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A common myth about Fetal Alcohol Spectrum Disorders is that children outgrow the disability.  FASD is a lifelong disorder.  Early diagnosis, intervention and the use of "FASD friendly" strategies by people who have contact with the individual, can make a big difference.   Research on FASD has primarily focused on children, but there is a growing interest in adulthood and what support and interventions are useful during these years. Adults with FASD have been a major catalyst for this interest by advocating for experts in the field to investigate solutions. There is research suggesting that brain maturation is delayed in FASD and that progress may be seen in their thirties.

 

While no two people with FASD are the same, there are common symptoms of the disability that occur across the lifetime.

FASD Over the Lifespan

Neuro Profile

Neurodevelopmental Profile

 

FASD Throughout the Lifetime

Infants and Toddlers

  • State dysregulation: difficulty falling and staying asleep

  • Irritable and very difficult to soothe. Long periods of intense crying

  • Feeding difficulties: problems with sucking

  • Sensory overwhelm

  • Hyperactive

  • Low birth weight and length (may be diagnosed with failure to thrive)

  • Frequent illness starting in the 1st weeks of life

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Preschool

  • Intense tantrums, hyperactive, aggressive

  • Resists change

  • No sense of danger/fearless; accident-prone

  • Sleep difficulties: parasomnias, falling/staying asleep, apnea

  • Sensory overwhelm

  • Motor and language delay

  • Hyperactive

  • Anxious, shy, avoidant

 

School Age

  • Learning disabilities diagnosed

  • Still intense tantrums/meltdowns. Aggression.

  • Sensory overwhelm

  • Otitis media, respiratory illnesses, and serious reactions to the flu

  • “Behavior" problems at school; poor self-regulation

  • Social but no friends or lots of conflict with peers

  • Executive function deficits

  • Slow processing, memory problems, reduced language comprehension

  • Mood swings; Diagnoses of mental health problems including anxiety

  • Developmentally young for age

  • Repeats same mistakes, discipline does not seem to work

  • Reduced effect of medications for ADHD

 

Adolescence

  • Increased difficulty with academics. Math is the lowest subject

  • Ongoing difficulty with discipline

  • Sensory sensitivity and overwhelm

  • Poor understanding of abstract concepts: money, ownership, time

  • Affiliation with at-risk peers; poor understanding of risky behavior or danger

  • Difficulty with the law

  • Suspensions, expulsions, dropping out of school, school refusal

  • Substance abuse

  • Mood volatility and multiple mental health diagnoses

  • Developmentally young for age

  • Adaptive function deficits increase (life skills and social communication)

  • Rage reactions

  • Easily influenced

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Adults

  • Increasing health problems

  • Adaptive function deficits get worse, even with normal IQ

  • Poor judgment and critical thinking

  • Poor social skills/social understanding

  • Can be very verbal but has difficulty understanding

  • Meltdowns ongoing: This is neurological

  • Sensory processing difficulties

  • Sleep disorders

  • Difficulty with employment and independent living

  • High risk for difficulty with the law and substance abuse

  • Multiple mental health diagnoses

  • Difficulty understanding danger, suicide, increased medical risk, accidents (The average lifespan for an adult with FASD is 34 years)

  • Repeats the same mistakes

Dubovsky, D. Fetal Alcohol Spectrum Disorders: Treatment Improvement Protocol (TIP 58). SAMHSA. 2014 

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Popova, S. Comorbidity of fetal alcohol spectrum disorder: a systematic review and meta-analysis. Lancet. 2016; Mar. 387 (10022), 978-987

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