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What are the signs and symptoms of fetal alcohol spectrum disorders?

Dr. Charles J. Sophy, MD
Adolescent Medicine Specialist

Most infants with FASD are irritable, have trouble eating and sleeping, are sensitive to sensory stimulation, and have a strong startle reflex. They may hyperextend their heads or limbs with hypertonia (too much muscle tone) or hypotonia (too little muscle tone) or both. Some infants may have heart defects or suffer anomalies of the ears, eyes, liver, or joints.

Most children with FASD have developmental delays and some have lower than normal intelligence. Only 15% of children with FASD have an IQ under 70. Most children with FASD have IQ in the normal or above normal range.

The most serious characteristics of FASD are the invisible symptoms of neurological damage from prenatal exposure to alcohol. These symptoms persist into adulthood and include the following:

  • Attention deficits
  • Memory deficits
  • Hyperactivity
  • Difficulty with abstract concepts
  • Inability to manage money
  • Poor problem solving skills    
  • Difficulty learning from consequences
  • Immature social behavior
  • Inappropriately friendly to strangers
  • Lack of control over emotions
  • Poor impulse control
  • Poor judgment

These symptoms are not just "behavior problems" but are "soft signs" - symptoms of permanent, unchanging damage to the brain (static encephalopathy) and are not within the child's control. Although psychological factors such as abuse and neglect can add to the intensity of the problems, the behaviors should be viewed first and foremost as a result of brain damage from alcohol.

Adults with FASD have difficulty maintaining successful independence. They have trouble staying in school, keeping jobs, or sustaining healthy relationships. They require long-term support and some degree of supervision in order to succeed.

FASDs refer to the whole range of effects that can happen to a person whose mother drank alcohol during pregnancy. These conditions can affect each person in different ways, and can range from mild to severe.

A person with an FASD might have:

  • Abnormal facial features, such as a smooth ridge between the nose and upper lip (this ridge is called the philtrum)
  • Small head size
  • Shorter-than-average height
  • Low body weight
  • Poor coordination
  • Hyperactive behavior
  • Difficulty paying attention
  • Poor memory
  • Difficulty in school (especially with math)
  • Learning disabilities
  • Speech and language delays
  • Intellectual disability or low IQ
  • Poor reasoning and judgment skills
  • Sleep and sucking problems as a baby
  • Vision or hearing problems
  • Problems with the heart, kidneys or bones

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.