Functional Disabilities Associated with Prenatal Alcohol Exposure

© 2006 Teresa Kellerman

Most children and adults with Fetal Alcohol Spectrum Disorders (FASD) do not have any noticeable physiological characteristics, and most have cognitive development in the normal range.1 However, almost all individuals affected by prenatal exposure to alcohol have functional disabilities that affect their ability to learn and control behavior.

According to the Centers for Disease Control and Prevention’s Guidelines for Identifying and Referring Persons with Fetal Alcohol Syndrome2, certain symptoms can be observed in children affected by prenatal exposure to alcohol. The CDC guidelines list a wide array of functional disabilities that might be present. They are as follows:

In younger children, developmental delays in multiple domains may be present. However, many children with FASD do not have significant developmental delays and neurological problems may not become apparent until the school years.

In older children, deficits are seen in at least three of the following functional domains:

  • Cognitive or developmental deficits or discrepancies
  • Executive function
  • Motor function delays
  • Attention deficits (with or without hyperactivity)
  • Social skill deficits
  • Other deficits such as sensory problems, pragmatic language problems, or memory deficits

Most individuals with FASD have cognitive development in the normal range and do not have significant motor deficits.

However, most children and adults with FASD do have problems in the areas of executive functions, social skills, sensory integration, and memory deficits. The language problems are most notable in the area of comprehension, even with typically good expressive language skills.

If an individual with confirmed or suspected prenatal exposure to alcohol exhibits the symptoms of functional limitations listed above, the CDC guidelines suggest that the individual receive a thorough neuropsychological evaluation to determine the functional level. In this way, appropriate intervention services can be ascertained to help the individual achieve success and minimize the effects of serious secondary disabilities associated with FASD.

1. Streissguth, A.P., Barr, H.M., Kogan, J. & Bookstein, F. L., "Understanding the Occurrence of Secondary Disabilities in Clients with Fetal Alcohol Syndrome (FAS) and Fetal Alcohol Effects (FAE)," Final Report to the Centers for Disease Control and Prevention (CDC), August, 1996, Seattle: University of Washington, Fetal Alcohol & Drug Unit, Tech. Rep. No. 96-06, (1996).

2. Centers for Disease Control and Prevention. Guidelines for identifying and referring persons with fetal alcohol syndrome. MMWR 2005;54(No. RR-11):[5-6].