Fetal Alcohol Syndrome

What is it?

  • Also known as FAS, the signs and symptoms are birth defects that result from the mother drinking during pregnancy.
  • FAS is a leading cause of birth defects but is also one of the most preventable causes of mental retardation.
  • Each year 5,000 - 12,000 American babies are born with this condition.


FAS is caused by a woman's use of alcohol during her pregnancy. The alcohol that a pregnant woman drinks travels through her bloodstream and across the placenta to her fetus. A fetus's small body breaks down alcohol much more slowly than an adult's body does. So the alcohol level in the fetus's blood is higher than in the mother's blood, and the alcohol remains in the fetus's blood longer. This exposure of the fetus to alcohol causes FAS.


FAS is diagnosed when the child shows these major clinical signs;

Characteristic Features:

  • Small eyes with drooping upper lids
  • Short upturned nose
  • Flattened cheeks
  • Small jaw
  • Thin upper lip
  • Flattened philtrum (groove located in the middle of the upper lip)

Central Nervous System Symptoms:

  • Hyperactivity
  • Delayed development in gross motor skills such as rolling over, sitting up, crawling, and walking.
  • Delayed development in fine motor skills such as grabbing objects with thumb and index finger, and moving objects from one hand to another.
  • Memory issues, poor judgement, easily distracted, and impulsiveness.
  • Increased learning problems compared to kids in the same age group.
  • In some cases seizures will also occur.

Children may also have:

  • Decreased birth weight.
  • Smaller than average skull size.
  • Hearing disorders.

Secondary Conditions

  • Mental health issues such as attention deficit disorder (ADD), behavioral issues, depression, and psychotic episodes.
  • Can have issues in school, children with FAS have a higher rate of suspension and expulsion due to their difficulty getting along with others.
  • Drug and alcohol abuse. More than one-third of those with FAS have issues which require inpatient treatment for substance abuse.
  • Can also have difficulties holding a job and living independently.


There's no cure or specific treatment for fetal alcohol syndrome. The physical defects and mental deficiencies typically persist for a lifetime.

However, early intervention services can help reduce some of the effects of fetal alcohol syndrome and prevent some of the secondary disabilities that result. Intervention services may involve:

  • A team that includes a special education teacher, a speech therapist, physical and occupational therapists, and a psychologist
  • Early intervention to help with walking, talking and social skills
  • Special services in school to help with learning and behavior issues
  • Counseling to benefit parents and the family in dealing with a child's behavior problems
  • Medications to help with some symptoms
  • Medical care for health problems, such as heart abnormalities
  • Treatment of the mother's alcoholism to enable better parenting and prevent future pregnancies from being affected


  • CDC studies have identified 0.2 to 1.5 infants with FAS for every 1,000 live births in certain areas of the United States.
  • The lifetime cost for one individual with FAS in 2002 was estimated to be $2 million.
  • More severe cases can reach up to $4 billion annually.
  • Among pregnant women, the highest estimates of reported alcohol use were among those who were:
    • Aged 35-44 years (14.3%);
    • White (8.3%);
    • College graduates (10.0%);
    • Employed (9.6%)

Teaching Strategies

When giving instructions or assignments keep in mind that students with FAS are similar to children with learning disabilities, in that they have issues with auditory, and/or visual perception.

  1. Make sure you have the students attention and when giving instructions use gestural movements and voice variations. Use pictures of steps involved, or have the instructions written down.
  2. Instructions should be clear, simple, and given one step at a time.
  3. Use the same verbage/words when giving instructions or going over an activity, i.e., calendar skill: if an activity is started by saying "today is Monday, yesterday was Sunday" the activity should be continued the rest of the week by repeating the same word format "today is ________, yesterday was___________ ,"
  4. Utilize all the senses whenever possible, as multisensory learning strengthens the information and provides for more than one way to recall.
  5. Act out directions whenever possible. If a student is to pick up papers and put them in a certain place, walk through each step before you have the student do the task.
  6. Modify assignments as needed. Remember to teach at developmental level not age level, using materials that are adapted so that the student is not embarrassed by peers for using a "lower level" book or materials.
  7. Students with Fetal Alcohol Syndrome are very visual, and the use of pictures, images, photos of the children actually involved in activities help the students remember the structure and/or schedule, which is important each day in providing the organization that these students need.
  8. Always remember to praise the students. Positive reinforcement works best and helps builds their self-esteem. Use statements, certificates, or coupons that can be later traded for rewards.

Assistive Technology

There's different options available but some may be more simpler for elementary than for high school students;

  • The Fetal Alcohol Spectrum Disorders Institute suggests an electronic alarm clock for elementary students, a desktop computer with a calendar program for middle school students, and a personal digital assistant for high school students. Since students with FAS tend to struggle more with their grasp on time.
  • Computers can be helpful when teaching students with fetal alcohol syndrome—programs can help with sustaining attention and make learning fun for the students.
  • The Fetal Alcohol Spectrum Disorders Institute suggests tape recording the presentation, then allowing the student to listen to it either in the classroom or at home, letting her have more time to gather the information. Videotaping is another option for recording presentations.
  • Timers and stopwatches can be beneficial assistive technological devices for fetal alcohol syndrome, especially if sustained attention is a difficulty for the student. When the student is working on an assignment, the teacher can set the timer, letting the student know how long she has; if the student needs to take a break while working, she can stop the timer for the length of the break.

Community Resources

NOFAS DC and Maryland FASD Family Support Group
The National Organization on Fetal Alcohol Syndrome sponsors a free family support group meeting for anyone who has been affected by FASD.

Call 202-785-4585
Quarterly Meetings held at:
Holy Cross Hospital
1500 Forest Glen Road
Silver Spring, MD
Contact: NOFAS; Kathy Mitchell


National Organization on Fetal Alcohol Syndrome (NOFAS)                           1200 Eton Court NW
Third Floor
Washington, DC 20007
Phone: 202-785-4585 Fax: 202-466-6456 Toll Free: 800-66-NOFAS
Contact: Tom Donaldson, President
Develops and implements innovative community based and culturally appropriate prevention, intervention, education and advocacy strategies nationwide. Comprehensive information available by E-mail or postal mail.

Fetal Alcohol Spectrum Disorders (FASD) Center for Excellence
2101 Gaither Road
Suite 600
Rockville, MD 20850
Phone: 301-294-5401 Fax: 301-294-5401 Toll Free: 866-786-7327
Contact: Jon Dunbar

The FASD Center is a Federal initiative devoted to preventing and treating FASD. Additionally, The Center is dedicated to providing training, technical assistance, and conference/event speakers.

Johns Hopkins Bayview Medical Center – Center for Addiction and Pregnancy
4940 Eastern Avenue
Baltimore, MD 21224
Phone: 410-550-3020 Fax: 410-550-3027
Contact: Robert Brooner, Director
A one-stop treatment program for substance abusing women and their families, providing care for the affected pregnant woman, her baby, and for her other children as indicated.


An Overview of Available Options in Assistive Technologies for Students with Fetal Alcohol Syndrome. (n.d.). Retrieved April 12, 2015, from http://www.brighthubeducation.com/special-ed-neur...

Data & Statistics. (2015, January 28). Retrieved April 10, 2015, from http://www.cdc.gov/ncbddd/fasd/data.html

Feature, W. (n.d.). Fetal Alcohol Syndrome. Retrieved April 10, 2015, from http://www.webmd.com/parenting/baby/features/fetal-alcohol-syndrome

Fetal Alcohol Syndrome and Educational Strategies. (n.d.). Retrieved April 12, 2015, from http://www.psychiatry.emory.edu/PROGRAMS/GADrug/Edfas.htm

Fetal alcohol syndrome. (n.d.). Retrieved April 12, 2015, from http://www.mayoclinic.org/diseases-conditions/fet...

Fetal Alcohol Syndrome - QuitAlcohol.com. (2013, June 25). Retrieved April 12, 2015, from http://www.quitalcohol.com/information/fetal-alcohol-syndrome.html

State Resources for Maryland. (n.d.). Retrieved April 12, 2015, from http://www.nofas.org/state-resources-for-maryland/

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