Better recognition of FASD by health and social care professionals will help give affected young people better chances in life, writes Joanna Buckard
By Joanna Buckard, specialist trainer and health and social care lecturer
Foetal alcohol spectrum disorder (FASD) is a lifelong, largely invisible disability. It’s caused by prenatal alcohol exposure and is a well-known preventable cause of intellectual and behavioural disorders.
Young people with FASD commonly experience difficulties around impulsivity, social understanding, relationships, criminality, mental health and linking cause and effect. They can be vulnerable to all types of grooming, including child sexual exploitation (CSE), in their pursuit for relationships and acceptance. In adulthood, they’re more likely to have problems with housing, relationships, employment, parenting and the law.
Studies suggest that in the general population, between 1 and 5% of people could be affected by FASD, which has been a diagnosable condition since 1973. Yet it is still sometimes thought to be rare, with some professionals believing that they’ve never worked with a child with the condition, and is frequently missed or misdiagnosed.
This is often down to a lack of recognition and training, among social workers as well as GPs, paediatricians, and teachers. Parents and carers of children and young people with FASD comment on a lack of appropriate understanding, support and resources – factors that can lead to family breakdown and failed adoption.
‘Alcohol and ambiguities’
Alcohol is a known teratogen, a substance that disrupts typical development in pregnancy. Foetal exposure to a teratogen can cause death, malformations, growth deficiency or functional deficits. Not all teratogens cause all four of these outcomes, but alcohol is one that does. It is a neuro-behavioural teratogen that can affect the central nervous system and developing brain, even at low levels of exposure. This can result in brain damage and behavioural changes without necessarily causing physical malformations.
In the UK, advice around alcohol consumption has been ambiguous, and a clear understanding of the risks – both among professionals and pregnant women – remains limited. Women have been advised that they can drink one to two units once or twice a week during pregnancy.
But studies have shown that understanding around units is poor, as is recollection. This means women may have been drinking far more alcohol than is recorded. Earlier this year, England’s chief medical officer Dame Sally Davies warned that there is no safe level of alcohol use in pregnancy.
FASD is a spectrum disorder and a child or young person should receive a specific diagnosis of foetal alcohol syndrome (FAS), alcohol-related neurodevelopmental disorder (ARND), alcohol-related birth defects (ARBD) or partial foetal alcohol syndrome (PFAS).