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Fetal Alcohol Syndrome in Adults: 9 Essential Things

Fetal Alcohol Syndrome Adult
Fetal alcohol syndrome adult (FAS) is a condition that results from maternal drinking during pregnancy. In most cases, FAS is diagnosed in adults who were exposed to alcohol while they were still a child.
 This article aims to summarize the syndrome, its symptoms, and how it can be diagnosed.
Image by Vinicius “amnx” Amano on Unsplash

1. What Is Fetal Alcohol Syndrome?

In the United States and western European nations, 1-5% of the population is affected by FASDs, making it a reasonably prevalent disorder. The Centers for Disease Control and Prevention (CDC) classifies FASDs as a collection of diseases that affect people who were exposed to alcohol in utero before birth. Adults with fetal alcohol syndrome may experience health issues as well as issues with behavior and learning.

Because FASD is a spectrum disorder, the severity of the problem varies according to how much alcohol was ingested during pregnancy. The severity of the illness increases with consumption. There is no “safe time” to drink while pregnant, despite the fact that some people think “drinking an occasional glass of wine” during the third trimester is less harmful.

Thankfully for those who struggle with drinking alcohol before and throughout pregnancy, cutting back at any point reduces the severity, even though the condition may already be present.

2. Adults with Fetal Alcohol Spectrum Disorders

Prenatal alcohol consumption can have a number of effects, including birth defects, craniofacial deformities, growth retardation, and central nervous system dysfunction (PAE). When all of these problems appear at once, they are referred to be fetal alcohol spectrum disorders (FASDs).

Human adults with FASDs mostly experience results linked to mental health and adaptive living, as well as changes to behavior, cognition, and facial and physical phenotypes.

2.1. Facial and Physical Phenotype

Individuals who have FASDs are frequently identified when they are young. Adults can also be checked for and diagnosed, but there are challenges, including gathering reliable histories of alcohol intake and phenotypic alterations in the body.

Although more investigation is needed to determine the physical phenotype in adulthood, current data suggests that low stature, a narrow upper lip, and microcephaly persist.

2.2. Behavior and Cognition

There are numerous studies on neurobehavioral deficiencies in kids and teens with FASDs. Although there is little research on adults, some studies have looked at neurobehavioral consequences in young adults.

Adults with FASDs have so far had their behavior issues, motor function, attention, learning and memory, executive function, theory of mind, and sense of coherence assessed. Almost little data is available for adults aged 30 and older, therefore much more research is required to identify the precise cognitive and behavioral strengths and challenges seen in individuals with PAE.

According to a study on the impact of parental alcohol use and fine motor coordination, those with FASDs had worse balance, moved more slowly while using their fingers, hands, or feet, and had more motor sequencing mistakes. Alcohol had a mild dose-response effect on motor performance in a prospective sample of young individuals (24–27y) with a range of PAE (from none to heavy).

Patients struggle to focus and maintain their attention, and when forced to focus, maintain, and shift their attention, they do poorly.

Rangmar et al. used a variety of cognitive and social tests to examine individuals (30–8 years) with FAS. Adults with FAS took more steps to complete the Tower of Hanoi puzzle and had lower memory spans for the Digit Span Forward and Backward task as compared to controls, which is an indication of worse short-term memory, working memory, and planning skills.

According to the available research, adults with FASDs have more behavioral issues than controls do. They may also be less effective and more prone to getting sidetracked while working on tasks, have more trouble focusing, learning, remembering, planning, and analyzing social situations, and feel less equipped to deal with their environment.

The results are based on a small number of measurements, and only a small number of domains have been analyzed. To guide clinical therapy, a more thorough evaluation of neurobehavioral function in adults with PAE across a larger age range is required.

2.3. Mental Health and Adaptive Living Outcomes

People with FASDs have difficulty functioning daily due to their physical, cognitive, emotional, and/or social problems. Secondary disabilities, which a person does not naturally have but instead acquires as a result of other issues, are prevalent among FASDs.

According to Streissguth et al., 90% of individuals with FASDs (aged 21 to 51) had mental health issues, 60% had legal issues, and 45% had drug and alcohol issues. 92% of 25 persons with FASDs who were examined with the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID) satisfied the criteria for an Axis-I illness. These adults ranged in age from 19 to 51 and had IQs between 73 and 110.

Another study by H.M. Barr et al. found that prenatal exposure to one or more binge-drinking episodes increased the likelihood of somatoform disorder, substance dependence, or abuse, as well as paranoid, passive-aggressive, and antisocial personality disorders by more than a two-fold margin.

3. Health Effects

There are some instances of children exposed to alcohol having worse overall health, including impaired immunological response, glucose intolerance, and hyperinsulinemia. According to a review of case studies, children with FASDs may have some childhood malignancies at a higher rate than children without FASDs. The health effects on people with FASDs are not sufficiently studied, and there is no information on adults. Yet, through fetal programming, prenatal experiences can have a long-lasting effect on health.

Some studies done on animals have led some researchers to hypothesize that adults with FASDs may be more prone to common illnesses like influenza and may also be at higher risk for autoimmune diseases, diabetes, cardiovascular diseases, and cancer. As far as we are aware, no studies have looked at the effects of PAE on adult human health; this is a crucial area that urgently needs investigation.

4. The Causes Of Fetal Alcohol Syndrome 

The alcohol consumed by a pregnant woman quickly crosses the placenta to the fetus. A developing fetus’ body does not metabolize alcohol in the same manner that it is by an adult. When alcohol is more concentrated in the fetus, it may be difficult for the fetus’s important organs to receive enough nutrients and oxygen.

In the early stages of pregnancy, when a woman may not yet be aware that she is pregnant, damage can be done. If the mother drinks heavily, the danger rises.

Several studies have suggested that the first three months of pregnancy are the most dangerous for drinking. Yet, according to recommendations from the American Academy of Pediatrics, drinking alcohol at any point during pregnancy may be detrimental.

The amount of alcohol consumed during pregnancy and the severity of FASDs are related. The situation worsens as more alcohol is drunk.

5. Diagnosis of Fetal Alcohol Syndrome Adult

FASD is a continuum condition, so some individuals may only have mild symptoms. A youngster with a more serious illness might get a diagnosis right away, whereas those with fewer visible symptoms can take years to get one. Some children endure long-term suffering, in part because they are unaware of their condition.

It’s also possible that the mother did not take the necessary steps to get her unborn kid evaluated for the problem if she struggles with alcohol even after giving birth. People may experience childhood and adolescence in particular under these circumstances without being conscious of their state, which amplifies the different ways in which alcoholism impacts families.

FASDs are not intended to be used as a clinical diagnosis. Due to the lack of a blood test or other medical tests for FASDs, the diagnosis might be challenging. Moreover, several illnesses, like Williams syndrome and ADHD (attention-deficit/hyperactivity disorder), share symptoms with FAS.

One can receive a diagnosis for FASD from a primary care physician, mental health counselor, social worker, psychologist, or psychiatrist, to name a few professionals. Even if there isn’t a single test to identify FASDs, medical experts can assess:

  • Prenatal alcohol exposure

  • Abnormal facial features

  • Short stature

  • Low body weight

  • Central nervous system problems,

  • Problems with attention, impulsivity, and coordination

  • Difficulty communicating, socializing and learning.

6. Different FASD Diagnoses Include:

  • Fetal Alcohol Syndrome (FAS): FAS is the most complex end of the FASD spectrum. Patients with FAS have problems with their growth, minor facial characteristics, and central nervous systems (CNS). Patients with FAS may experience problems with communication, learning, memory, attention span, vision, and hearing. Individuals might experience several of these problems. Those with FAS frequently experience social and academic challenges.

  • Alcohol-Related Neurodevelopmental Disorder (ARND):

    Intellectual disability, behavioral issues, and learning difficulties are possible in people with ARND. They may perform poorly in school and struggle with math, memory, attention, judgment, and impulse control.

  • Alcohol-Related Birth Defects (ARBD):

    Individuals with ARBD may experience issues with their hearing, hearts, kidneys, or bones. They may have a combination of these.

  • Neurobehavioral Disorder with Prenatal Alcohol Exposure (ND-PAE):

    A child or young person with ND-PAE will experience difficulties in three different areas: thinking and memory, behavior, and day-to-day living. These difficulties can include issues with bathing, dressing for the weather, and playing with other kids. The child or young person may also forget information they have already learned or have trouble planning.

    APA defines excessive alcohol consumption as more than 13 alcoholic drinks every month of pregnancy (i.e., any 30 days of pregnancy) or more than 2 alcoholic drinks in one sitting for the mother of the child to be diagnosed.

7. Symptoms of Fetal Alcohol Syndrome Adult

FASD symptoms in adults vary depending on whether alcohol was consumed during pregnancy. Because of this, diagnosing FASD in less severe forms might be challenging. Adults can nonetheless experience difficulties even if they don’t exhibit symptoms.

We have calculated the population’s FASD prevalence using several different techniques. It is uncertain how many people experience fetal alcohol spectrum disorders. Alcohol use during pregnancy is one of the problems linked to the baby’s exposure to FASDs. When many physical and developmental abnormalities are present, the most difficult diagnosis, fetal alcohol syndrome (FAS), is employed.

A variety of symptoms exist in adults with secondary fetal alcohol syndrome that aren’t very evident at birth. They consist of:

  • Mental health problems

  • Having a messed up school experience (being suspended, expelled, or dropping out)

  • Getting into trouble with the law (being charged or convicted of a crime)

  • Alcohol and/or drug problems

  • Poor academic achievement and school failure

  • Sexually deviant behavior

  • Problems with employment

  • Dependent living

The more symptoms you have and the more severe they are, the greater the likelihood that you have FASDs, although not all of the symptoms must be present for a diagnosis to be made.

Physical characteristics and symptoms may be less noticeable in adults than in children because they have already gone through puberty and reached their prime physical stature and attractiveness.

It’s also possible that by age, without a prior FASD diagnosis, some physical characteristics may have evolved into accepted parts of one’s look. Whatever the situation, there are physical characteristics that can indicate a diagnosis.

Fetal alcohol syndrome in adults can show:

  • Large or malformed ears

  • Underdeveloped fingernails or toenails

  • Short neck

  • Poor eye-hand coordination

  • Hearing problems

  • Joint and bone abnormalities

  • Short eye slits

  • Droopy eyelids

  • Widely spaced eyes

  • Nearsightedness

  • Crossed eyes

  • Short upturned nose

  • Low and/or a wide bridge of the nose

  • Thin upper lip

  • Flat midface

  • Small underdeveloped jaw

Moreover, neurological hard or soft indicators (according to age appropriateness) of the central nervous system (CNS) problems include the following:

  • Impaired fine motor skills

  • Neurosensory hearing loss

  • Poor tandem gait

  • Poor eye-hand coordination

8. Fetal Alcohol Syndrome Treatment For Adults

Although FAS is incurable, some symptoms can be treated. More progress can be made the earlier the diagnosis is made. Depending on the signs a child with FAS displays, they may require numerous visits to the doctor or a specialist. Very young children can benefit from social assistance and special schooling. For instance, speech therapists might work with young children to encourage their verbal development.

Photo by National Cancer Institute via Unsplash

8.1. At home

A secure and caring family will be beneficial for children with FAS. They may be significantly more sensitive than the normal child to schedule disturbances. If they experience abuse or violence at home, children with FAS are particularly likely to struggle with violence and substance abuse later in life. These kids respond better with a set schedule, clear rules to follow, and incentives for good behavior.

8.2. Medications

There are no specific drugs for the treatment of FAS. Nonetheless, several drugs can treat symptoms.

These medicines consist of:

  • medicines to help with depression 

  • stimulants to treat hyperactivity, inability to concentrate, and other behavioral issues

  • Using neuroleptics to combat anger 

  • medication for anxiety

8.3. Counseling

Behavioral training can also be helpful. Children learn social skills for connecting with their classmates, for instance, through friendship training. Training in executive function may enhance abilities including self-control, logic, and cause-and-effect comprehension. FAS children may also require academic support. A math tutor, for instance, could assist a youngster who has academic difficulties.

To deal with the difficulties that this disease may bring about, parents and siblings may also need assistance. Talk therapy or support groups may be able to provide this assistance. Also, parents can get parenting instruction that is specific to their kids’ needs. Parental education teaches you the finest ways to relate to and look for your child.

8.4. Alternative Treatments

Some parents and their kids look for alternative therapies outside of the realm of medicine. They consist of therapeutic procedures like acupuncture and massage (the placement of thin needles into key body areas). Movement strategies such as yoga or exercise are also used as alternative treatments.

For adults with FASDs, the earlier you intervene, the better. The most beneficial interventions have been found to include early diagnosis, special education, social assistance, a loving, supportive, and secure home environment, as well as little violence throughout childhood.

9. How to Help a Person With Fetal Alcohol Syndrome

FAS cannot be cured. But if they get the correct help, people with the condition can live happy, healthy lives.

Early therapies, including physical therapy, occupational therapy, and speech therapy, are beneficial for children with FAS. These therapies may enable them to avoid some developmental setbacks.

9.1. Special Education

The majority of children with FAS struggle in conventional educational settings due to symptoms like hyperactivity and intellectual challenges. Therefore, they should receive customized education tailored to their particular learning needs.

9.2. Stable Home Environment

The best chances for success for children with FAS are in stable households with supportive, understanding parents. Parents are welcome to enroll in parent education programs that provide detailed, scientifically based advice on how to support a child with FAS.

9.3. Ongoing Support

After they reach adulthood, people with FAS will still need support from their families and communities. With this assistance, they can reach their full potential and reduce their chance of secondary problems.

Medical professionals must help both children and adults with FAS. The following specialists might fit their needs:

  • primary care providers

  • audiologists

  • neurologists

  • nutritionists

  • psychologists

  • psychiatrists

Holistic therapies such as meditation, yoga, and animal-assisted therapy can also help certain FAS patients.

10. Conclusions 

Fetal alcohol syndrome is nothing to be feared for. It causes some difficulty but the disease itself is highly treatable. Despite the difficulties that accompany this condition, with the right support, adults with FASDs can lead fulfilling and productive lives. It is important to seek help early and keep up with treatments as they may change over time. Hope this helped!  

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