FASD: Where we have come from, trends, and future directions

Fetal alcohol spectrum disorder (FASD) refers to a range of conditions caused by prenatalexposure to alcohol. First described in the 1970s as fetal alcohol syndrome, continuingprogress has been made in the understanding, recognition and treatment of what is nowrecognised to be a range of related neurodevelopmental disorders. FASD is common,especially in countries with higher levels of alcohol consumption such as those in Europeand North America, where the prevalence is estimated to be around 3%. A number ofdiagnostic systems are in operation in different countries, and work is ongoing to develop aninternationally agreed set of diagnostic criteria. People with FASD often have otherdevelopmental, mental and somatic conditions, and there appears to be a high rate oftraumatic and other adverse experiences in this population. People with FASD are atincreased risk of being involved in the criminal justice system, but they may be ill-equippedto successfully navigate it and are likely to provide false confessions, leading to wrongfulconvictions. Some interventions and treatments have been shown to be effective inimproving functioning in children and families affected by FASD, which tend to take the formof coaching, education, advocacy and support. People with FASD have many strengths,which are often overlooked in research. They have been described as skilled musicians,artists and sportspeople with wide vocabularies who are resilient, compassionate, hardworking, and kind. Increasing attention is being paid to FASD but this is not enough. Moreresearch, diagnostic capacity, recognition, understanding, infrastructure and support areneeded across the world.