Quackery Myth: Fetal Alcohol Spectrum Disorders is a Form of Autism


Fairly often fetal alcohol spectrum disorders (FASD) is mistaken for autism. Alcohol use does not cause autism.  FASD is a condition that happens to a child when there is alcohol exposure during the pregnancy. FAS causes brain damage and growth delays. The different characteristics of this disability differs from person to person and the brain damage is not reversible. 

There is no definitive amount of alcohol that is safe during pregnancy, even one drink can put the baby at risk. 

Research shows that binge drinking and regular heavy drinking puts a fetus at the greatest risk for severe issues. This study was done by the National Institute on Alcohol Abuse and Alcoholism. Studies have also shown that genetics may also play a role on how severe the brain damage will be.

All types of alcohols effect the baby. This includes, wines, beers and even liquid cold medicine.  When alcohol enters the blood stream and reaches the fetus, it crosses the placenta. Alcohol causes a higher blood alcohol concentrations in the developing baby than the mother because a fetus metabolizes alcohol slower than an adult does. Alcohol interferes with the delivery of oxygen and nutrition to the developing baby. Exposure to alcohol during pregnancy can harm development tissue and organs that cause permanent brain damage to the baby. 

If a pregnant person is drinking during pregnancy, it is never too late to stop. This is because brain growth takes place throughout the pregnancy. The sooner they stop drinking the better. 

Signs of FASD

Physical signs:
  • distinctive facial features, including small eyes, thin upper lip, short upturned nose and smooth skin between the nose and upper lip. 
  • Deformaties of joints, limbs and fingers
  • slow physical growth before and after birth
  • small head circumference and brain size
  • heart defects and problems with kidneys and bones
  • low body weight
Brain and Centeral Nervous System Signs
  • poor coordination or balance
  • intellectual disability, learning disabilities and delayed development
  • poor memory
  • trouble with attention and with processing information
  • difficulty with reasoning and problem solving
  • difficulty identifying consequences in choices
  • poor judgement skills
  • jitteriness or hyperactivity
  • rapidly changing moods
Social and behavioral sings
  • difficulty in school, especially math
  • trouble getting along with others
  • poor social skills (I don't like this one, this is what is listed)
  • has issues transitioning
  • impulsive
  • problems staying on task
  • difficulty planning or working towards a goal

Diagnosing FASD

There are three different disabilities in the FASD category

Fetal Alcohol Syndrome is when the child has the most brain damage. People with FAS have central nervous system issues, minor facial features, and growth delays. People with FAS can have learning disabilities, memory issues, short attention span, communication differences, low vision or be Deaf or Hard of Hearing. People with FAS often have a hard time in school or have a hard time making friends

Alcohol Related Neurodevelopmental Disorder (ARDND) People with ARND may be intellectually disabled and have learning disabilities. They may have trouble in school and have a hard time with math, memory, attention, judgement and be impulsive.

Neurobehavioral Disorder Associated with Prenatal Alcohol Exposure (ND-PAE) ND PAE was included as a recognized condition in the DSM 5 in 2013. A child with ND-PAE will have difficulty in these areas:
  • thinking and memory
  • meltdowns and unstable mood
  • day to day living
Also the child's mother must have consumed more than minimal levels of alcohol before birth. This would be more than 13 drinks in one month or more than 2 drinks in one sitting. 

These conditions are clinically diagnosed. This means that hard to diagnose because there is no medical test. A lot of other conditions have similar signs, which makes it especially difficult. 

When diagnosing FASD, doctors look for:
  • prenatal alcohol exposure
  • central nervous system issues
  • lower than average height, weight or both
  • the facial features that are typical with FASD

Support After Diagnosis

  • Diagosnis before the age of 6
  • loving, nurturing and stable home environment during childhood
  • absence of violence
  • involvement in special education and social services
  • advocacy in the school and workplace
  • transition planning
  • parent training
  • primary care in a high quality medical home setting with care integration

FASD is Not Autism

While FASD is not autism and does not cause autism, the signs can be very similar.  A child with FASD can also be autistic. According to the Proof Alliance, 72% of children with FASD are also autistic. 

According to the the Proof Alliance (please don't kill me about the ableist language, I edited it as best I could):

FASDAutism
Occurs as often in males as in femalesOccurs in males 4 times as often as in females (this is normally due to missed diagnosis)
Able to relate to othersDifficult to relate to others
Restricted patterns are not commonly seenRestricted patterns of behavior (stimming), interests (special interests), and activities as a core area
Verbal communication may be slow to develop but is not commonly significantly impairedDifficulty in verbal and non-verbal communication
Difficulties begin at birthDifficulties may begin after a period of typical growth
Difficulty in verbal receptive language; expressive language is more intact as the person agesDifficulty in both expressive and receptive language
Spoken language is typicalSome do not develop spoken language
Spontaneously talkativeformal speech
Echolalia not commonEcholalia-repeating words or phrases
Stereotyped movements not seenStereotyped movements
Ritualistic behaviors not commonly seenRitualistic behaviors
Repetitive body movements not seen; may have fine and gross motor coordination and/or balance problemsRepetitive body movements e.g., hand flapping, and/or abnormal posture e.g., toe walking (Stimming)
Social and outgoingRemaining aloof; preferring to be alone, but many autistic people can be outgoing as well
Difficulty with change and transitionsdifficulty with transitioning
Can share enjoyment and laughterLack of spontaneous sharing of enjoyment
Can express a range of emotionRestricted in emotional expression
Funny; good sense of humorDifficulty expressing humor that typical people can relate to
Microcephaly more commonMacrocephaly more common
Considered a medical disorder in the ICD.  Not in the DSM-IVConsidered a mental disorder in the DSM-IV

Sources:
https://www.mayoclinic.org/diseases-conditions/fetal-alcohol-syndrome/symptoms-causes/syc-20352901
https://www.cdc.gov/ncbddd/fasd/facts.html
https://www.healthychildren.org/English/health-issues/conditions/chronic/Pages/Fetal-Alcohol-Spectrum-Disorders.aspx
https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/fetal-alcohol-exposure
https://pediatrics.aappublications.org/content/early/2015/10/13/peds.2015-3113
https://www.proofalliance.org/2012/02/fasd-vs-asd/

Comments

  1. Thanks for the point about the cough medicine and the alcohol in it.

    ReplyDelete

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