Fetal Alcohol Spectrum Disorder

Fetal Alcohol Spectrum Disorder (FASD) is a term used to describe a range of significant adverse effects on development when alcohol is consumed during pregnancy.  FASD is a brain-based neurodisability that can include physical abnormalities.

International prevalence studies suggest FASD is conservatively estimated to occur in at least 1 out of every 100 live births and may be much higher in communities where binge and hazardous use of alcohol is prevalent.  This would equate to around 600 children born each year with FASD.  No research has confirmed the prevalence in New Zealand but it is thought the numbers could be substantially higher due to hazardous drinking patterns [1].

FASD is linked to primary disabilities, those that are the direct toxic effect of alcohol altering cellular development.  The brain and nervous system are affected the most because they are under construction throughout the pregnancy, leading to lifelong cognitive, functional and emotional difficulties.  Binge drinking (4+ Units per occasion) can increase the risk of physical problems and unusual facial features during the first trimester.  When learning and functional needs are not adequately understood and appropriately supported, FASD can lead to secondary disabilities such as mental health disorders, educational and social problems.

FASD is recognised as the leading preventable cause of intellectual disability in the developed world, but full IQ scores can vary, with most being in the borderline to average IQ range. However other aspects of brain function are often found to be much lower than measured IQ would indicate, such as language, memory, executive and adaptive functioning. FASD is therefore described as a hidden or invisible disability. FASD without physical symptoms can often be misdiagnosed.  Accurate diagnosis requires a specialised, multidisciplinary assessment.  New Zealand (and Australian) clinics able to assess for FASD follow the Canadian Guidelines for Diagnosis[2].

Though significant research continues into understanding the effects of alcohol on the fetus, attention has turned to the long-term outcomes and best practice interventions. New Zealand has very few specialist diagnostic centres and little research and consequently FASD remains significantly under-recognised and the needs of the affected individual and their families unaddressed.