FREE ESSAY ON FETAL ALCOHOL SYNDROME

FETAL ALCOHOL SYNDROME

Fetal Alcohol Syndrome (FAS) is a condition affecting children born to women who 
drink heavily during pregnancy. There are three criteria used to describe the effects of
prenatal alcohol exposure and to make a diagnosis of FAS.
The first of these is a pattern of facial anomalies, these features include:
 Small eye openings
 Flat cheekbones
 Flattened groove between nose and upper lip
 Thin upper lip
These characteristics can gradually diminish as the child ages, but it is important to
note that diagnosis does not change because of this.
The second criteria is growth deficiencies: 
 Low birth weight
 Decelerating weight over time, not due to malnutrition
 Disproportional low weight to height
 Height and weight below the tenth percentile
The third criteria used to diagnosis FAS are brain injury. This includes:
 Decreased head size
 Behavioral and/or cognitive problems such as: mental handicap; learning
difficulties; problems with memory; problems with social perception
 Neurological problems (impaired motor skills, poor coordination, hearing loss)
A person diagnosed with FAS may show one or more characteristics listed above, and there
is a great variability in the outcome. ( McCreight, 1997)
Partial FAS is the recommended term used to describe the cluster of problems facing those
who have some of the characteristic facial abnormalities associated with FAS, and one
other component of FAS such as: growth deficiency; behavioral and cognitive problems or
brain injury. This is only of course if it is known that there was significant prenatal
exposure to alcohol. (Abel, 1984)
Fetal Alcohol Effects (FAE) a term no longer used, refers to the cognitive and behavioral
problems that may affect those with Partial FAS. FAE has often been used indiscriminately
to label individuals with these problems, whether it not it was known they had been
exposed to alcohol in the uterus. 
It is now recommended that the term FAE no longer be used, instead the more specific
terms Partial FAS (PFAS) be used when applicable. ( Blume, 1996)
Neonatal Abstinence Syndrome NAS describes the presence of withdrawal symptoms in infants
exposed to one or more drugs during pregnancy. These drugs may include: alcohol,
narcotics, sedatives, anti-convulsants and others. Some of the symptoms of NAS include
wakefulness, irritability, diarrhea, vomiting, respiratory distress and lack of sucking.
(Abel, 1966)
Alcohol-related birth defects that may be present to those born with FAS can easily be
identified because of the cluster of characteristic features involving facial appearance,
growth and brain damage. Children born to mothers that drink heavily in pregnancy may
also have serious congenital birth defects such as :
 Heart defects;
 Kidney and other internal organ problems;
 Skeleton abnormalities;
 Cleft palate and other facial abnormalities;
 Vision and hearing problems.
These are known as alcohol-related birth defects (ARBD). The range of these birth defects
is likely due to such factors as:
1. variations in the timing of alcohol use;
2. variations in the amount of alcohol used;
3. use of one or more substance that can cause birth defects;
4. and many other individual and genetic factors. ( Villarreal, 1992.)
It is not known how much alcohol a woman can safely drink. However, it is known that the
more alcohol a pregnant woman consumes, the greater the range and severity of problems to
the developing fetus. Drinking alcohol regularly, or daily during pregnancy is considered
to be of high risk. Drinking alcohol to the point of intoxication on an occasion is also
a risk.
There is no "safe" time period during pregnancy to consume alcohol. There are critical
periods during pregnancy for the development and growth of all body systems. Different
FAS features may be linked with the period in which alcohol is heavily consumed. This
underlines the benefits of stopping or reducing alcohol use at any one point possible
during pregnancy. (Davis, 1984)
Other factors such as malnutrition, smoking, and the use of other drugs increase the risk
of FAS. The mothers overall health, age and exposure to environmental toxins such as
lead, mercury, and stressful life events associated with poverty and including physical
abuse may also increase the risk of FAS. It is not known how much of a contributor these
other factors make, but addressing these related health issues may have a significant
bearing on the prevention of FAS. (Kleinfeld, 1993)
The risk of FAS is higher for those who already have a child affected with FAS. It is
also higher when the mother has a long history of alcohol misuse and has not accessed
routine health and prenatal care. A range of resiliency factory also influences the risk
of having a child affected by FAS.
There is some indication that men's use of alcohol and other drugs can affect the
viability of sperm. It is also clear that men's drinking can have an impact on that of
their partners. Thus, fathers play an important role in encouraging and supporting their
partners to reduce their alcohol and other drug use, both before and during pregnancy.
(Blume, 1992)
Estimates of incidence for full FAS range from one in 500 births to one in 3,000 births,
with the rate for other alcohol related effects estimated at five to ten times higher.
Prevalence of FAS and other alcohol related effects in high-risk populations such as
First Nation communities may be as high as one in five. ( Streissguth, 1998)
FAS is the leading known cause of mental handicap in children, even greater than Down's
Syndrome or spina bifida. FAS is also the leading cause of preventable birth defects in
developed countries.
The human cost for each child born with FAS are high.
 To both birth parents and foster parents, an FAS child may prove to be very
challenging and special programs may not be available. 
 Many of those affected by FAS may require foster home and/or group home
placement over the course of their life lives.
 Many youth and adults affected by FAS come in contact with the corrections
system
 Those affected by FAS have learning disabilities and behavioral problems that
often require extensive and specialized help
Diagnosis of FAS is difficult for many reasons. There are no standard tests to detect FAS
and the range of characteristics is diverse. Many of the characteristics are not only
distinctive of FAS, but other disorders as well. Symptoms vary widely in severity among
FAS-affected individual and may change with age. In infancy, central nervous system
impairments and facial abnormalities due to FAS may be difficult to identify. (McCreight,
1997)
Diagnosis involves the disciplinary work-up, including assessment of language, motor
coordination, growth and development patterns, craniofacial features, as well as a
psychological assessment and identification of the mother's alcohol and drug use.
Assessment of vision, hearing and dental problems can assist in planning an intervention
program. Assessment of the child's strength, special interest, and abilities should also
be included. ( Abel, 1996 )
Without identification or diagnosis, parenting a child with FAS is like trying to find
your way around Saskatoon with a map of Prince Albert. An early diagnosis can support
parents in:
 Understanding the child's needs and challenges an in establishing realistic
expectations;
 Taking care of themselves- respite care, support groups;
 Ensuring careful monitoring of the child health issues as they develop;
 Validating the experience of the person affected with FAS and supporting his/her
self awareness and growth;
 Supporting the establishment of realistic expectation and goals for each child
by educators;
 Supporting a respectful interaction between parents and teachers and health
professionals.
All of these benefits of diagnosis and early intervention can prevent or lessen the
impact of "secondary disabilities" such as mental health problems, alcohol and other drug
problems, school problems, etc. When used positively, a diagnosis can validate and
individual problems and support the intervention needed to maximize his/her abilities. It
can also lead to identifying and supporting women at risk to prevent FAS and other
alcohol related effects in future children. ( Davis, 1994)
Without understanding the impact of FAS, it is easy to think the affected person is being
"difficult" rather than being "unable to process and remember" information. It is also
important to note that those affected by FAS are all different, and may show some or all
of these characteristics in varying degrees:
 Easily distracted by sounds or movement;
 Impulsive;
 Hyperactive;
 Short attention span and poor concentration;
 Trouble with expressing feelings to others;
 Problems adapting to normal stresses of day-to-day living;
 Difficulty incorporating change in routine;
 Limitations in ability to generalize.
These characteristics can also make those affected by FAS prone to "secondary
disabilities" such as having trouble with the law, problems with employment and housing,
mental health and alcohol and drug problems. While it is easy to focus on only the
difficulties, individuals with FAS also exhibit positive characteristics such as being
happy, friendly, spontaneous, trusting, loving, determined, caring, helpful,
affectionate, creative, and artistic.
Some people with FAS are mentally retarded and some are not. People with FAS can have
normal or above average intelligence. While there is injury to the brain, each affected
person will have specific area strength and weaknesses. (Davis, 1994)
Brain injury can lead to behavioral problems because people with brain injuries do not
process information in the same way that other people do. Children with brain injuries
are challenging to raise, and their parents need help and support--not criticism
FAS lasts a lifetime, even though the manifestations and types of problems can change
with age. Knowing this, a person can never give up on a child with FAS. Instead, they
need to understand the needs of those affected with FAS and learn how to help them.
Many people view children affected with FAS as being unmotivated, but the explanation
lies in memory problems, and the inability to solve problems effectively, or simply a
state of being overwhelmed. To deal with these and other problems it is important that a
variety of agencies be involved in the intervention is lieu of a single agency. Research
is needed on all aspects of FAS—epidemiology prevention, early intervention and
treatment. (Blume, 1992)
FAS is related to use of alcohol during pregnancy, not to race or ethnicity. The levels
and cultural values related to drinking vary across First Nation communities and thus the
prevalence of FAS varies as well.
Whether we choose to acknowledge it or not, alcohol plays a strong role in the lives of
many First Nations people. FAS may be 100 percent preventable, but alcohol is so much a
part of our culture that proactive prevention activities must continue. A drinking
problem is never easy to stop and quite often a pregnancy does not make it any easier for
the struggling alcoholic to cease drinking while pregnant. These women need support,
respect, understanding and caring assistance. 
Alcohol and drugs are available everywhere in our society, even in supposed protective
environments. Instead of imposing solutions on a woman, it is important to support her as
she works toward a chosen and suitable change for herself and her children. 
Bibliography
1. Abel, E.L. 1984. Fetal Alcohol Syndrome & Fetal Alcohol Effects. Toledo: Perseus 
Publishing.
2. Abel, E. L. 1996. Fetal Alcohol Syndrome: From Mechanism to Prevention. New York:
CRC Press.
3. Blume, Sheila B. 1992. What You Can Do to Prevent Fetal Alcohol Syndrome: A 
Professionals Guide. Washington: Trade Paperback.
4. Davis, Diane. 1994. Reaching Out to Children with FAS-FAE: A Handbook for Teachers,
Counselors, & Parents Who Live & Work With Children Affected by Fetal Alcohol
Syndrome & Fetal Alcohol Effects. Washington: University of Washington Press.
5. Kleinfeld, Judith/ Wescott, Siobhan. 1993. Fantastic Antoine Succeeds! Experience in 
Educating Children with Fetal Alcohol Syndrome. Alaska: University of Alaska Press.
6. McCreight, Brenda. 1997. Recognizing & Managing Children with Fetal Alcohol
Syndrome-.
Fetal Alcohol Effects: A Guidebook. Washington: Trade Paperback.
7. Streissguth, Ann P. / Kanter, Jonathan. 1998. The Challenge of Fetal Alcohol Syndrome:

Overcoming Secondary Disabilities. Washington: University of Washington Press.
8. Villarreal, Sylvia Fernandez. 1992. Handle With Care: Helping Children Prenatally
Exposed 
to Drugs and Alcohol. Santa Cruz: ETR Associates.