
  • Low Self-Esteem
  • Memory Impairments
  • More Pronounced Impulsiveness (Often seen as lying, stealing, or defiant acts)
  • Poor Judgment
  • School Failure (“Fetal Alcohol”, p. 9,10).

According to National Center on Birth Defects and Developmental Disabilities, early diagnosis is key to a more positive prognosis:

Children with FAS (Fetal Alcohol Syndrome) who are identified early have an improved prognosis. A child who is identified early in life can be placed in appropriate educational classes and given access to social services that can help the child and his or her family. In addition, early diagnosis helps families and school personnel understand why the child might act or react differently from other children in some situations (qtd in “Fetal Alcohol”, p. 21).

Prevention

Fetal Alcohol Syndrome is 100% preventable. That being said, prevention should not fall solely on the shoulders of the expectant mother. According to experts in the field of fetal alcohol syndrome and women’s health service professionals, support should be provided by the spouse, significant other, and society as a whole.

The “5 P’s of Prevention”, a concept developed by noted researcher Ann Streissguth, Ph.D., “work together to affect not only women who are or may become pregnant but also the society around them” (qtd in “Fetal Alcohol”, p. 22).

  • Public Education:  Posters, lectures, brochures, and media exposure are all tools which can be used to educate the public concerning the dangers of alcohol use during pregnancy.
  • Professional Training:  Focus is on educating health care and social service professionals about Fetal Alcohol Spectrum Disorders. Professionals should be trained in how best to approach women about not drinking during pregnancy and how to aide women to stop drinking.
  • Public Policy:  Public policy refers to the way every level of government deals with fetal alcohol syndrome. U.S. Surgeon General’s warning labels on alcoholic beverages and laws which require certain individuals to report to the state when if they are aware of a woman drinking during pregnancy are examples of public policy.
  • Programs and Services:  Programs which intervene with women who are drinking during pregnancy and services which support women during and after pregnancy.
  • Parent and Citizen Activism: Parents and ordinary citizens being active and involved in the prevention of Fetal Alcohol Disorder. (qtd in “Fetal Alcohol”, p. 22).

References

“Fetal Alcohol Spectrum Disorders; Handbook” Sanford School of Medicine; The University of South Dakota Center for Disabilities. Sanford School of Medicine. Web. Retrieved from: http://www.usd.edu/medical-school/centerfordisabilities/upload/fasdhandbook.pdf

O’Neil, Erica. “The Discovery of Fetal Alcohol Syndrome”. The Embryo Project Encyclopedia. Arizona Board of Regents. Web. Retrieved from: http://embryo.asu.edu/pages/discovery-fetal-alcohol-syndrome

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