For professionals: Fetal alcohol spectrum disorder (FASD)

Access detailed information on fetal alcohol spectrum disorder (FASD) trends, risk factors, current initiatives, key publications and effective prevention approaches.

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What health professionals need to know about FASD

FASD is a diagnostic term describing the constellation of effects resulting from prenatal alcohol exposure. Alcohol is a known teratogen. It can harm the development of the brain and the rest of the central nervous system, resulting in disabilities that are:

  • mental
  • physical
  • behavioural
  • learning related

The diagnostic term FASD is now used to represent the continuum of symptoms resulting from prenatal alcohol exposure. Health professionals and their allies should become acquainted with FASD and its spectrum of manifestations.

FASD is recognized at birth if a newborn presents with the sentinel facial features associated with the condition, which are:

  • thin upper lip
  • smooth philtrum
  • short palpebral fissures

However, the majority of people affected will not have these features. FASD is often not identified until children reach school age and begin to miss average behavioural and developmental milestones.

FASD is a differential diagnosis and is largely under-diagnosed. It may be mistaken for other disorders, such as:

  • autism spectrum disorder (ASD)
  • attention deficit hyperactivity disorder (ADHD)

Other disorders are often comorbid with FASD. Therefore, it's important that practitioners understand the prevalence of alcohol use in pregnancy and screen for possible prenatal alcohol exposure.

Likewise, practitioners should discuss alcohol with all women of child-bearing age. Women who consume alcohol may be at risk for an alcohol-exposed pregnancy. Preventing alcohol use in pregnancy is the only way to prevent FASD.

Diagnosis

Diagnosis is undertaken by a multidisciplinary team and includes:

  • a full medical assessment, including:
    • family history
    • differential diagnosis
    • physical examination
    • maternal alcohol history
  • a neurodevelopment assessment in 10 brain domains
  • the measurement of sentinel facial features, including the:
    • philtrum
    • upper lip
    • palpebral fissure length

Risk factors

FASD can affect any person whose mother drank alcohol during pregnancy.

Screening for alcohol use among all women of child-bearing age can reduce FASD and other health problems resulting from alcohol use. Health care providers can access Canada's Low-Risk Alcohol Drinking Guidelines for further information.

The frequency and amount of alcohol use should be recorded in a woman's chart on a routine basis throughout their lifetime. This information should be transferred to appropriate health care providers and health records to ensure a continuum of care.

Key publications and reports

For health and allied professionals interested in more information about FASD, the following resources are key publications related to:

  • diagnosis
  • screening
  • prevention 
  • prevalence

Diagnosis

Screening

Prevention

Prevalence

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