Preparation for Child Psych PRITE and Boards
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Introduction

Fetal alcohol spectrum disorders (FASD) is a term that encapsulates different consequences of prenatal exposure to alcohol. The prevalence is about 1%. Specific syndromes of FASD include alcohol-related neurodevelopmental disorder (ARND) and fetal alcohol syndrome.

Pathophyisiology

  • Alcohol and acetaldehyde readily cross the placenta and can cause fetal demise and/or spontaneous abortion.
  • A surviving infant of an alcohol-abusing mother is likely develop some combination of neurodevelopmental and cognitive abnormalities, which are referred to as fetal alcoholism spectrum disorder (FASD).

Fetal alcohol syndrome

Fetal alcohol syndrome (FAS) occurs in 5% of children of alcohol-abusing mothers.

  • The prevalence in US is about 0.1%

Individuals with FAS exhibit prenatal and postnatal growth retardation as well as functional and structural CNS abnormalities.

  • Many microcephaly, low birth weight, an atrial septal defect, and syndactyly.
  • Characteristic dyspmorphic features include mid-face hypoplasia, flat nasal bridge, an absent philtrum, small palpebral fissures, and an epicanthal eye fold.
  • Most children with FAS will have ADHD.
  • mood diorders, ODD, and seizures are common.

Other developmental impairments

  • Cognitive impairment may be global (intellectual disability) or specific (math learning disability is common).
  • While ADHD is nearly universal, children with FAS have particular difficulty with encoding of information and ability to shift attentional sets (K&S)
  • Gross and fine motor skills can be impaired, with visual-spatial coordination a particular area of vulnerability.
  • Social perception or social communication problems that make it difficult for them to grasp the subtler aspects of human interactions (K&S)