Fetal alcohol spectrum disorder
From Freepedia
Fetal alcohol spectrum disorder (FASD) is an umbrella term used to describe fetal alcohol syndrome (FAS) and the less noticeable, but sometimes equally serious, fetal alcohol effects (FAE).
FASD is a permanent, and often devastating, birth-defect syndrome caused by maternal consumption of alcohol during pregnancy. Fetal alcohol exposure is regarded by researchers as the leading known cause of mental and physical birth defects, surpassing both spina bifida and Down syndrome, and producing more severe abnormalities than heroin, cocaine, or marijuana. It may be the most common preventable cause of birth defects in the United States. [2]
FASD can cause mental retardation, facial deformities, stunted physical and emotional development, behavioral problems, memory deficiencies, attention deficits, impulsiveness, an inability to reason from cause to effect; a failure to comprehend the concept of time; and an inability to tell reality from fantasy. Secondary disabilities develop over time because of problems adapting to the environment.
Researchers believe that the risk is highest early in the pregnancy, but there are risks throughout, because the fetus's brain develops throughout the entire pregnancy, and no amount of alcohol during any trimester is regarded as absolutely safe.
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Facial effects in FAS
Physical abnormalities are visible in children with FAS, though not in children with FAE. Generally, children with FAS have a smaller head circumference and low birth weight, and they may fail to thrive. Their facial features are distinctive and diagnostically significant, in that they are a sign of brain damage, although there may be brain damage without the visible facial effects.
Dr. Sterling Clarren, one of the world's leading FASD researchers, of the University of Washington in Seattle, told a conference in 2002.
I have never seen anybody with this whole face who doesn't have some brain damage. In fact in studies, as the face is more FAS-like, the brain is more likely to be abnormal. The only face that you would want to counsel people or predict the future about is the full FAS face. But the risk of brain damage increases as the eyes get smaller, as the philtrum gets flatter, and the lip gets thinner. The risk goes up but not the diagnosis.
At one-month gestation, the top end of your body is a brain, and at the very front end of that early brain, there is tissue that has been brain tissue. It stops being brain and gets ready to be your face ... Your eyeball is also brain tissue. It's an extension of the second part of the brain. It started as brain and "popped out." So if you are going to look at parts of the brain from alcohol damage, or any kind of damage during pregnancy, eye malformations and midline facial malformations are going to be very actively related to the brain across syndromes ... and they certainly are with FAS. [3]
Key physical features
- Growth — Pre- and postnatal onset growth retardation.
- Performance &mash; The I.Q. may be in the region of 63, though this depends on the severity of the condition. Poor eye-hand coordination. Fine motor dysfunction manifested by a weak grasp.
- Craniofacial — Mild to moderate microcephaly. Small palpebral fissure lengths (PFL). (Palpebral fissures are the opening of the eyelids. These are measured from between the exocanthion and endocanthion of each eye.) A thin upper lip. Smooth philtrum, the vertical "divot" or groove between the nose and upper lip. Flattened cheekbones and a short nose.
- Skeletal — Joint anomalies including abnormal position and function, altered palmar crease patterns. Small distal phalanges and small fifth fingernails.
- Cardiac — A heart murmur that frequently disappears by one year of age. Ventricular septal defect most commonly seen, followed by an atrial septal defect.
- Occasional abnormalities — Ptosis of the eyelid. Microophthalmia, cleft lip with or without a cleft palate, webbed neck, short neck, Tetralogy of Fallot, coarctation of the aorta, Spina bifida, and hydrocephalus.
Social consequences for sufferers
Support groups estimate that 90 per cent of children with FASD have mental health problems, 61 per cent a disrupted school experience, 60 per cent trouble with the law, 50 per cent experience imprisonment, and 35 per cent abuse substances. [4]
References
- Astley, S.J. and Sterling, C.K. "Measuring the facial phenotype of individuals with prenatal alcohol exposure: correlations with brain dysfunction", Alcohol & Alcoholism, Vol. 36, No. 2, pp.147-159, 2001
- Fetal Alcohol Syndrome Diagnostic & Prevention Network (FAS DPN)
- Well.com FAS Fact Sheet
- FAQ on FAS from National Organization on Fetal Alcohol Syndrome
- Dr Sterling Clarren's keynote address on FASD, Prairie Northern Conference on Fetal Alcohol Syndrome, Yukon 2002
- FASD in CanadaLakeland Centre for FASD, Alberta Canada
- "Whose baby is this?" FAS Community Resource Center



