Fetal alcohol spectrum disorder

Also called FASD, Foetal alcohol spectrum disorder

Brain differences caused by alcohol before birth. Probably the most under-diagnosed condition in this library.

What it is

FASD is thought to affect somewhere between 2% and 4% of the UK population, which would make it more common than autism. Almost nobody has a diagnosis.

Alcohol crosses the placenta and interferes with how the brain develops. The result is a lifelong set of differences: executive function, memory, impulse control, cause-and-effect reasoning, and often sensory processing.

Most children with FASD have no distinctive facial features at all. That surprises people, and it is why the visible-features stereotype has held diagnosis back for decades.

FASD is heavily over-represented among children who are fostered and adopted, which makes it a condition every corporate parent should know about.

Signs you might notice

A large gap between how articulate a child sounds and what they can actually do.

Memory that does not hold: something learned on Monday is genuinely gone by Wednesday, and it gets read as defiance.

Cause and effect not connecting, so consequences do not shape behaviour the way they do for other children.

Sensory sensitivity, poor sleep, and difficulty with change.

Emotional age well behind chronological age, often by half.

How it can affect day-to-day life

The tragedy of FASD is how well conventional parenting and behaviour management fail it. Reward charts and consequences rely on remembering, on connecting actions to outcomes, and on generalising from one situation to another. Those are exactly the skills affected.

So the child gets labelled naughty, the parents get labelled inconsistent, and everybody tries harder at the thing that does not work.

Without recognition, the secondary outcomes are stark: school exclusion, mental ill health, unemployment and contact with the criminal justice system are all substantially raised. With recognition and the right environment, they fall sharply.

Supporting someone well

Think brain-based, not behaviour-based. Ask "can't" before "won't", every time. It changes what you do next.

Externalise memory: visual schedules, photographs, checklists, the same routine daily.

Reduce choice. Two options, not five.

Teach the same thing in the same place repeatedly. Generalisation does not happen on its own.

Match support to developmental age rather than to the birthday.

Reduce sensory load before expecting regulation.

Our neurodiversity and SEND pre-screening maps needs across all four SEND areas, which fits FASD better than a single-condition checklist would. Fiducia Life carries the visual daily structure and the Calm Room, and Fiducia Guardian is built for exactly the fostering and adoption situation where a child's history and health sit across several agencies.

Where to get help

Ask a GP or paediatrician for referral to a FASD assessment service. They are scarce, so persistence matters.

The National Organisation for FASD provide training that schools and social workers can actually use.

Support does not require the diagnosis. Tell the SENCo what the child needs and ask for it under the SEND Code of Practice.