FASD stands for Fetal Alcohol Spectrum Disorder, which is a brain-based disability caused by alcohol exposure in utero. The FASD(s) include Fetal Alcohol Syndrome (FAS), pFAS (partial Fetal Alcohol Syndrome), ARND (Alcohol Related Neurobehavioral Disorder), all medical diagnoses, and the DSM V includes the mental health diagnosis ND-PAE, Neurobehavioral Disorder Associated with Prenatal Alcohol Exposure.
The CDC reports that incidences of FASDs (meaning FAS, pFAS, ARND, ND-PAE,and static encephalopathy related to probable prenatal alcohol exposure) may be as high as 2-5 children in every 100. Current prevalence studies by Dr. Philip May suggest the prevelance is closer to 4% of the population. Some experts estimate that 99% of people with an FASD are undiagnosed or mis-diagnosed.
That means that between 1 and 50 and 1 in 20 babies born each year in the U.S. have been impacted by prenatal alcohol exposure. 1 in 20! That’s one child (at least) in every classroom. One child in every 10 families. Mis- or missed diagnoses are common.
FASD is the most prevalent brain-based disorder in the world. It’s the number one cause of developmental delay. It occurs in families across race, religions, and socio-economic status. And it’s widely misunderstood.
FASD is an invisible disability. Because alcohol in utero causes structural, developmental, and even cellular changes in the brain, most people with an FASD have only behavioral symptoms of the disorder. Brain changes cause behavioral changes. The prevailing paradigm for managing behavior is to provide consequences, good and bad, so that individuals will learn what is right. But for people with brains that may process more slowly, may have difficulty with executive functioning, memory, abstract thinking, receptive language, and trouble modulating their emotions, not to mention significant developmental delays, consequences-based behavioral change is entirely inappropriate.
To help people with FASD succeed we need to shift the paradigm: away from looking at eradicating unwanted behaviors once they occur, and towards providing strengths-based accommodations and environmental change so we can prevent difficulties before they happen.
Petrenko, C., Demeusy, E. M., & Alto, M. E. (2019). Six-Month Follow-up of the Families on Track Intervention Pilot Trial for Children With Fetal Alcohol Spectrum Disorders and Their Families. Alcoholism, clinical and experimental research, 43(10), 2242–2254. https://doi.org/10.1111/acer.14180
Petrenko CL. Positive Behavioral Interventions and Family Support for Fetal Alcohol Spectrum Disorders. Curr Dev Disord Rep. 2015 Sep;2(3):199-209. doi: 10.1007/s40474-015-0052-8. PMID: 26380802; PMCID: PMC4569135.