Fetal Alcohol Spectrum Disorder (FASD)

Fetal alcohol spectrum disorder (FASD) is a diagnostic term used to describe a range of neurodevelopmental impairments and other health effects on an individual caused by prenatal alcohol exposure (PAE)[51039]. Neurodevelopmental impairments can include; difficulties with learning, language, memory, planning, emotional regulation and motor skills [42715]. FASD is also associated with an increased risk of health issues with hearing, vision, the heart and musculoskeletal problems [49051]. Diagnosing FASD is complex. It is recognised that some features common to FASD can also be a result of genetic and environmental factors and that the effects of PAE interact with protective and risk factors [51039].

The Australian guidelines for assessment and diagnosis of Fetal Alcohol Spectrum Disorder [51039] and the accompanying Australian guidelines for assessment and diagnosis of Fetal Alcohol Spectrum Disorder: FASD Indigenous framework [51275] are resources aimed at supporting culturally responsive, strength-based and healing informed assessment and diagnostic services for FASD in an Australian context.

FASD may be diagnosed at birth, but in many cases, the diagnosis occurs later, when an individual is having significant problems with learning or behaviour that impacts on their daily functioning [51039]. Early diagnosis can help parents and carers to understand the needs and behaviours of a family member affected by FASD [42527][26090][35916].

Strategies to support families and individuals affected by FASD

Strategies which help to improve the long term outcomes for individuals and families affected by FASD include [51039][51275]:

• shared decision making between practitioners, families and the individual with FASD
• supporting capacity and connection within the whole family
• providing information to access resources and services to support wellbeing
• monitoring changing needs over the life span.

How can we prevent FASD?

At a population level, FASD can be prevented by promoting awareness of the harmful effects of exposure to alcohol while pregnant, and reducing the ready availability of alcohol [35916].

While not every alcohol exposure during pregnancy results in FASD, there is no safe time to have alcohol during pregnancy [42089]. The Australian guidelines to reduce health risks from alcohol recommends that individuals who are planning to have a baby, or are pregnant should not drink alcohol, and for individuals who are breast feeding, the safest choice is not to drink alcohol.

Health workers, GPs, and maternity services have an important role in reducing the risks of FASD through routine screening of all pregnant individuals [35916]. Routine screening creates opportunities to provide information, brief intervention or referral to support services. The role of partners in supporting individuals who are pregnant or breastfeeding to not drink alcohol during pregnancy and breastfeeding is also important [23933].

What is being done about FASD?

The most recent policy in response to FASD, the National Fetal Alcohol Spectrum Disorder (FASD) Strategic Action Plan 2018-2028 outlines four national priorities [35916].

These are:

• prevention
• screening
• support and management
• priority groups and populations at increased risk.

A range of health promotion and practice resources have been developed to support health practitioners and raise awareness of FASD. Please see the Knowledge Centre’s listing of  resources, programs, organisations.

For more information about FASD for carers and health professionals please also visit FASD Hub Australia.