There are different characteristics that accompany FAS in the different stages of a child's life. "At birth, infants with intrauterine exposure to alcohol frequently have low birth rate; pre-term delivery; a small head circumference; and the characteri stic facial features of the eyes, nose, and mouth" (Phelps, 1995, p. 204). Some of the facial abnormalities that are common of children with FAS are: microcephaly, small eye openings, broad nasal bridge, flattened mid-faces, thin upper lip, skin folds at the corners of the eyes, indistinct groove on the upper lip, and an abnormal smallness of the lower jaw (Wekselman, Spiering, Hetteberg, Kenner, & Flandermeyer, 1995; Phelps, 1995). These infants also display developmental delays, psychomotor retardatio n, and cognitive deficits.
As a child with FAS progresses into preschool physical, cognitive and behavioral abnormalities are more noticeable. These children are not the average weight and height compared to the children at the same age level. Cognitive manifestations is another problem with children who have FAS. "Studies have found that preschoolers with FAS generally score in the mentally handicapped to dull normal range of intelligence" (Phelps, 1995, p. 205). Children with FAS usually h ave language delay problems during their preschool years. Research has also shown that these children exhibit poorly articulated language, delayed use of sentences or more complex grammatical units, and inadequate comprehension (Phelps, 1995). There are many behavioral characteristics that are common among children with FAS. The most common characteristic is hyperactivity (Phelps, 1995). "Hyperactivity is found in 85% of FAS-affected children regardless of IQ" (Wekeselman et al., 1995, p. 299 ). School failure, behavior management difficulties, and safety issues are some of the problems associated with hyperactivity and attention deficit disorder. Another behavioral abnormality of with children with FAS, is social problems. "Specific diffic ulties included inability to respect personal boundaries, inappropriately affectionate, demanding of attention, bragging, stubborn, poor peer relations, and overly tactile in social interactions" (Phelps, 1995, p. 206). Children are sometimes not diagnosed with FAS until they reach kindergarten and are in a real school setting. School-aged children with FAS still have most of the same physical and mental problems that were diagnosed when they were younger. The craniofa cial malformations is one of the only physical characteristic that diminishes during late childhood (Phelps, 1995).
"Several studies have evaluated specific areas of cognitive dysfunction in school-age children exposed prenatally to alcohol. Researchers have substantiated: (a) short term memory deficits in verbal and visual material; (b) inadequate processing of inf ormation, reflected b sparse integration of information and poor quality of responses; (c) inflexible approaches to problem solving; and (d) difficulties in mathematical computations" (Phelps, 1995 p. 206).
The behavioral manifestations of a child with FAS during the early years of life are still apparent in children who are in grade school. Hyperactivity is still the most common characteristic portrayed by these children. Some of the descriptions used to explain these school-aged children's behaviors include: distractible, impulsive, inattentive, uncooperative, poorly organized, and little persistence toward task completion (Phelps, 1995).
As a child reaches puberty and develops into an adult, some of the physical, mental and behavioral characteristics change. These adolescents begin to gain weight, but still remain short and microphalic (Phelps, 1995).
Cognitive abilities of children with FAS continue to be low through adolescence and adulthood. Low Academic performance scores of adolescents and adults are persistent throughout their lives. Many cognitive tests have been done on adolescent/adults wi th FAS, and each of them have found deficiencies in mathematics and reading comprehension (Shelton & Cook, 1993).
The behavioral manifestations of adolescents and adults with FAS continue to concentrate around the problem of hyperactivity. Inattentiveness, distractibility, restlessness , and agitation are the main behaviors stem from hyperactivity. "Vineland Adap tive Behavior Scales results suggest that communication and socialization skills average around the seven year old range"(Phelps, 1995, p. 207).
The prevalence of children with FAS is on the rise. More than ever, children are being diagnosed with FAS. Better techniques and knowledge by physicians are accountable for the increase. Physicians are diagnosing more babies today with FAS, because th ey have more knowledge and resources to evaluate the children at risk. FAS has no racial barriers and has been reported by variable ages from neonatal to young adult (Becker, Warr-Leeper, & Leeper, 1990).
Estimates in the United States of people with FA S vary from 2 live births per 1,000 to 1 per 750 (Shelton & Cook, 1993). "In a medical review of 5602 women, six instances of FAS were identified among 38 children of alcohol abusing women. Although 22 of the 38 were traced at follow-up, the outcome fo r the 6 FAS cases per se was not specified. Nevertheless, 18 of 22 children of the alcohol-abusing women were found to be in state hospitals" (Emhart, Greene, Sokol, Martier, Boyd, & Ager, 1995, p.1550). For a doctor to identify a child as having FAS, he/she must have the proper education. A test to see if a child has a central nervous system dysfunction or growth deficiency is not enough for a reliable diagnosis.
An accurate diagnosis would also involve a facial phenotype study (Astley & Clarren, 1 995). The Southwestern Native Americans have the highest incidence of FAS in the United States (Shelton & Cook, 1993). "Native Americans are three times as likely as Caucasians to produce FAS children" (Shelton & Cook, 1993, p. 45). Tribes that have a loose social organization reflect a higher rate of FAS compared to a structured organization because the structured organization views a alcoholic female in the tribe as socially unacceptable (Shelton & Cook, 1993). More cases of FAS are being diagnosed , but there is many children who slip through the cracks and do not receive the support that is needed.
There are few interventions and programs to help children that are affected by FAS. "Most states fail to identify FAS program coordinators, it is difficult to ascertain respective program parameters" (Shelton & Cook, 1993, p. 45). Many children with FAS are living with an alcoholic parent. Children of alcoholics are at greater risk for developing social and emotional problems that need intervention options so they do not follow in their parents footsteps and become alcoholics (Wekselman et al., 199 5). "Even though public schools are attempting to work with FAS, the bottom line is that more research needs to be done on treating FAS" (Shelton & Cook, 1993, p.46).
Educators and administration personnel working in the school system should be knowledgeable about FAS and the different age characteristics, degrees of incidences , and interventions that are available to their students. All children with FAS are at ri sk for failure in school and in every day life. With proper diagnosis and treatment that is available, some of these failures will be avoided.
The main element that is causing FAS is addiction. Children with FAS did not have the choice of saying no and have to live with their mothers decision to drink every day of their lives. Something needs to be done with mothers who have babies that are ad dicted at birth. Laws and other regulations will probably not solve the problem, but make it more complex. A mother shouldn't have a child if she has an addiction problem. Woman should be able to receive free abortions if they are addicts and don't wan t to quit drinking during their pregnancy. A child should never be born with fetal alcohol syndrome.
- Astley, S. J., & Clarren, S. K. (1995).
- A fetal alcohol syndrome screening tool. Alcoholism: Clinical and Experimental Reearch. 19, 1565-1571. Becker, M., Warr-Leeper, G. A., Leeper, H. A. (1990).
- Fetal alcohol syndrome: a description of oral motor, articulatory, short-term memory, grammatical, and semantic abilities. Journal of Communication Disorders. 23, 97-124. Ernhart, C. B., Greene, T., Sokol, R. J., Martier, S., Boyed, T. A., Ager, J. (1995).
- Neonatal diagnosis of fetal alcohol syndrome: not necessarily a hopeless prognosis. Alcoholism: Clinical and Experimental Research. 19, 1550-1557. Phelps, L. (1995).
- Psychoeducational outcomes of fetal alcohol syndrome. School Psychology Review. 24, 200-211. Shelton, M., Cook, M. (1993).
- Fetal alcohol syndrome: facts and prevention. Preventing School Failure. 37, 44-46. Wekselman, K., Spiering, K., Hetteberg, C., Kenner, C., Flandermeyer, A. (1995).
- Fetal alcohol syndrome from infancy through childhood: a review of the literature. Journal of Pediatric Nursing. 10, 296-303.