“The most outstanding characteristics of FASD are bad judgment & the inability to make the connection between an act & its consequences”

Fetal  Alcohol Spectrum Disorders (FASD) are a group of conditions caused by prenatal alcohol exposure. FASD is a brain-based disability affecting development, learning, behavior, and daily functioning across the lifespan. 

Conservative estimates suggest FASD affects 1 in 20 people in the United States—that's 5% of the population, more prevalent than autism spectrum disorder. 

Despite its prevalence, FASD remains one of the most underdiagnosed and misunderstood disabilities. Most medical, mental health, and education professionals receive little to no training on FASD during their graduate programs. 

FASD doesn't have one "look."  Most individuals with FASD have no distinctive physical features, leading to the dangerous assumption that they should be able to perform at their chronological age level.  

Brain differences in FASD can affect:

• Executive function (planning, organization, impulse control)
• Memory (especially working memory and learning from consequences)
• Abstract thinking and understanding cause-and-effect
• Processing speed and adaptive functioning
• Emotional regulation and sensory processing
• Social communication and reading social cues

  These are neurological differences, not behavior problems or willful defiance. 

FASD is complex—symptoms overlap with many other conditions, and it's frequently misdiagnosed as :

• ADHD
• Oppositional Defiant Disorder (ODD)
• Autism Spectrum Disorder
• Conduct Disorder
• Anxiety or mood disorders
• Learning disabilities

When FASD goes unrecognized, traditional interventions often fail because they don't address the underlying brain-based differences. Families spend years trying approaches that weren't designed for how their child's brain actually works. 

While only qualified diagnosticians can diagnose FASD, these patterns may suggest the need for evaluation. Although no two people experience FASD the same way, a person living with FASD might have challenges in these areas: 

Executive functioning challenges: Impulsivity, planning, starting and completing tasks, organization, adapting to changes, inhibitory control, and time management can be difficult

Memory differences: Strong rote memory but poor working memory; remembering instructions, routines, or new information can take extra effort

Processing information: Understanding, remembering, or learning new information may require more time or different approaches

Attention: Maintaining focus during school, work, or homework can be difficult for extended periods

Abstract reasoning: Understanding ideas that aren't concrete, such as love, fairness, or hypothetical situations, may be more difficult

Generalization: Applying skills or knowledge learned in one situation to a different situation may be challenging

Academic struggles: Difficulty with math, especially word problems and abstract concepts; significant gap between verbal ability and actual performance; difficulty in school due to challenges with learning, memory, or attention

Impulsive decisions with poor judgment: Difficulty predicting outcomes of actions

Reasoning and judgment skills: Making safe choices or understanding consequences can be tough without extra guidance; repeats same mistakes despite consequences

Developmental maturity: Seems immature compared to same-age peers

Transitions and flexibility: Struggles with changes in routine; restlessness, frequent movement, or difficulty sitting still may occur

Daily living skills: Needs reminders for daily tasks despite years of practice; difficulty managing money or time; requires more supervision than expected for age

Skill inconsistency: Skills learned one day seem lost the next

Emotional regulation: Feelings can be very strong and intense, seeming disproportionate to situations, and it may take effort to manage them

Social skills: Forming connections and interacting with others may be harder; easily influenced by others; difficulty reading social cues; understanding emotions or joining conversations can be challenging

Relationships: Friendships that don't last; social isolation

Communication: Speech and language challenges; developing speech or understanding and using language may take longer

Memory and communication: Confabulation (filling in memory gaps with fabricated details, not intentional lying)

Sensory processing: Sensory inputs such as sounds, lights, taste, smell, touch, and movement can sometimes feel overwhelming or uncomfortable

Motor skills: Poor coordination; balance or fine motor skills may be affected

Sleep and eating: Sleep challenges or feeding issues, especially in early childhood

Vision or hearing: Eyes or ears may need extra care or support from specialists

Medical concerns: Heart, kidney, or bone problems; physical differences in organ or bone development may also occur

If these patterns sound familiar, consider seeking FASD evaluation.