Fetal Alcohol Spectrum Disorders (FASD) represent a range of disorders that can occur in an individual whose mother consumed alcohol during pregnancy.
The term “FASD” is not a diagnosis but is an umbrella term generally understood to include the following diagnoses: Fetal Alcohol Syndrome (FAS), the diagnosis given to the most profoundly affected children; Partial Fetal Alcohol Syndrome (PFAS) for children who display some but not all of the physical/neurodevelopmental characteristics of FAS; Alcohol-related Neurodevelopmental Disorder (ARND) for children who demonstrate cognitive or behavior impairment without the characteristic physical features; and alcohol-related birth defects (ARBD) for children with a physical malformation linked to maternal drinking without other symptoms.
The effects of prenatal alcohol exposure may include physical, mental, behavioral, or learning disabilities with possible lifelong implications. These disorders often co-occur with substance use and mental illness, and generally require modifications to traditional treatments for successful outcomes. More than 400 health conditions can co-occur with FASD. Nationally, FASDs are under-diagnosed and are often misdiagnosed. A recent study found that 86.5% of youth with behavioral health disorders and an FASD had not been previously diagnosed, or had been misdiagnosed. Additionally, issues of stigma surrounding FASDs may lead to under-reporting, disguising true prevalence. The Center for Disease Control (CDC) estimates that up to 1 in 20 children in the US have an FASD; Massachusetts estimates range from between 2-5%.
The presentation of FASDs varies widely from person to person, and generally reflects the timing of exposure during pregnancy, amount of exposure, genetic susceptibility, and a number of other factors. Deficits may span a very wide range of intellectual and social characteristic. For example, a child with a fetal alcohol related disorder may be diagnosed with Intellectual Disability despite having some areas of clear intellectual strength. Alternatively, a child with an FASD may be exceptionally bright, yet continually underperform in school. Often, children with an FASD exhibit peculiar social and emotional characteristics and may be misunderstood as having autism, or simply as being oppositional, defiant, hyperactive, or impulsive.
Parents and teachers of children with an FASD and are often perplexed by a child’s unusual learning style, inconsistent social and academic performance, and unpredictable behavior. Children with an FASD often do not “fit” well into traditional academic and social support services.
 Popover, S.et al. (2016) Comorbidity of fetal alcohol spectrum disorder: a systematic review and meta-analysis. The Lancet, Vol. 387, Np. 10022, p978-987. 5 March 2016.
 Chasnoff, I., Wells, A., & King, L. (2015). Misdiagnosis and missed diagnoses in foster and adopted children with prenatal alcohol exposure. Pediatrics, 135(2), 264-270. DOI: 10.1542/peds.2014-2171
 May PA, et al. (2014). Prevalence and characteristics of fetal alcohol spectrum disorders. Pediatrics. 2014;134:855-66.