Fetal Alcohol Spectrum Disorder
This article was produced in collaboration with the Public Health Agency of Canada.
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The Issue
Drinking alcohol during pregnancy can seriously harm an unborn baby. Each year in Canada, it is estimated that nine babies in every 1,000 are born with Fetal Alcohol Spectrum Disorder (FASD). The birth defects and developmental disabilities that result from FASD are preventable by avoiding alcohol during pregnancy.
Background
Fetal Alcohol Spectrum Disorder (FASD) is an umbrella term used to describe the range of disabilities and diagnoses that result from drinking alcohol during pregnancy. The impact and effects of FASD vary. Specific birth defects and the degree of the disability can depend on how much alcohol was drunk, how often and when during the pregnancy; they can also depend on the state of health of the pregnant woman. No amount or type of alcohol during pregnancy is considered safe.
It is estimated that in Canada, more than 3,000 babies a year are born with FASD, and about 300,000 people are currently living with it. Research suggests that the occurrence of FASD is significantly greater in Aboriginal populations, and in rural, remote and northern communities. Prevention, identification and intervention efforts are key to improving this situation.
A large number of pregnancies in Canada are unplanned, meaning that a large number of women in the early stages of their pregnancies - not knowing they are pregnant - may use alcohol and unknowingly cause damage.
If you suspect that a family member may have FASD, talk to your doctor about having him/her diagnosed. An early diagnosis can lead to interventions which will minimize the impact of FASD.
FASD is a national public health, education, economic and social concern as those affected suffer a lifelong disability and may need lifelong support. A great deal has been learned about the best way to prevent future births affected by alcohol and how to help those who live with FASD. From 2002 to 2006, the Public Health Agency of Canada (PHAC) funded several projects on FASD and how to help those who live with it. Highlighted projects are given in the Need More Info? section.
Health Effects of FASD
Those who live with FASD may have mild to very severe problems with their health. They may have delays in their development, intellectual problems and problems in their social lives.
Examples of these include:
- learning disabilities, particularly in mathematical concepts;
- difficulty understanding the consequences of their actions;
- depression;
- obsessive-compulsive disorder;
- physical disabilities such as kidney and internal organ problems; and
- skeletal abnormalities such as facial deformities.
There is no cure for FASD. People live with FASD for their entire lives, so early intervention is key to minimizing the disabilities associated with it.
Other effects of FASD
When they hear about the impact of drinking alcohol during pregnancy, many parents or care-givers wonder what to look for, especially if their family members have behavioural or medical problems that don't respond to treatment. Those with FASD may have difficulties such as:
- handling money or telling time;
- thinking things through and reasoning;
- learning from past experiences and not repeating mistakes;
- remembering things like appointments; or
- interacting with other people and getting along with others in a socially appropriate manner; or
- dealing with everyday tasks such as holding a job, buying food or paying rent.
People with FASD may need life-long support to deal with these difficulties.
Secondary disabilities
Diagnosis, particularly an early diagnosis, and an effective management plan for on-going supports can help prevent people with FASD from developing secondary disabilities, such as:
- mental health problems (like depression or obsessive-compulsive disorder);
- dropping out of, or disrupting, school;
- trouble with the law;
- chronic unemployment;
- alcohol and drug problems; and
- homelessness.
If FASD is suspected, it is important that a trained doctor do a medical diagnosis to rule out other medical conditions that might be treatable. Diagnosis also involves a team of professionals who assess the psychological, speech and everyday functioning of the individual. Diagnosis and early intervention and support can help people with FASD lead more productive lives.
Despite their disabilities, people with FASD have many positive qualities and can enjoy very successful lives.
Minimizing Your Risk
FASD can be prevented by following these steps.
- More than 50 per cent of pregnancies are thought to be unplanned, and, in the early stages, most women do not know that they are pregnant. If you are pregnant, or planning to become pregnant in the near future, do not drink alcohol. No amount or type of alcohol is considered safe.
- If you have sex and are not using birth control, avoid drinking alcohol.
- If you are worried about your alcohol use, talk to your doctor, community health nurse, midwife or healthcare provider. Your local public health unit, health centre, Friendship Centre or provincial/territorial Ministry of Health can all provide you with help, information and advice.
In preventing FASD and improving outcomes for those who live with it, no one single organization, community group or government can work alone. It is a complex disability that requires a strong commitment to working together.
Government of Canada's Role
The Government of Canada has initiated many projects to deal with the impact of alcohol use during pregnancy.
In 2003, Health Canada released FASD: A Framework for Action to guide the development and implementation of collaborative efforts to address the issues associated with FASD. When Canada's Drug Strategy was renewed in 2003, investments helped develop and distribute the diagnostic guidelines and planning tools to guide earlier assessment.
In 2005, Fetal alcohol spectrum disorder: Canadian guidelines for diagnosis was published in the Canadian Medical Association Journal (CMAJ) through support from the Public Health Agency of Canada and the First Nations and Inuit Health Branch of Health Canada. See the Need More Info? section to obtain a copy of the guidelines.
Health Canada's First Nations and Inuit Health Branch provides community-based programming to reduce FASD births and improve the quality of life for those affected by FASD. Programs include:
- training for community health workers and early childhood educators to increase community awareness;
- helping communities develop local plans to reduce FASD; and
- supporting mentoring projects that pair pregnant at-risk women with community members who have had similar experiences.
Other Government of Canada departments or agencies that have invested in a range of FASD activities include Justice Canada; Canadian Institutes for Health Research; Indian and Northern Affairs Canada; Human Resources and Social Development Canada; and Public Safety and Emergency Preparedness Canada.
Need More Info?
For more information on FASD, visit these web sites:
For more on FASD projects funded by the Public Health Agency of Canada:
-
 The FAS/Eout project sponsored by the Canadian Institute of Child Health provides access to FASD training modules, contacts for trainers across Canada and a Guide to assist organizations in developing an action plan on FASD prevention, diagnosis and intervention.
- A database of the latest information and events on FASD has been developed through a project with the Canadian Centre on Substance Abuse.
- The Victorian Order of Nurses, Atlantic Region, developed a concise guide for parents called "Let's Talk FASD" that is available through their web site.
- For more on Fetal alcohol spectrum disorder: Canadian guidelines for diagnosis or a copy of the guidelines in PDF along with articles about the diagnostic process, visit the CMAJ web site.
- For more information about FASD, call a toll-free number, 1-800-559-4514. A bilingual information specialist is available at this number through the Canadian Centre on Substance Abuse (CCSA).
For additional articles on health and safety issues go to the It's Your Health Web site.
You can also call toll free at 1-866-225-0709 or TTY at 1-800-267-1245*
Original: September 2006
© Her Majesty the Queen in Right of Canada, represented by the Minister of Health, 2006
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