Fetal Alcohol Spectrum Disorders (FASD)

Overview

When a woman consumes alcohol while pregnant, her fetus is exposed directly to alcohol through her bloodstream. Alcohol can interfere with the growth and development of all fetal body systems; however, the developing central nervous system (the brain and spinal cord) is especially vulnerable to the damaging effects of alcohol. These effects, which can vary from mild to severe, may include physical, mental, behavioural, and/or learning disabilities with lifelong implications. There is no cure, but early and appropriate supports can make a positive impact and improve outcomes for individuals with FASD.

FASD affects individuals from all socioeconomic and ethnic backgrounds.

Signs & Symptoms

While every individual with FASD has a unique set of strengths and weaknesses, all people with FASD have some brain dysfunction as a result of prenatal alcohol exposure.

The signs and symptoms of FASD are most commonly broken down into primary and secondary disabilities. However it should be noted that not all primary and secondary disabilities listed below will apply to all individuals; rather the lists are reflective of the disabilities commonly observed among this unique population.

The primary disabilities of FASD are those that most directly reflect the underlying central nervous system damage caused by prenatal exposure to alcohol. This damage manifests in a range of difficulties with adaptive behaviour, attention, cognition, executive functioning and memory. As a result, individuals with FASD may have trouble with abstract reasoning, organization, planning, understanding or recalling a sequence of events, connecting cause and effect relationships, and/or regulating their own behaviours and emotions.

Typical brain-based, primary disabilities of FASD include:

• inconsistent memory and recall
• inability to filter out environmental or emotional distractions and sensory stimuli
• slow and inconsistent cognitive and auditory processing
• decreased mental stamina
• difficulty interpreting and applying abstract concepts (for example, managing money and time)
• impulsivity and poor judgment
• inability to predict outcomes (of their own or others' actions)
• difficulty shifting from one context to another
• resistance to change
• inability to see another person's perspective
• inability to recognize indirect social cues.

Another common characteristic of individuals diagnosed with FASD is dysmaturity. Dysmaturity is a term used to refer to widely varying levels of maturity in different areas of development, such as expressive language and language comprehension, social and self-care skills, and awareness and regulation of emotions. Individuals with FASD do not have the ability to meet many of society’s age-based social and academic expectations. Since FASD is not usually outwardly visible, the effects of dysmaturity can be confusing and frustrating to people who have FASD and to those around them.

Alcohol is toxic and can affect any organ or system of the fetus. Individuals with FASD can also have permanent vision and hearing problems; poorly developed bones, limbs and fingers; and damage to the heart, kidney, liver and other organs.

Secondary disabilities are those not present at birth, but occur later in life as a result of the primary disabilities associated with FASD. They include:

• mental health problems
• disrupted school experience (suspension, expulsion, and/or drop-out)
• involvement with the law (trouble with authorities, charged and/or convicted of a crime)
• confinement (inpatient treatment for mental health and/or alcohol/drug problems, or incarceration for crime)
• alcohol and/or drug problems
• poor academic achievement and school failure
• sexually deviant behaviour
• problems with employment
• dependent living.

When combined with individuals’ primary disabilities, these secondary disabilities increase the complexity of care, and result in significant social and economic costs to society.

Causes & Risk Factors

FASD is preventable. There is no safe amount or type of alcoholic beverage, and no safe time to drink alcohol during pregnancy. Pregnant women are advised not to drink any alcohol during pregnancy.

Diagnosis & Treatment

If FASD is diagnosed early, interventions may be able to lessen its impact and prevent secondary disabilities.

Many types of treatments are available for individuals with FASD:

• medical care/specialists (for example, speech-language pathology, occupational therapy, physical therapy, mental health care, etc.)
• medication to help lessen some of the symptoms of FASD
• behavioural and educational therapy
• parent training
• alternative approaches (auditory training, creative art therapy, meditation, etc.)

An individual with FASD can be assisted by special programs with their learning and behaviour. Such assistance can enable a person with FASD to maximize their independence and achievements.

Some protective factors can help reduce the effects of FASD and help individuals with these conditions reach their full potential:

• early diagnosis
• involvement in special education and social services
• loving, nurturing and stable home environment
• absence of violence. 

Related Programs and Services

• Treatment at CAMH: Access CAMH
• Help for families from CAMH
• ConnexOntario
• Kids Help Phone at 1 800 668-6868

Additional Resources

• FASD Outreach Canada eLearning videos
• SAMHSA FASD Treatment improvement protocol addressing FASD
• The Story of Iyal  CDC (Centres for Disease Control and Prevention) video telling the story of one family living with FASD
• Fetal Alcohol Syndrome (FASD) Mothers and their counsellors talk about how alcohol  use during pregnancy affected their children; parenting; and recovering hope.
• Birth mother of person with FASD A video from NOFAS (National Organization on Fetal Alcohol Syndrome)
• Teaching Students with Fetal Alcohol Spectrum Disorder: Building Strengths, Creating Hope A teacher resource from Alberta Learning with information and specific ideas to better meet the learning needs of students with FASD
• Fetal Alcohol Spectrum Disorder: A guideline for diagnosis across the lifespan Newest FASD guidelines from the CMAJ (Canadian Medical Association Journal)
• Fetal Alcohol Spectrum Disorder: Canadian guidelines for diagnosis Older (2005)  FASD guidelines, still used by many, and a very informative document
• Alcohol Use and Pregnancy Consensus Clinical Guidelines

If you drank alcohol before you knew you were pregnant, stop drinking now and talk to your health care provider. When a pregnant woman stops drinking at any time during pregnancy, she decreases the risk of harm to her child.

If you cannot stop drinking or someone you know cannot stop drinking alcohol, help is available through CAMH’s COMPASS or any META:PHI Rapid Access Addiction Medicine Clinic.

If you are worried about your child, there are a number of diagnostic clinics in Canada.

ALBERTA

• Alberta Health Services/NEAFAN
  600 Signal Rd. (Rec Centre)
  Fort McMurray, AB T9H 3Z4
  Phone: 780 750-6678
  Website: www.neafan.ca
• Central Alberta FASD Network Adult Clinic

  #5-3608 50th Ave.
  Red Deer, AB  T4S 3Y6
  Phone: 403 342-7499 ext. 1
  Website: https://centralfasd.org/contact/
  

• FASD Assessment and Support Services

  Bridges Family Programs
  477-3rd St. SE
  Medicine Hat, AB T1A 0G8
  Phone: 403 526-7473
  Website: https://www.bridgesfamilyprograms.com/cfas.html
  

• Prairie Central FASD Clinical Services

  4838-49th St.
  Camrose, AB  T4V 1N2
  Phone: 587 386-0186
  Website: http://prairiecentralfasd.ca/assessment-and-diagnosis/ 

  • Foothills FASD Assessment and Diagnostic Clinic
    101–520 Macleod Trail SW
    High River, ABT1V 1M3
    Phone: 403 652-4776
    Website: https://www.foothillsfas.org/assessment-diagnosis
    
  • Lakeland Centre for FASD
    4824 50th St., Box 479
    Cold Lake, AB  T9M 1P3
    Phone: 780 594-9905
    Website: https://lcfasd.com/
    
    
  • Lethbridge Family Services
    FASD Assessment and Diagnostic Clinic
    1107-2nd Ave. “A” N
    Lethbridge, AB  T1H 0E6
    Phone: 403 320-9119
    
    
  • North West Central FASD Clinic
    Box 5389
    Westlock, AB  T7P 2P5
    Phone: 780 284-3415
    Website: http://nwcfasd.ca/services/assessment-diagnosis/
    
    
  • NW Alberta FASD Clinic
    10205-98th St.
    PO Box Bag 4000
    Grande Prairie, AB T8V 6V3
    Phone: 780 357-4996
    
    
  • NWR FASD Society, Mackenzie Network
    Box 3668
    High Level, AB  T0H 1Z0
    Phone: 780 926-3375
    Website: http://nwr-fasd.ab.ca/

  BRITISH COLUMBIA

  • Asante Centre

    Suite 103, 22356 McIntosh Ave.
    Maple Ridge, BC  V2X 3C1
    Phone: 604 467-7101; toll free 1 877 327-7101
    Website: https://www.asantecentre.org/
    

  • FASD Okanagan Valley Assessment and Support Society 
    #104-3402 27 Ave.

    Vernon, BC  V1T 1S1
    Phone: 250 938-5022
    Website: https://www.fasdokanagan.ca
    

  • Sunny Hill Health Centre for Children - BC Children's Hospital

    3644 Slocan St.
    Vancouver, BC  V5M 3H4
    Phone: 604 453-8300
    Website: www.bcchildrens.ca

  MANITOBA

• Manitoba FASD Centre

  1155 Notre Dame Ave.
  Winnipeg, MB R3E 3G1
  Phone: 204 258-6600
  Website: https://fasdmanitoba.com/

  NEW BRUNSWICK

• Vitalité Health Network
  275 Main St., Ste. 600
  Bathurst, NBE2A 1A9
  Phone: 506 862-3783
  Website: www.vitalitend.ca
  
  

  NORTHWEST TERRITORIES

• Adult FASD Diagnostic Clinic

  Northwest Territories Health and Social Services Authority
  PO Box 1320
  Yellowknife, NT  X1A 2L9
  Phone: 867 446-3522
  Website: www.nthssa.ca
  

• FASD Family and Community Support Program

  Northwest Territories Health and Social Services Authority
  Stanton Territorial Hospital
  PO Box 10
  Yellowknife, NT X1A 2N1
  Phone: 867 669-4195

  NUNAVUT

  • Akausisarvik – Mental Health Children & Youth Division
    PO Box 1000 Stn. 1035
    Iqaluit, NU  X0A 0H0
    Phone: 867 979-7633
    Website: https://canfasd.ca/

  ONTARIO

• Associated Youth Services of Peel (AYSP)

  160 Traders Blvd. E., Ste. 100
  Mississauga, ON  L4Z 3K7
  Phone: 905 890-5222
  Website: http://www.aysp.ca/
  

• Breaking the Cycle FASD Diagnostic Clinic

  Breaking the Cycle
  860 Richmond St. W., Ste. 100
  Toronto, ON  M6J 1C9
  Phone: 416 364-7373
  Website: www.mothercraft.ca
  

• Erinoak Kids

  1230 Central Pkwy. W.
  Mississauga, ON  L5C 0A5
  Phone: 905 855-2690
  Website: https://www.erinoakkids.ca/
  

• Fetal Alcohol Spectrum Disorder Diagnostic Clinic, St. Michael’s Hospital

  Pediatric Ambulatory Clinics
  61 Queen St. E, 2nd Floor
  Toronto, ON  M5C 2T2
  Phone: 416 867-3655
  Website: www.stmichaelshospital.com
  

• Grandview Children’s Centre

  600 Townline Rd. S.
  Oshawa, ON  L1H 7K6
  Phone: 905 728-1673
  Website: https://grandviewkids.ca
  

• Infant and Child Development Services Peel

  6660 Kennedy Rd., Ste. 200
  Mississauga, ON  L5T 2M9
  Phone: 905 564-7485
  Website: http://www.icdspeel.ca/
  

• Lansdowne Children’s Centre

  39 Mount Pleasant St.
  Brantford, ON  N3T 1S7
  Phone: 519 753-3153; toll free 1 800 454-7186
  Website: http://www.lansdownecentre.ca/about.php

• McMaster University - Ron Joyce Children’s Health Centre

  325 Wellington St. N.
  PO Box 2000
  Hamilton, ON  L8N 3Z5
  Phone: 905 521-2100 ext. 44446
  Website: www.hamiltonhealthsciences.ca 
  

• NEO Kids FASD Diagnostic Clinic

  Health Sciences North
  NEO Kids Building
  Ramsey Lake Health Centre
  41 Ramsey Lake Rd.
  Sudbury, ON  P3E 5J1
  Phone: 705 523-7120 ext. 1073
  Website: www.hsnsudbury.ca 
  

• Northwestern Ontario FASD Diagnostic Clinic

  Kenora-Rainy River Districts Child and Family Services
  820 Lakeview Dr.
  Kenora, ON  P9N 3P7
  Phone: 807 467-5437; toll free
  Website: http://www.krrcfs.ca/
  

• NorWest Community Health Centres

  PO Box 104
  Armstrong, ON  P0T 1A0
  Phone: 807 583-1145
  Website: www.norwestchc.org
  

• Peel FASD Clinical Services

  Child Development Resource Connection Peel
  75 Watline Ave., Unit 103
  Mississauga, ON  L4Z 3E5
  Phone: 905 507-9360
  Website: https://www.cdrcp.com/sp/fasd
  

• Reach Out Centre for Kids (ROCK)

  Halton FASD Assessment and Diagnostic Clinic
  Phone:  905 634-2347 ext. 1234
  Website: http://rockonline.ca
  

• Resources for Exceptional Children and Youth

  865 Westney Rd. S.
  Ajax, ON  L1S 3M4
  Phone: 905 427-8862
  Website: http://www.rfecydurham.com
  

• Surrey Place Centre
  2 Surrey Place

  Toronto, ON  M5S 2C2
  Children and Youth FASD Diagnostic Team
  833 575-5437
  FASD Adult Diagnostic Clinic
  Phone: 416 925 5141
  Website: www.surreyplace.ca
  

• Waterloo Region FASD Diagnostic Clinic

  Children's Mental Health Centre
  285 Benjamin Rd.
  Waterloo, ON  N2J 3Z4
  Phone: 519 884-1470
  Website: fasdwaterlooregion.ca
  

• Youthdale

  227 Victoria St
  Toronto, ON
  M5B 1T8
  Phone: 416-368-4896
  Website: www.youthdale.ca

  SASKATCHEWAN

  • Fetal Alcohol Spectrum Disorder Services
    Child, youth and adult diagnosis and assessment services in Northern, Central and Southern Saskatchewan, as well as links to community supports
    Website: www.saskatchewan.ca
    
   

  YUKON TERRITORY

• Children & Youth FASD Diagnostic & Support Team

  Child Development Centre
  1000 Lewes Blvd.
  PO Box 2703
  Whitehorse, YK  Y1A 2C6
  Phone: 867 456-8182; toll free 866 835-8386
  Website: http://www.cdcyukon.ca  
  

• Congenital Anomalies Support Yukon (CASY)

  Health and Social Services, Government of Yukon
  PO Box 2703
  Whitehorse, YK  Y1A 2C6
  Phone: 867 667-8563; toll free (Yukon, Nunavut and NWT) 1 800 661-0408 ext.8563
  Website: www.hss.gov.yk.ca
  

• Developmental and Diagnostic Support Clinic
  Whitehorse, YK
  Phone: 867 332-5030
• Fetal Alcohol Syndrome Society of the Yukon (FASSY)
  FASSY Office
  #120 – 205 Black St.
  Whitehorse, YK  Y1A 1J1
  Phone: 867 393-4948
  Website: http://fassy.org