Medical Notes
FASD has a whole range of presentations from milder difficulties with concentration to the most extreme situations which lead to a diagnosis such as ADHD or autism. What is important to bear in mind is that not all children have the facial features of FAS (Foetal Alcohol Syndrome), but they can still have a severe condition. Some 10% of children affected will have the facial features of FAS, and therefore it can be recognised at birth. For the majority however it is more likely to present as behavioural or developmental difficulties, which are frequently not realised until a later stage, such as when a child is at school.
We do not know how common FASD is in the UK as no study has ever been undertaken. However, if we take what information has been found in other parts of the world, rates of 1% having FASD have been shown, with this increasing to 10% amongst high risk sections of the population.
To obtain a diagnosis, the first step is to consult a GP. They are in overall charge of the healthcare and can direct the care towards other teams such as Paediatrics, Genetics and Developmental Psychiatry. It is also important that other possible conditions are ruled out and the underlying exposure risk is clarified, ie did the mother drink?
As well as a diagnosis, it is essential that all the associated functional and physical difficulties are assessed as well to ensure best management is given going forward. This will, in reality, probably require a multi-disciplinary approach, but the GP (or Community Paediatrician) will remain the first point of contact for any concerns or worries.
The BMA published a report in 2007 on this issue. To view it follow this link:
Professional Intervention & Support may well be offered or required by the following disciplines (NB this list is not exhaustive or pertinent to every child):
Audiology- frequent ear infections can be common in the FASD child.
Cardiology - some children have heart and other organ defects, which may require corrective surgery.
Child / Adolescent Psychiatry- help with behaviour strategies and dealing with emotions.
Dentistry- poor enamel, odd-shaped teeth; also, for those with FAS features, because of the mis-shaped facial structure, other problems can occur.
Genito-Urinary Medicine - problems with bladder control and structure, genital deformities. Referrals may also be given to Incontinence Nurse Advisors.
Occupational Therapy- advice on daily living skills such as dressing, in school with writing and seating arrangements, help with manipulative and fine motor skills.
Optician / Optometry- long or short-sightedness, squints, other vision and developmental problems with the eyes.
Physiotherapy- under-developed muscle tone, problems with hip and shoulder joints, gross motor skills and balance can all be aided by physiotherapy.
Speech & Language Therapy- many FASD children present with advanced expressive language, but poor receptive skills. S< can also aid social skills, such as turn taking, waiting in queues, holding a conversation, listening skills.
For Medical Professionals who wish to study / research FASD further, please contact us for the latest suggested reading list and details of current research studies
