Tact: Harm of drinking during pregnancy lasts a lifetime

Tuesday, 22 February 2011 12:00 AM

Kevin Williams, Chief Executive of The Adolescent and Children's Trust (TACT) explains the impact of foetal alcohol spectrum disorder (FASD) on the unborn child and its lifelong consequences.

On 19 January 1725, The London College of Physicians told the House of Commons: "We do think it our duty humbly to represent that we have concern observed... the frequent use of several sorts of distilled Spirituous Liquors... and too often the cause of weak, feeble, distempered children, who must be instead of advantage and strength, a charge to their country."

The language might have changed but the problem remains nearly 300 years after these words were spoken: foetal alcohol spectrum disorder (FASD) remains the largest preventable disability in the western world. This is a real scandal, yet we have failed to address the consequences of alcohol intake in early pregnancy.

FASD is a term that describes a range of effects that can occur in a child whose mother drank alcohol when pregnant. It is an incurable condition with a very conservative estimate of 7,000 children affected each year. However, it can be diagnosed and, with the right strategies in place, much can be done to help those affected.

Part of the problem with analysing the impact of FASD is that there are many variables and there has been little research. Traits of those affected by FASD include poor memory, hyperactivity, short attention span or difficulty in communicating or coping with social situations.

Children with FASD can be misdiagnosed with similar, but distinct, conditions such as autism or ADHD. They might not be diagnosed at all and just labelled as "naughty" or "disruptive". If undiagnosed, children with FASD are likely to suffer long-term harmful consequences such as disrupted school experiences, substance misuse, unemployment, homelessness and criminality.

Children in care are particularly at risk. More than 80 per cent are in care because of abuse and neglect, family dysfunction or families experiencing acute stress. We know that alcohol and drugs play a huge part in the chaos of these families. We also know that children in care are more likely than their peers to abuse alcohol and drugs and more likely to have their own children taken into care.

This cycle means that we must routinely collect data about maternal alcohol misuse during pregnancy so that we can properly assess the needs of the care population.
We need a range of measures to help reduce and deal with the repercussions of FASD, including better diagnosis. Indeed, FASD assessment should take place as a matter of course for children entering the care system with a history of maternal alcohol abuse. And crucially, we need training for social workers, education and health professionals on the strategies needed to help affected children.

Of course, these measures have financial implications. In the current economic environment, local authorities may be concerned by potential costs. However, the long-term benefit of identification and intervention hugely outweighs any short-term expenditure.

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