Diagnosing and Caring for Children with Fetal Alcohol Disorders

Rainbow's Fetal Alcohol Spectrum Disorders Clinic, part of the Division of Developmental and Behavioral Pediatrics and Psychology, provides diagnostic services and comprehensive, multidisciplinary treatment of the complex cognitive, behavioral, sensory and neurodevelopmental problems associated with fetal alcohol spectrum disorder. While the neurocognitive and behavioral problems that result from prenatal alcohol exposure are lifelong, both short-and long-term outcomes for children can be significantly improved by early recognition, diagnosis and therapy. The clinic brings a team approach to assessment and intervention, leveraging the expertise of developmental pediatricians, pediatric psychologists, pediatric neuropsychologists, and social workers, as well as occupational, physical, and speech therapists.

What are Fetal Alcohol Spectrum Disorders?

Fetal alcohol spectrum disorders (FASD) are the leading preventable cause of birth defects and intellectual and neurodevelopmental disabilities. FASD is a group of physical, mental and social problems that are caused by alcohol exposure in the womb. When a mother drinks alcohol during her pregnancy, it can pass from the mother’s blood through the placenta to the fetus, affecting the baby's growth and brain development.

Different terms are used to describe variations of FASD, depending on the type of symptoms:

• Fetal Alcohol Syndrome is the most severe form of FASD. Children with fetal alcohol syndrome have recognizable facial structure abnormalities including small wide set eyes, a smooth ridge between the upper lip and nose (philtrum), and thin upper lip. Symptoms can include hyperactivity, cognitive disabilities, learning disabilities, and difficulty with social interactions. Children with fetal alcohol syndrome are also affected neurodevelopment and may experience impaired fine motor skills, poor eye/hand coordination, and sensitivities to light or sound.
• Alcohol-Related Neurodevelopmental Disorder typically results in intellectual disabilities, problems with behavior and learning, and impairments in memory, attention, judgment, and impulse control.
• Alcohol-Related Birth Defects lead to congenital abnormalities that can include a mix problems with the heart, kidneys, skeleton, vision or hearing.
• Neurobehavioral Disorder Associated with Prenatal Alcohol Exposure generally involves cognitive and memory impairment, behavior problems like severe tantrums or mood issues, difficulty with transitions, social problems, and impairment in daily living skills.

Children and teens with alcohol-related neurodevelopmental disorder, alcohol-related birth defects, and neurobehavioral disorder usually do not have the physical characteristics associated with fetal alcohol syndrome, but do display learning problems and behavioral difficulties that significantly impact home and school life and social relationships.

Diagnosing Fetal Alcohol Spectrum Disorders

There is no simple blood test or medical screening to identify fetal alcohol spectrum disorders. If you suspect your child may be affected or you have been referred by your pediatrician for screening, the team in Rainbow’s Fetal Alcohol Spectrum Disorders Clinic will gather information on your child’s medical history, development, and behaviors from your family, your pediatrician, and your child’s school. At the assessment appointment, we will conduct a full medical screening and thorough neurodevelopmental assessment. Testing may be conducted to rule out genetic disorders with similar symptoms and behaviors.

Results are reviewed by a multidisciplinary team in Rainbow’s Division of Developmental and Behavioral Pediatrics and Psychology and a follow up appointment will be scheduled with your family to discuss results and recommendations. We know you will have lots of questions and we will help you work through them all.

If your child does not receive a fetal alcohol spectrum disorders diagnosis but other behavioral, developmental, or genetic issues are identified, you’ll be referred to the appropriate specialty area in Rainbow for more help. If your child lies somewhere on the fetal alcohol spectrum, we will help your family begin to make sense of the diagnosis and begin initial planning for interventions.

Treatment of Fetal Alcohol Spectrum Disorders

There is no cure for FASD. Children affected with fetal alcohol spectrum disorders will face challenges throughout their lives, but early intervention can improve a child’s development and decrease problems at home and school. Medication therapy may be used to manage behaviors, while intensive behavioral therapy can foster children’s strengths and build capacity. Environmental modifications and educational interventions can be used to address some of the cognitive and neurologically based problems related to fetal alcohol spectrum disorders. Treatment recommendations are tailored to meet the individual needs of your child and family. Rainbow’s Fetal Alcohol Spectrum Disorders Clinic also works directly with parents to give you the tools to better manage your child’s behavior and cope with cognitive delays, memory impairment, and information processing deficits, while also learning to manage your own stress and fatigue.