Foetal Alcohol Spectrum Disorder Forensic Psychology Consultancy

What is Foetal Alcohol Spectrum Disorder?

Also known as FASD, it is a term used to describe the range of lifelong disabilities that drinking alcohol during pregnancy can cause to the baby. This includes developmental, physical, mental, emotional and learning impairments. It is the leading known preventable intellectual disability and is only caused by prenatal alcohol exposure. No amount or type of alcohol is safe to drink while pregnant.

How prevalent is FASD?

FASD is believed to be the most commonly known cause of neurodevelopmental disability. Although there is a lack of UK research on the prevalence of FASD, one study has suggested that up to 17% of UK children could have symptoms consistent with FASD, and up to 79% of women consumed alcohol while pregnant (McQuite et al.2018). 

Why is FASD so prevalent?

There are many reasons why an individual may drink while pregnant; it could be due to an individual:

• Being unaware that they are pregnant.
• Using alcohol to cope.
• Having an undisclosed pregnancy.
• Experiencing partner pressures.
• Being addicted to alcohol.
• Being unaware of the harm it could cause.

There is an overrepresentation of those in the criminal justice system with FASD. Although there is no clear consensus on the prevalence within the criminal justice system, one study found that 60% of individuals with FASD experienced trouble with the law (Streissguth et al.1996). It is known as the ‘invisible problem plaguing the criminal justice system’. It is very rare for individuals to have a screening for FASD while in the criminal justice system; therefore, their vulnerabilities are not always accounted for.

What does FASD look like?

An individual with FASD could experience:

• Abnormal facial features such as a smooth ridge between the nose and upper lip, a thin upper lip and small eyes.
• Small head size.
• Low body weight.
• Vision and hearing problems.
• Delayed speech and language development.
• Poor coordination.

Diagnosis and Treatment

FASD can be difficult to diagnose due to the varied nature of symptoms and is, therefore, often missed. Diagnosing the condition requires expertise and thorough assessment. There is no cure, but the earlier the diagnosis, the better the outcome could be. `Early interventions might reduce some of the effects and improve a child’s development.

Difficulties individuals may face and how to support them.

Chronological age and development age

An individual with FASD may be operating at the cognitive age of a much younger individual. Therefore, it is important to understand their developmental age and begin to explore their capacity, adapting questions and using visual cues. If the individual comes across as non-compliant, explore if it is their lack of understanding and ask them to repeat back what they understand in their own words.

Confabulation

• An individual may blend facts and non-facts. This could include things that they have been told or seen on television, along with their lived experience.
• Consider that timelines may not be consistent, and do not assume an individual intends to deceive.

Executive functioning

• An individual may struggle with time management, planning and associated skills.
• Repeat instructions and state them in understandable language.
• Try and build mechanisms for reminders of appointments and important information.

Processing speed

• An individual may struggle with remembering and processing information. They may have delayed speech, slow processing, and difficulties following instructions. They may speak or read well but not understand the content.
• Try to speak in short, concise sentences to make things simple to understand.
• Test their understanding and avoid abstract language and metaphors.

Sensory processing

• An individual may experience over-responsiveness and under-responsiveness and may be unable to make sense of what is happening around them.
• Remove distractions and ask the person if they can identify any issues. 

Further reading:  What I want the world to know about FASD | FASD Hub

Support: https://www.drymester.org.uk

Drinkline: 0300 123 1110

Frank: 0300 123 6600

References

McQuire, C., Mukherjee, R., Hurt, L., Higgins, A., Greene, G., Farewell, D., Kemp, A., & Paranjothy, S. (2019). Screening prevalence of fetal alcohol spectrum disorders in a region of the United Kingdom: A population-based birth-cohort study. Preventive Medicine, 118, 344–351. https://doi.org/10.1016/j.ypmed.2018.10.013

Streissguth AP, Barr HM, Kogan J, et al. Understanding the occurrence of secondary disabilities in clients with Fetal Alcohol Syndrome (FAS) and Fetal Alcohol Effects (FAE). Final report to the Centers for Disease Control and Prevention (CDC). 1996; 96-06.