The varying effects of alcohol have been observed by human civilization for thousands of years. Its use is often varied, having a place in all levels of society and utilised consistently in medicine, religion, and social ritualism. The eternal contradiction between alcohol as essential for pleasure yet being a catalyst for pain and societal evil, is found throughout much of world history. In modern times, the UK in particular has a close relationship with alcohol; it is central to many of our traditions such as weddings, christenings, funerals and social gatherings.
While few would argue against the potential harm excessive alcohol consumption can have on health, a substantial number of drinkers regularly consume more than the recommended daily and weekly guidelines, despite the best efforts of numerous health campaigns to educate and inform the public on alcohol’s many and varied dangers. Throughout our modern culture there still exists a conflict of views as to whether alcohol should be seen as a desirable elixir or a portentous poison. It has long been accepted that alcohol can have a negative impact on family life, capable of leading to abuse, domestic violence, and neglect of children. More recently the debate over alcohol has shifted focus to include the cost to the individual when alcohol leads to premature illness and death, and the impact this can have on the community, the public health services and the police.
Whatever the benefits or disadvantages of alcohol, for one important group it will always be a toxin to be avoided. That group is the unborn child. Any amount of Prenatal Alcohol Exposure (PAE) can result in a child being born with a form of FASD. FASD – Foetal Alcohol Spectrum Disorder – is the umbrella term for a range of preventable conditions that are all related to Prenatal Alcohol Exposure. Since 1985, medical statistics cite FASD as the most common, non-genetic cause of learning disability in the UK. It is now accepted that PAE is the most common, yet preventable cause of acquired brain damage and mental retardation in the world. UK research suggests that at least 1% of the British population is affected by FASD, equating to over 7,500 babies born annually with irreversible conditions related to alcohol exposure in utero. International statistics highlight between 2% and 5% of newborns are affected, with the most recent UK study proposing that between 6 – 17% of all newborn babies showed signs consistent with Prenatal Alcohol Exposure.
Of all the common substances of abuse (marijuana, cocaine, heroin and tobacco) alcohol results in by the far the most serious and permanent physical and neuro-behavioural conditions in unborn children. Alcohol is classed as a teratogen – a substance that easily passes from mother to infant within the womb and has a toxic effect on the embryo or foetus, frequently resulting in birth defects or malformity. Alcohol effects developing cells in many ways, causing cellular damage, dysfunction and even death. It disrupts the ability of cells to generate energy and interferes with growth factors necessary for normal development. As a potent neurotoxin, alcohol is particularly devastating to the development of the brain and spinal cord, leading to more rapid cell death and vital parts of the brain never even developing at all.
The impact of alcohol exposure leads to a categorization of harm under the umbrella term of FASD:
- Foetal Alcohol Syndrome (FAS) – Death, miscarriage and stillbirth are at the most extreme ends of alcohol consumption during pregnancy. Children born with FAS may present with physical birth defects such as abnormal facial features, microcephaly (small head indicating a poorly formed or underdeveloped brain) and problems with the normal functioning of vital organs such as the heart and kidneys. Children may also present with growth problems and damage to the Central Nervous System. CNS and brain damage may present as learning, memory and communication problems, effecting vision and hearing.
- Partial Foetal Alcohol Syndrome (PFAS) – PFAS is diagnosed when the child has a confirmed history of Prenatal Alcohol Exposure but doesn’t present with physical deficiencies in growth or complete facial dysmorphology. Damage to the brain and CNS can be present at the same level as FAS.
- Alcohol-related Birth Defects (ARBD) – Those with ARBD may present with specific problems to their hearing, sight, bones, heart and kidneys, or have a mix of abnormal or limiting health conditions as a result of Prenatal Alcohol Exposure.
- Neurodevelopmental Disorder as a result of Prenatal Exposure to Alcohol (ND-PAE) – People diagnosed with ND-PAE present with intellectual disabilities and behavioural They may struggle with learning, performing poorly in school. They may be inattentive, have difficulty with memory and recall, and have poor judgement and impulse control as a result of poor brain development and permanent damage.
FASD is often called a hidden or invisible disability; it can frequently present with behavioural issues but without visible and physical signs of disorder such as facial abnormality or reduced growth patterns. Only 10% of children prenatally exposed to alcohol have all the physical characteristics required for a diagnosis of FASD. Behavioural problems may be wrongly attributed to conditions such as ADHD or Autism – this can often result in FASD remaining completely undiagnosed, meaning the affected child and parents never receive the correct treatment, advice or support they require.
FASD affects everyone differently; no two presentations of FASD are the same. For both child and parent, getting the right support and information is vital. FASD, especially if unrecognised and unsupported, can contribute to serious social and behavioural problems, having a detrimental effect on the individual and those around them throughout all stages of their life. Behavioural issues are common and often result in a higher chance of being excluded from school, not achieving average grades, being socially isolated, and struggling with social interactions. As people with FASD mature, they are much more likely than average to develop mental health problems. Many (roughly 80 per cent) find living independently as adults difficult, and many jobs are unsuitable for them. Processing information is more difficult, as is differentiating between fantasy and reality.
FASD victims have a much higher rate of incarceration than average, and commit a disproportionate amount of crime. About 60 percent of FASD victims will be charged or convicted of a crime. Poor impulse control and anger management skills are common, leading in some to destructive and harmful behaviour. About half of individuals with FAS demonstrate inappropriate sexual behaviour, including touching, unwanted advances, and dangerous promiscuity. Roughly 50 per cent of FAS victims over the age of 12 will be incarcerated or confined in their lives, either through being sentenced to imprisonment; or committed for substance abuse or psychiatric care.
Although there is no cure for FASD (the condition typically persists for a lifetime and is irreversible), research shows that early intervention treatment services can drastically affect positive outcomes and improve a child’s development. Early diagnoses, active involvement in special education and social services, and a loving, stable, non-violent and nurturing home environment are all factors that contribute to an increased likelihood of long term success and happiness. Despite the challenges they face, people with FASD are shown to be creative, loving, and imaginative. They are socially competent, gregarious and show increased empathy toward people and animals. They often show an affinity for language and words. With the right support in place, the effects of FASD can be reduced and people with the condition can reach their full potential; their inherent strengths encouraged and admired.
Able Training are now delivering a course on Understanding Foetal Alcohol Spectrum Disorder. This course is ideal for social workers, carers, teachers, foster carers, and all those who work with vulnerable people and those supporting children on a regular basis. For more information on this course, and many more of the courses we offer please contact us.