Clinical Conversations: Fetal Alcohol Syndrome – A Practical Approach for GPs | Part two

Clinical Conversations: Fetal Alcohol Syndrome – A Practical Approach for GPs | Part two


Fetal alcohol spectrum disorder (FASD) is an underdiagnosed condition that should be suspected in patients with neurodevelopmental delay, learning difficulties and in some cases, specific facial features.

Those who have been in the justice system are also at high risk, based on research by A/Prof. Carmela Pestell and her colleagues. She has been involved with FASD for decades and wants to increase awareness of this condition. Early diagnosis and intervention gives the best chance of a productive life for the person with FASD.

This is part two of this series. Read Part 1 >>

Practice points

• Any clinician that is taking a developmental history should always ask whether or not there was alcohol exposure during pregnancy.
• Children are quite individual with FASD and are at risk of a whole host of different secondary long-term outcomes. They have a lower life expectancy, they are more likely to develop substance issues themselves, they are more likely to come into contact with the justice system or develop severe mental health challenges.
• It is a myth that all children with FASD will have an intellectual difficulty; two thirds may have average to high average intelligence, but they have particular struggles in certain areas.
• An accurate diagnosis requires a multidisciplinary team approach. It is very important to tease out the child’s strengths and weaknesses and determine their unique cognitive profiles. If we know these, then we can then help tailor appropriate treatment intervention. Neuropsychological input can be particularly useful for these cases.

Are there any lifestyle or genetic factors that would make FASD more or less likely?

There has been some research looking at epigenetic factors, but it is still in its very early stages. I think alcohol consumption during pregnancy has a really complex aetiology. Given the high risk groups in which it is likely to occur, ...

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