FASDs: the hidden cause of behavioural issues?

Author: TACT

Tags: FASDs, Foetal Alcohol Spectrum Disorders

What are Foetal Alcohol Spectrum Disorders (FASDs)?

Foetal Alcohol Spectrum Disorders (FASDs) are a set of neurodevelopmental impairments that result from brain damage caused by alcohol exposure before birth. Alcohol in the mother’s blood stream is passed through to the baby via the umbilical cord, resulting in possible mental and physical disorders.

Diagnosing FASDs very much depends on what symptoms the person displays. To start with, they can cause some tell tale external facial characteristics – but only in about 10% of cases. Those facial characteristics are called Sentinel Facial Features (SFF), and are:

  • A short palpebral fissure (the length of the eye laterally)
  • An indistinct philtrum (the vertical groove between the base of the nose and the border of the upper lip)
  • A thin upper lip

A person must display all three facial characteristics to aid a diagnosis of FASDs (specifically a diagnosis of Foetal Alcohol Syndrome – just one of 123 conditions on the spectrum). However, not all cases of FASDs display these distinct facial features. The person could display intellectual disabilities and problems with behaviour and learning. These are classed as Alcohol-Related Neurodevelopmental Disorders (ARNDs). They may also have Alcohol-Related Birth Defects (ARBDs) such as problems with the heart, kidneys, bones or with their hearing. However, reliable reports that the mother consumed alcohol during her pregnancy is important in order to help formulate a diagnosis.

One of the more alarming facts about FASDs is that they can occur as a result of any amount of alcohol consumed during pregnancy, including the early period where the future mother may not yet be aware that she is pregnant – and of course, the more that is consumed the greater that risk becomes. Therefore, contrary to any guidelines that may have been published in the past, there is no safe alcohol consumption level if you are pregnant.

Unfortunately, FASDs lasts a lifetime and there is no cure, but early intervention can help with a child’s development.

So what are the symptoms of FASDs?

As mentioned above, FASDs can affect a person physically and mentally – with further mental health issues occurring as a by-product of having to cope with FASDs.

The main conditions include:

  • Low body weight and shorter-than-average height
  • Poor coordination
  • Hyperactivity and difficulty with attention
  • Poor memory
  • Learning disabilities
  • Speech and language delays
  • Intellectual disability or low IQ
  • Poor reasoning and judgment skills
  • Vision or hearing problems
  • Problems with the heart, kidneys, or bones

Generally, the person can experience difficulty in school, particularly with subjects such as maths.

Caring for a child with FASDs

As mentioned earlier, there is no cure for FASDs – so supporting children is about putting in place a number of strategies and understanding their behaviour. These strategies could include creating structure, routine and consistency, being positive, developing a more nurturing approach and being aware of how change can impact the child or young person. Children with FASDs are also very visual, so lots of drawings and pictures are recommended.

Behaviours can easily be misinterpreted, so understanding the underlying possible reason for certain behaviours could unlock a key support strategy. This is called ‘reframing’. For example, a child displaying ‘inappropriate behaviour’ may not actually understand social rules. A young person who steals may not understand the concept of ownership.

Each case of FASDs will be different, so there is no set strategic approach. Therefore, it is vital to obtain a formal diagnosis in order to formulate specific strategies for a person. FASD Strategies Not Solutions and Focus On Strategies provide some general advice and guidance.

How do TACT support a child with FASDs?

TACT provides dedicated training for foster carers, enabling them to support children who have been diagnosed with FASDs. Martin Clarke, TACT’s FASDs trainer, said: “I strongly believe that many of the children we care for, possibly even a majority of them, are actually affected at the foetal stage and it is vital that all carers and social workers understand this condition and look for it early in order to prevent us wasting time, wasting money – but most critically of all raising carers expectations on strategies that are doomed to fail if actually FASD is the primary problem. We owe it to the children.”

Amanda, one of TACT’s foster carers, talks about fostering three children with FASDs: “They couldn’t read very well, they were behind their peers in school, they kept forgetting to do simple things and struggled to stick to routines. We didn’t know what was wrong. However, one day I attended one of TACT’s training sessions, and listened to a member of staff talking about Foetal Alcohol Spectrum Disorders (FASDs).

“We have established routines, taking into account what works for each and every one of our children. They thrive when routines are in place but these absolutely need to be child-lead. That’s when we have seen excellent progress.”

You can read Amanda’s blog here.

You can read more about FASDs and where to get help and advice here.