Fetal Alcohol Syndrome (FAS) is one of the most common and devastating birth abnormalities among American children. This paper will provide an in-depth look at FAS, using four reliable sources as a basis of this analysis. The sources used are Streissguth, Jacobson & Jacobson, the National Center on Birth Defects and Developmental Disabilities (NCBDDD), and National Organization on Fetal Alcohol Syndrome (NOFAS). The information obtained from these sources will be compared with the textbook Infants and Children Prenatal Through Middle Childhood (Berk, 2001). FAS is a combination of birth defects that is associated with consuming alcohol during pregnancy. It is the leading cause of mental retardation and birth defects, and is entirely preventable. About 12,000 infants are born every year with FAS, while three times this number have ARND or ARBD (NOFAS).

Those with FAS have a distinctive set of growth deficiencies, facial abnormalities, and central nervous system (CNS) dysfunction (NOFAS). Facial abnormalities include a thin upper lip, a flat midface, and short eyelid openings (Jacobson & Jacobson). Learning and behavioral problems include difficulties with judgment, attention, and memory, while other neurological problems include bad eye-hand coordination and limited motor skills (NOFAS).

Individuals with FAS can have a variety of defining characteristics. Many people with FAS have characteristic facial features, growth deficiencies, and CNS effects (Streissguth). However, notes Streissguth, "others have only partial manifestations, usually the CNS effects without the characteristic facial features or growth deficiency" (p. 5). Individuals with FAS often score well on language tests, but have difficulty with arithmetic and attention. A substantial number of FAS individuals have an IQ in the low average to average range, and are not mentally retarded (Jacobson & Jacobson).

The terms FAS, fetal alcohol effects (FAE), possible fetal alcohol effects (PFAE), and alcohol-related neurodevelopmental disorder (ARND) are not interchangeable. Notes Streissguth, "Children who have only some of the characteristics of FAS (i.e., not enough for a full diagnosis) are often said to have fetal alcohol effects (FAE) or possible fetal alcohol effects (PFAE)" (p. 5). The terms FAE and PFAE have no distinct distinguishing criteria that make them a separate diagnosis, although they can be as destructive as FAS on the patient. The Institute of Medicine introduced the term alcohol-related neurodevelopmental disorder (ARND) in the mid-1980s, a term that centered in on the CNS characteristics of the disease, rather than growth deficiencies and facial characteristics. ARND is often used synonymously with FAS, but it is important to note that ARND can be caused by factors other than (and including) alcohol, so ARND and FAS are not truly synonyms (Streissguth). The term Alcohol-Related Birth Defects (ARBD) refers to "malformations in the skeletal and major organ systems" (NOFAS).

Like individuals in the general population, people with FAS have a wide variety of talents and abilities. Father, they have a wide range of intellectual and functional capabilities that are often related to the location and degree of brain damage during development. Those with FAS have a number of secondary disabilities, including mental illness, drug and alcohol problems, problems with the law, and drop-outs from school are common (Streissguth).

Despite this wide range of ability, individuals with FAS often have a number of shared characteristics. "They are usually trusting (even overly trusting), loving, and naive despite their years. They can also be grumpy, irritable, and rigid. As a result of their prenatal brain damage they may have difficulty, especially as they mature, in evaluating a situation and using their past experiences to come with the problems at hand. They seem to need more protection, supervision, and structure for a longer period of life than usual" (Streissguth, p. 6).

Individuals with FAS benefit enormously from involved, educated, and caring familial and community support. A large number of individuals with FAS need "ongoing help across the life span - anything from a protective environment to a trusted...

6). Communities and families can indeed do a great deal to protect children with FAS from developing secondary disabilities, including reducing risk factors, and increasing protective factors (Streissguth).
While environment can help improve the quality of live of those with FAS, environment plays a limited role in the development and continuation of FAS ((NOFAS; Streissguth). Notes Streissguth, "a bad environment (e.g., one in which there is abuse, neglect, or poverty) cannot cause FAS, just as a good environment (e.g., one with loving, caring parents) cannot fully undo it. A good environment and proper community supports, however, can protect the person with FAS from secondary disabilities, which can be debilitating" (Streissguth, p. 4). Further, "one does not outgrow FAS, although the manifestations may change with age" (Streissguth, p. 4).

FAS and related conditions can be prevented simply if a pregnant woman abstains from alcohol (NCBDDD). Notes the NCBDDD "If a woman is drinking during pregnancy, it is never too late for her to stop." Alcoholics Anonymous and other treatment centers offer help for women with difficulties in stopping drinking alcohol. Women can contact The Substance Abuse and Mental Health Services Administration (SAMHSA) for help in finding treatment centers for alcohol abuse (NCBDDD). Further, the NCBDDD notes that prevention efforts for FAS should also focus on women who may become pregnant, who engage in unprotected sex, and drink at levels that are relatively high risk.

Unlike the other sources noted within this paper (which primarily provide a scientific and technical overview of FAS), Berk's textbook gives a real human face to the issue of FAS. In the text, Berk describes the story of Adam, a young boy with FAS whose mother died of alcohol poisoning after his birth. Adam was three years old when he entered the life of university anthropology professor Michael Dorris. Dorris recounts a number of anecdotes that show the real impact of FAS in the lives of its sufferers.

Streissguth, Jacobson & Jacobson, the NCBDDD, and NOFAS all note that FAS patients suffer from problems with poor judgment and difficulty concentrating. While this is important and informative material, it does little to humanize the disorder. In contrast, Berk also notes that FAS patients suffer from problems with poor judgment and difficulty concentrating, but she also includes anecdotes from Adam's life that help to humanize these aspects of FAS. For example, Berk notes that Adam would "buy something and not wait for change, or he would wander off in the middle of a task" (p. 117).

Further, Berk's book goes into more significant detail about the neurophysiological origin of FAS than Streissguth, Jacobson & Jacobson, the NCBDDD, or NOFAS. While Berk notes that alcohol "interferes with cell duplication and migration in the primitive neural tube" (p. 117), and that the woman's drinking of alcohol takes oxygen away from the developing fetus. In contrast, the other sources noted here do not go into such detail.

In addition, Berk's analysis effectively describes the demographics of FAS. He notes that alcohol abuse is higher in low-income areas of the population. Streissguth also discusses the demographic aspect of FAS, but Jacobson & Jacobson, the NCBDDD, and NOFAS do not give the subject a thorough treatment. Here, Berk describes Adam's lower-income origins on a reservation, while none of Streissguth, Jacobson & Jacobson, the NCBDDD, or NOFAS give such a human face to the disease.

Berk's discussion of the amount of alcohol that is safe during pregnancy differs from that of the other sources in this paper. Berk notes that one study suggests that two ounces of alcohol can result in FAS-like facial features, but notes that there is no real evidence that defines a "precise dividing line between safe and dangerous drinking levels (118). As a precaution against FAS, Berk suggests that pregnant women should not drink alcohol. In contrast, NOFAS gives less attention to studies that show that there may be a safe level of alcohol use during pregnancy. Further, NOFAS and the NCBDDD…