Fetal alcohol spectrum disorders (FASD) are the largest known causes of intellectual disability, with their harmful lifelong effects spreading across various stages of development, from infancy through adolescence to adulthood.
Children and adults who receive diagnoses at an early age and grow up in stable environments, however, are two to four times more likely to avoid adverse life outcomes due to FASD. In addition to early identification and a nurturing home environment, two other factors that can help mitigate future disabilities include involvement in special education and social services, and an absence of violence in their lives.
Child welfare and health care systems report difficulty in screening, diagnosing, and responding to FASD with appropriate interventions. This brief is intended to provide child protection agencies the awareness and strategies they need to respond more effectively to the needs of children and families affected by FASD.
Prevalence
Recent diagnostic studies estimate that as many as 1 in 20 children in the U.S. suffer effects related to prenatal alcohol exposure (PAE). The presence of FASD — the range of harmful conditions caused by PAE — has been documented in as many as 17% of all substantiated cases of child maltreatment. PAE can create lifelong cognitive and behavioral disabilities. Alcohol is a teratogen, meaning it can directly interfere with fetal development and cause permanent damage to the brain and other organs.
Data compiled in the 2023 Pregnancy Risk Assessment Monitoring System (PRAMS) indicated that about 1 in 9 pregnant women (11.3%) reported drinking alcohol in the past 30 days.While all instances of PAE carry a potential risk of FASD, not every instance of PAE leads to FASD. Still, the FASD conditions resulting from PAE are typically misdiagnosed or not diagnosed at all. The American Academy of Pediatrics sums up FASD screening directly: “Most children with an FASD are never diagnosed or are misdiagnosed, despite frequent occurrence of severe disabilities in neurocognitive, adaptive, and behavioral function.”