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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. It can affect the development of cells and organs, but the brain and nervous system are particularly vulnerable. It is a syndrome and the effects may be mild, moderate or severe.

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 autism, Asperger Syndrome or attention deficit hyperactivity disorder (ADHD).

Incidence

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. 

However, the correlation between alcohol and FASD is not as straightforward as it might at first seem. Some doctors feel that alcohol is not entirely to blame for FASD and that a prime cause may be poor diet, in particular a lack of folic acid before and during pregnancy. Their argument is that women who drink moderately but have a good balanced diet rarely have children with FASD, and a minority of children born to alcoholic mothers have FASD.  

Other risk factors are thought to be smoking, poverty, malnutrition, a high number of births, and advanced maternal age. Further, there appears to be a genetic component. Some foetuses may be more vulnerable than others due to different ways that bodies break down ethanol.

Effects of FASD

FASD can result in a range of difficulties affecting both physical and mental functioning

Physical issues

  • 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

  • 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

  • Impulsive, inattentive
  • 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

What can your school do to help a child with FASD?

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 identify a safe space that the child can go to when necessary.

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 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

What can parents do to help children with FASD?

  • 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

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