REVIEW
Fetal alcohol spectrum disorders : A brief overview
FASD is a common disorder that often is unrecognised and might present with one of many comorbid presentations . Recognition and management are the key to changing the trajectory of people ’ s lives
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Raja Mukherjee PhD Consultant Psychiatrist and Service Lead , National FASD Clinic , UK ; Honorary Professor , University of Salford , School of Health and Social Science , Salford , UK
Fetal alcohol spectrum disorders ( FASD ) represent a range of body and brain conditions that are caused by consuming alcohol during pregnancy . First labelled and recognised in the English scientific journals by Smith and Jones as fetal alcohol syndrome ( FAS ), it later became understood and established that this condition had existed for a long time but had simply not been properly identified or labelled . 1
Initial reports focused on some specific groups and very much on the physical presentation more than the neurological . For example , Smith and Jones reported on a case series from a first Nations population based around Seattle ,
Washington , USA . Earlier reports , in other journals , included a large case series from France identifying children who had physical and cognitive difficulties . 1
It was only later that the spectrum of presentation began to be better understood and the physical stigma took less prominence . it became understood that the cognitive features have the greatest impact on behaviour and cause the lifelong difficulties . 2
Diagnostic criteria Early work identified four components that were crucial to a diagnosis . These included facial features , growth retardation , cognitive deficits and alcohol exposure .
The facial features include short palpebral fissures , an elongated and thinner philtrum and a thin upper lip vermilion as core ( Figure 1 ). Additionally , a small head size and flat midface were noted as discriminatory but the former being
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