Pondering FASD

Recently I had the opportunity to take part in a webinar on speechpathology.com (if you aren’t a member and want to join, feel free to click here [disclaimer: I receive a credit toward membership if you join after following that link]). The webinar was on Fetal Alcohol Spectrum Disorder and how to improve outcomes, presented by Dan Dubovsky, MSW FASD Specialist.

To say it was mind-blowing is an understatement.

alcohol alcoholic beverage celebration

I’m not going to go over the whole webinar here because 1) that would be a violation of copyright and 2) hearing it from the expert is better…but I did want to give you a brief synopsis of a couple of points that were mentioned, and my thoughts about them.

I have been interested in fetal alcohol spectrum disorder (previously known as fetal alcohol syndrome and fetal alcohol effects) for a long time. I have first-hand knowledge of some of the challenges associated with this spectrum.

One of my greatest frustrations is that it is so often undiagnosed or misdiagnosed. For instance, I’ll bet some of these stats might surprise you (these are all according to the webinar):

  • FASD has a prevalence between 1.3% – 5%.
  • Weighted prevalence in one study has a prevalence of 1:32 to 1:10.
    • “Estimated prevalence of fetal alcohol spectrum disorders among first-graders in 4 US communities ranged from 1.1% to 5.0% using a conservative approach.”
  • The range of FASD is more common than disorders such as Autism and Down Syndrome.


We have whole classes on how to treat autism…yet this disorder which is potentially just as devastating and MORE prevalent is not talked about? It’s not actively taught?

Why is it undiagnosed?

One of the reasons for this is that because of the stigma associated with it, and the fact that it IS 100% preventable, most parents aren’t willing to just announce that it is a possibility. Unfortunately, it is not something we can just go up to someone and say, “Hey….how much did you drink while you were pregnant?”

Because we can’t just go up to them and ask, we’ve been operating under the impression that if we treat the symptoms, it should be fine. Which, for some, may be the case. Unfortunately, for other challenges, treating the symptoms can actually CAUSE additional problems.

FASD is brain damage. 

This is an important consideration because it impacts how we teach – what we teach – and what we expect. When we understand the brain damage, the specific structures of the brain and their functions that are no longer working the way they were designed to work, we can better treat the condition.

For instance, many individuals with FASD have anxiety. They have a tendency to be aggressive, quick to anger, and stressed over a lot of things. Until this webinar, I had no idea why this was the case. Now I understand it is because there is damage to the amygdala. In addition, the hypothalamus-pituitary-adrenal (HPA) system helps the body deal with anxiety and stress. However, in people with FASD, the HPA system “over-reacts to minor stressors with an over-release of cortisol.” Because these structures are damaged, I need to not say “wow, you’re over reacting” and instead actually TEACH how to deal with these (for them) very real fears and anxieties. Individuals with FASD literally can’t help feeling overly anxious in minor situations any more than a diabetic can help needing insulin [note: this is my take away from the seminar – he didn’t say it]. In all honesty, I wish I knew this about 18 years ago.

There are so many points to this webinar that I want to explore deeper. It intrigues me and, in all honesty, if I can write my doctoral dissertation on it I will.

So…How many students do you suspect you may have with Fetal Alcohol Spectrum Disorder? Have you done any research on it? Is your therapy any different?  Are you interested in learning how pot and alcohol combined are even more devastating? Let me know.

Until then…Adventure on!




7 thoughts on “Pondering FASD

  1. That particular study May et al 2018, also found that 99% of children with FASD ARE MISSED. That’s incredibly disheartening given the results of this studies (Andrews et al, 2018, Arnold et al, 2013, Payne et al, 2014, Price, & Miskelly, 2015, Nevin et al, 2002) Family physicians do not feel confident about diagnosing FAS. None of the physicians were aware of the current screening methods to accurately gauge alcohol use in pregnant and childbearing women

  2. Of course, certain students come to mind. But, unless they have the characteristic facial features, it can be difficult to tell. Would you mind sharing the course # at Speechpathology.com? I will share your blog with my daughter who is student teaching. I reckon teachers, especially in special education, should know about this. Thanks, Mary! Elana

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