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Of all environmental causes of mental retardation, Fetal Alcohol Syndrome (FAS) is the most common. FAS is a set of physical and mental birth defects that can result from the consumption of alcohol in the form of beer, wine or mixed drinks. Alcohol passes through the placenta to the developing fetus, which may cause lifelong damage. Therefore when a pregnant woman drinks alcohol, she is literally delivering alcohol to her baby.

The physical features of FAS make this disorder as recognizable as Down Syndrome. Some of the physical characteristics include: small head size, small eyes that make them look far apart, a thin upper lip, and no folds in the skin between the nose and the upper lip. Diagnosis is usually made by the baby’s physician, but may be delayed due to a doctor’s hesitance to diagnose FAS. Doing so involves a confrontation with the mother about her drinking during pregnancy and may require the involvement of social service agencies.

The effects of FAS are devastating. The most pronounced features of this disorder are mental retardation and developmental disability. Behavioral symptoms make family life, socialization, and education very difficult. FAS children have a low frustration tolerance and become easily overwhelmed. They become very easily excited and not very easily calmed. They have difficulties with changes in their lives and nearly all (87%) are also diagnosed with Attention Deficit Hyperactivity Disorder (ADHD). Children with FAS suffer from sleep disturbances and are often exhausted and irritable. FAS children also have trouble linking cause and effect, making discipline ineffective. Socially, they are handicapped even further by their difficulty in perceiving social cues from facial expressions. When things go badly for the child with FAS, as they often do, the child tends not to seek solace or comfort from his or her caregivers.

The most disheartening fact about this disorder is that it is life-long. Adults with FAS often outgrow the facial characteristics, but the mental retardation, the effects of social isolation and rejection, and the impulsivity remain. FAS adults are vulnerable to victimization, cannot manage their money, and are incapable of taking daily medication such as birth control.

Once a baby is born with FAS, it may seem as though it will not matter whether the baby is diagnosed or not since the damage is already done. But, there is hope. Some of the effects may be minimized by timely intervention. Lots of structure is the most important first step in dealing with an FAS child. Relaxation techniques, and stop and think plans are also helpful. Because of the disruptive nature of children with FAS, family education and support are much needed. The functioning of a 16 year old with FAS is similar to a normal child seven years of age. Parents need to become adept at recognizing when their FAS child is becoming overwhelmed to be able to intervene before the child explodes.

A woman need not be dependent on (addicted to) alcohol to have a baby with FAS. She may have consumed alcohol only in the beginning of her pregnancy before she was aware that she was pregnant. Or, she may have made some poor choices with her drinking during her pregnancy. Binge drinking (five or more drinks per occasion) puts the baby especially at risk. However, some women may find that they are unable to stop drinking during pregnancy even when they are aware of the risks and want to stop. To minimize the chances of having an FAS baby it is imperative that a woman who is pregnant stop drinking as soon as possible. If help is needed to stop drinking, it can be found at the Alcohol and Drug Council of Tompkins County, and Cayuga Addiction Recovery Services. (A resource for this article was Fetal Alcohol Syndrome—3 rd Thursday Breakfast Broadcast (video).)

Sober talk is a monthly column by the Alcohol & Drug Council and runs in the Journal on the first Thursday of each month. Sherri Reynolds, MA, ATR-BC, LPC, CASAC is a clinician at the Alcohol and Drug Council.