Foetal Alcohol Spectrum Disorder: The hidden disability we all need to understand better

To mark International Foetal Alcohol Spectrum Disorder (FASD) Awareness Day on 9 September, colleagues from Kent and Medway Mental Health NHS Trust’s Children’s Mental Health and All Age Eating Disorders directorate want to share some of what they have learned about FASD and why greater awareness matters across health, social care and education.

Despite being one of the most preventable causes of lifelong neurodevelopmental difficulties, FASD remains widely misunderstood. While the trust is not commissioned to provide specialist FASD services, it supports children, young people and families affected by FASD, and see first-hand the difference that understanding can make.

Perhaps the most important message is also the simplest: there is no known safe amount of alcohol during pregnancy, so the safest option is not to drink alcohol at all. Alcohol passes through the placenta to the developing baby, and because the liver is one of the last organs to fully develop, it cannot process alcohol in the same way as an adult. 

What is FASD?

FASD is caused by exposure to alcohol during pregnancy and can affect how a child's brain and body develop. It can lead to difficulties with:

•    Learning
•    Memory
•    Attention
•    Communication
•    Emotional regulation
•    Social understanding

Some children have physical features associated with FASD, but many do not.

The challenge is that FASD can easily be mistaken for behavioural problems or poor choices:

•    A child who appears not to listen may be struggling to process information
•    A young person who repeatedly breaks rules may find it difficult to understand consequences or adapt to changing situations. 

What can look like defiance is often confusion, anxiety or an unmet need.

Why do we all need to learn more about FASD?

Research suggests FASD may affect around 1.8% of children (although the true figure may be higher), yet awareness among professionals remains limited.

What should we consider doing differently?

The trust encourages colleagues and other healthcare professionals to:

•    Use simple language
•    Give one instruction at a time
•    Allow extra processing time
•    Maintain routines
•    Focus on the reason behind behaviours

Continuing to expand professional knowledge will help children get the right support, helping families feel understood, and ensuring professionals can make reasonable adjustments that help young people thrive.

Greater understanding and awareness of FASD will enable improved support for children, young people and families who live with its effects every day.