FASD FAQs

FASD is caused by exposure to alcohol while in the womb. There is no known amount of alcohol that is safe to drink while pregnant, including the months before one knows they are pregnant.⁴ Alcohol passes through the placenta directly to the developing fetus, impacting brain development, and other critical organs and physiological functions.⁵ Additionally, alcohol present in sperm during conception can also affect the genetic instructions which can increase the severity of FASD.⁶

Fetal Alcohol Spectrum Disorders include a group of conditions organized by the features presented and used by healthcare providers and behavioral health providers:^{7,8, 9}

•   Fetal Alcohol Syndrome (FAS)
•   Partial Fetal Alcohol Syndrome (pFAS) – not as commonly used anymore
•   Alcohol-Related Neurodevelopmental Disorder (ARND)
•   Alcohol-Related Birth Defects (ARBD) – not as commonly used anymore
•   Neurobehavioral Disorder Associated with Prenatal Alcohol Exposure (ND-PAE)

As FASD is a spectrum of presentations, every individual has unique strengths and needs. Although these are primary characteristics of prenatal alcohol exposure, not all of these are present for every individual.

Physical Differences (birth defects)

• Growth differences (short height or low weight or small head size)
• Facial features (narrow eye openings, flat space between upper lip and nose, thin upper lip) *only 10% of FASD presents with these
• Heart malformations, Kidney or bone issues
• Vision or hearing difficulties¹⁰
• Deformities of joints, limbs, and fingers

Neurocognitive Impairment

• Executive function¹³ (mental processes that help control and coordinate thoughts and behaviors, such as critical thinking, problem-solving, decision-making, etc.)
• Learning difficulties¹¹
• Memory issues¹²
• Visual spatial skills

Self-Regulation Impairment

• Mood or behavioral regulation
• Trouble paying attention¹³
• Impulsive behavior¹³
• Sensitivity to light, touch, or sound¹⁴
• Hyperactive behaviors

Adaptive Functioning Deficits

• Communication
• Poor social skills¹⁶
• Daily living
• Motor skills
• Feeding/eating abilities

Early identification of FASD is important for the well-being of individuals prenatally exposed to alcohol. Correct diagnosis is needed for appropriate supports, accommodations, medications, and interventions. Unfortunately, FASD is often undiagnosed or misdiagnosed. This may be due, in part, to a lack of information about the prenatal alcohol exposure, difficulty in distinguishing FASD from other developmental disorders, and the stigma related to prenatal alcohol exposure.

The American Academy of Pediatrics (AAP) emphasizes the importance of universal screening for prenatal alcohol exposure for all children.¹⁷ Initial assessment and diagnosis can be done by the child’s pediatrician if knowledgeable about FASD. However, families often report having more success with a team of specialists including a physician, psychologist, social worker, speech language pathologist, occupational therapist, and geneticist. Multidisciplinary teams can offer comprehensive evaluation and care. History of birth parents’ alcohol use is extremely useful, but understandably not always available.

If you have concerns about your child’s development, including behaviors, make an appointment with your child’s doctor as soon as possible. Consider keeping a journal of your child’s developmental milestones and daily challenges to share. You can also download our what to bring handout.

Finding the right provider for your family and child is important when looking for diagnosis and therapy services. It’s a good idea to interview the providers you are thinking of visiting (download our interview questions). Not every provider is trained in FASD, but your concerns are worthy. You can also use our Provider Directory to find a FASD-informed provider in your area. Multidisciplinary teams (groups of people with different skills and expertise) are recommended for comprehensive care.

There can be many benefits to having an FASD diagnosis, and we recognize it can also be a daunting task. Many self-advocates (individuals living with FASD) report increased mental health and success when they understand why their brain works differently. Correct diagnosis of FASD can also:

• Provide neurobiological reasoning for behavior (i.e., not oppositional, but rather disability and developmental differences)
• Guide appropriate interventions, medications, and strategies for support
• Reduce the number of secondary disabilities and/or mitigate adverse experiences (e.g., mental health problems, trouble with law, homelessness, substance use, etc.)
• Offer more protection with disability rights if there is a criminal justice involvement
• Provide accurate information regarding incidence and prevalence rates of FASD and increased funding and research

There are various approaches that may help increase well-being, improve skills, and support success. These include supported learning, environmental accommodations and modifications, medications, social support, counseling, case management, neurobehavioral education within systems of care, and behavioral interventions.^18,19

The length and intensity of treatment depends on a variety of factors including medical needs, behavioral challenges, and accessibility to accommodations. However, specialized treatment may not always be necessary. Research supports early intervention and life-long supports yield the best outcomes.

Talk to your doctor about your concerns and how they impact your daily life. Ask to see a specialist (someone who knows about FASD) such as a developmental pediatrician, psychiatrist, or neuropsychologist. Early diagnosis and appropriate intervention make a difference. 

Remember, individuals with FASD are the center of the support team, and you know your child best. Share your child’s voice. FASD does not just affect the child, it may affect the entire family. Trust yourself and your child and keep seeking answers.

There is hope. Individuals with FASD, when supported well, can live happy and successful lives.

You are not alone. Texas FASD Network has support services and family resources.

Family Support

Support Groups

Peer Mentoring Program

There are many ways to get involved. Whether you are looking to volunteer your time, donate funds, or join our peer mentoring program, click here to learn more.

1. May et al. Prevalence of Fetal Alcohol Spectrum Disorders in 4 US Communities. JAMA. 2018;319(5): 474-482.
2. Lebel C, Roussotte F, Sowell ER. Imaging the impact of prenatal alcohol exposure on the structure of the developing human brain. Neuropsychol Rev. 2011;21:102-118.
3. Subramoney S, Eastman E, Adams C, Stein DJ, Donald KA. The early developmental outcomes of prenatal alcohol exposure: A review. Frontiers in Neurology. 2018;9.
4. Roozen S, Peters G-JY, Kok G, et al. Systematic literature review on which maternal alcohol behaviours are related to fetal alcohol spectrum disorders (FASD). BMJ Open. 2018;8:e022578.
5. Treit et al. Longitudinal MRI reveals altered trajectory of brain development during childhood and adolescence in fetal alcohol spectrum disorders, Journal of Neuroscience. 2013;33(24):10098-109.
6. Thomas, K., Bedi, Tudhishtar, Golding, M. et al. Preconception paternal ethanol exposures induce alcohol-related craniofacial growth deficiencies in fetal offspring. Journal of Clinical Investigation. 2023; 133(11).
7. Stratton K, Howe C, Battaglia F, editors. Fetal alcohol syndrome: diagnosis, epidemiology, prevention, and treatment. Washington, DC: Institute of Medicine, The National Academies Press; 1996. Executive Summary; p. 4-5.
8. American Psychiatric Association. Diagnostic and statistical manual of mental disorders, fifth edition. Washington, DC: American Psychiatric Association; 2013, p. 86, 708–801.
9. Hagan JF, et al. Neurobehavioral disorder associated with prenatal alcohol exposure. Pediatrics. 2016;138(4):e20151553.
10.   Stephen JM, et al. Delays in auditory processing identified in preschool children with FASD. Alcohol Clin Exp Res. 2012;36(10):1720-1727
11.   Domeij H, et al. Experiences of living with fetal alcohol spectrum disorders: A systematic review and synthesis of qualitative data. Developmental Medicine & Child Neurology. 2018;60:741-752.
12.   Comasco E, Rangmar J, Eriksson UJ, Oreland L. Neurological and neuropsychological effects of low and moderate prenatal alcohol exposure. Acta Physiologica. 2018;222:e12892.
13.   Fuglestad AJ, Whitley ML, Carlson SM, et al. Executive functioning deficits in preschool children with Fetal Alcohol Spectrum Disorders. Child Neuropsychology. 2015;21(6):716-731.
14.   Fjeldsted B, Xue L. Sensory processing in young children with fetal alcohol spectrum disorder. Physical & Occupational Therapy in Pediatrics. 2019;39(5):553-565.
15.   Subramoney S, Eastman E, Adams C, Stein DJ, Donald KA. The early developmental outcomes of prenatal alcohol exposure: A review. Frontiers in Neurology. 2018;9.
16.   Panczakiewicz AL, et al. Neurobehavioral deficits consistent across age and sex in youth with prenatal alcohol exposure. Alcohol Clin Exp Res. 2016;40(9):1971-1981
17.   American Academy of Pediatrics. AAP Says No Amount of Alcohol Should Be Considered Safe During Pregnancy. https://www.aap.org/en-us/about-the-aap/aap-press-room/Pages/AAP-Says-No-Amount-of-Alcohol-Should-be-Considered-Safe-DuringPregnancy.aspx
18.   Reid N, Dawe S, Shelton D, Harnett P, Warner J, Armstrong E, LeGros K, O’Callaghan F. Systematic review of fetal alcohol spectrum disorder interventions across the life span. Alcohol Clin Exp Res. 2015;39(12):2283–95. PubMed PMID: 26578111
19.   Petrenko CL, Alto ME. Interventions in fetal alcohol spectrum disorders: an international perspective. Eur J Med Genet. 2017;60(1):79–91. PubMed PMID: 27742482
20.   Centers for Disease Control and Prevention. Fetal Alcohol Spectrum Disorders (FASDs). https://www.cdc.gov/ncbddd/fasd/alcoholuse.html