The topic of Fetal Alcohol Spectrum Disorder (FASD) is a sensitive one. No-one harms their baby intentionally, and the issues around alcohol and pregnancy are extremely complex. Women drink alcohol for a variety of reasons. Many women do not know for some time that they are pregnant. Some women need help to stop using alcohol while pregnant – often the services they need to accomplish this are not readily available.

FASD is:
• Completely preventable, in theory. However, in practice, while alcohol is socially accepted, there will be FASD in all parts of our community.
• Brain damage resulting from alcohol intake by the mother during pregnancy. The brain is developing throughout pregnancy, therefore alcohol use at any point in the 9 months can affect the fetus.
• The term used to cover the entire spectrum of the disorders related to alcohol damage to the fetus ( diagnoses may be FAS, pFAS, ARND, ARBD).
• Often not identified early, or at all.

Some of the characteristics
• Deficits in language, both comprehension and expression
• Problems with memory, attention and judgement
• Poor fine or gross motor skills
• Poor impulse control
• Poor abstract thinking ability (difficulty with math, time and money concepts)

Results of these characteristics, if intervention doesn’t happen (secondary characteristics)
• Mental Health problems – depression, suicide attempts…. (in one study, 90% of clients with FASD had experienced mental health issues at some time in their lives)
• Poor school performance, disrupted school experience (dropping out, suspension). Why would you want to go, if you don’t understand what’s going on or what’s expected of you? Imagine going through every day without feeling competent or understood.
• Trouble with the law. Once out of school, what is there to do? Get into trouble, because you have poor impulse control, difficulty with comprehension, abstract thinking ability, predicting consequences….
• Inappropriate sexual behaviour. Their social and emotional maturity level may be way below their chronological age. Typically, an 18yr old with FASD can have an expressive language ability of a 20yr old, yet the emotional maturity of someone who is 6 and the social skills of a 7 yr old. This can lead to being easily victimized.
• Alcohol and drug abuse.

As adults:
Although the person may know how to do a task, he or she may not be able to carry it out when needed. This is described as difficulty with adaptive behaviour, and has huge implications for independence. For example – the person may know how to cook a certain meal, but in order to be able to do it, she needs to buy the correct groceries, know when to start preparing the food, have everything ready at the same time etc. This may be impossible due to poor connections in the brain.

The result of these difficulties may look like this:
• May be able to find a job, but not keep it – life falls apart for them in one area, and everything comes down with it.
• Economic problems due to poor money management – lend money to someone expecting to get it back, over and over again
• Mental health problems continue, but difficult for them to take medication or counselling (time concept)
• Isolation due to lack of stable friendships/relationships – may lead to use of alcohol or drugs, or depression
• Difficulty with parenting. Although the person may be doing their very best, they don’t know where the gaps in their abilities may be, and so may not be safe unless given adequate (much) support. For example – recognizing when a child is sick, getting to a doctor, administering medications.
• Alcohol and drug use/abuse, and inappropriate sexual behaviour continue

It is important to note that, with early identification, diagnosis and support, individuals with FASD can be successful. The secondary disabilities do not always occur – some may be present, some may not. None of the secondary disabilities are chosen by the individual – they occur because of brain damage and the inability of those around them to adapt their environment for success.