Foetal alcohol spectrum disorder (FASD) is the umbrella term for a range of defects thought to be a direct result of the mother drinking alcohol while pregnant.
FASD can affect the development of cells and organs, but the brain and nervous system are particularly vulnerable. When the symptoms in the child are most distinct it is known as Foetal Alcohol Syndrome. It is a lifelong condition.
According to the British Medical Association, FASD is the most common, non-genetic cause of learning disability in the UK, although it can be misdiagnosed as Autistic Spectrum Disorder (ASD) or attention deficit hyperactivity disorder (ADHD).
Current estimates say around 6,000 to 7,000 babies are born with FASD of varying severity in the UK each year. The incidence is expected to rise as a result of greater alcohol consumption by women. Older mothers with higher levels of education are more likely to drink alcohol in pregnancy.
However, we don’t know the exact prevalence of FASD and the correlation between alcohol and FASD is not as straightforward as it might at first seem. Scientific studies are complicated by other factors, such as different populations studied and a variety of methods used.
FASD can result in a range of difficulties affecting both physical and mental functioning. Physical issues can include:
- Smaller head circumference
- Heart problems
- Limb and skeletal damage, especially joints, limbs, and fingers
- Kidney damage
- Damage to the structure of the brain
- Vision and hearing problems
- Poor coordination or balance.
Learning difficulties can include:
- Poor short term memory
- Speech and language delays
- Trouble with processing information,
- Hyperactivity
- Poor concept of time
- Problems staying on task
- Difficulties with mathematics and abstract concepts
- Poor concentration.
Behavioural and social difficulties can include:
- Impulsiveness and inattentiveness
- Inability to think through consequences of actions
- Poor social skills
- Trouble adapting to change or switching from one task to another
- Problems with behaviour
- Sudden mood changes
- Irritability, anger
- Mental health problems.
How schools can help
Children and adolescents with FASD can be immature and naïve and may trust too easily. Ask teachers to provide support both in the classroom and the playground, as children may struggle to relate to classmates. And teachers should think younger – a child with FASD is likely to have a developmental stage lower than the chronological age.
Ask school to refer the child to clinicians who can help, such as Speech and Language Therapists or Occupational Therapists.
In class:
- The child should sit near the front of the classroom to avoid distractions.
- Learning needs to be as concrete as possible with lots of examples - abstract words will confuse.
- Keep activities short and varied.
- Do not overload. Provide one instruction at a time and build up to longer sequences.
- Help them to sequence through the use of symbols and visual timetables.
- Teachers should encourage the child to repeat what they have said so that they focus and internalise instructions.
- Revise regularly to refresh knowledge before they forget it.
How parents can help
- Accentuate the positive. Children with FASD often have high energy levels, and a gregarious and caring nature. Praise them for their kindness.
- Many are skilled in visual arts, music, and sports so look out for opportunities to develop these and their self-esteem in and out of school.
- Children may be slow to process what you say, so keep everything simple - rules, routines, language, explanations and expectations.
- Use concrete and positive language - for example, say "Walk" rather than the negative "Don't run". Spell out precisely what you mean rather than an abstract instruction such as "Be careful".
- Provide a quiet place for homework to help them to concentrate. Encourage them to do their homework at a set time in a particular place and to put books and equipment away Teach strategies for remembering such as making lists, repeating aloud, and using a homework diary.
- Help children to put into words what they have to do. This will help them stay focused.
- Work with your school - you will know best which developmental areas have been most affected by FASD, and what strategies are most effective.
Further information
https://www.nhs.uk/conditions/foetal-alcohol-syndrome/
https://nationalfasd.org.uk/learn-more/practitioners/educators/