What is Fetal Alcohol Syndrome (FAS) and Fetal Alcohol Spectrum Disorders (FASD)?

A more complete term than Fetal Alcohol Syndrome (FAS) is Fetal Alcohol Spectrum Disorders (FASD), which is a wide range of effects that can occur in an individual whose mother consumed alcohol during pregnancy. Fetal Alcohol Spectrum Disorder / FASD can include physical disabilities, as well as difficulties with behavior and learning. There FASD related conditions are permanent and lifelong, and there is no cure.

Below, we will try to answer a lot of the common questions related to Fetal Alcohol Syndrome (FAS) and Fetal Alcohol Spectrum Disorders (FASD). Read through these questions and answers, and then contact us if you have any additional questions or concerns, or to get help with FAS and FASD related topics.

We would like to acknowledge and thank the Minnesota Organization on Fetal Alcohol Syndrome for allowing us to leverage much of their FAQ content for this section. 

About Fetal Alcohol Spectrum Disorders / FASD

For Families

How do you know if you/your child has an FASD?

These are some things to look for if you suspect someone you know may be affected:


  • low birth weight
  • sensitivity to light, noise and touch
  • irritability
  • unable to suck effectively
  • slow to develop
  • ear infections
  • poor sleep/wake cycles


  • poor memory
  • hyperactivity
  • no fear
  • no sense of boundaries
  • need for lots of physical contact

School-Age Children:

  • easily distracted
  • short attention span
  • poor coordination
  • trouble with large and fine motor skills
  • need lots of one-on-one attention

Older Children:

  • low self-esteem
  • trouble keeping up in school
  • poor impulse control
  • difficulty with public versus private environments
  • must be reminded of concepts on a daily basis

These signs may also be present in children without an FASD, however you will notice that “typical” parenting will not result in changes in behavior for children prenatally exposed to alcohol.

If you think it’s possible that you or your child has an FASD, visit our Resource Directory to find the resources you need near you.

Where can I find health care providers who understand FASD?

Indiana NOFAS maintains a Resource Directory of articles, research, training and other information. This directory also contains contact information for FASD-friendly professionals and programs such as diagnostic clinics, therapists and support groups.

Access to services for those who may have an FASD can be difficult in Indiana for a variety of reasons. Indiana NOFAS is working with key stakeholders to better coordinate existing services, and to identify areas where additional services are required. We are also working to grow our list of FASD friendly providers around Indiana.

If you have additional questions or needs, please feel free to contact us directly using this form.

What’s the difference between FASD and Autism?

Similarities Between Fetal Alcohol Spectrum Disorders (FASD) and Autism
Dan Dubovsky MSW SAMHSA FASD Center for Excellence

Both are developmental disabilities. Both affect normal brain function, development, and social interaction. In both, the individual often has difficulty developing peer relationships. In both, there is often difficulty with the give and take of social interactions. In both, there are impairments in the use and understanding of body language to regulate social interaction. In both, there is difficulty expressing needs and wants, verbally and/or non- verbally. A short attention span is often seen in individuals with Autism and an FASD. In both, we may see an abnormal sensitivity to sensory stimuli, including an over- or under-sensitivity to pain.

Differences Between Fetal Alcohol Spectrum Disorders and Autism
Dan Dubovsky MSW SAMHSA FASD Center for Excellence
FASD Autism
  • Occurs as often in males as in females
  • Occurs in males 4 times as often as in females
  • Able to relate to others
  • Difficult or impossible to relate to others in a meaningful way
  • Restricted patterns are not commonly seen
  • Restricted patterns of behavior, interests, and activities as a core area
  • Verbal communication may be slow to develop but is not commonly significantly impaired
  • Difficulty in verbal and non-verbal communication
  • Difficulties begin at birth
  • Difficulties may begin after a period of normal growth
  • Difficulty in verbal receptive language; expressive language is more intact as the person ages
  • Difficulty in both expressive and receptive language
  • Spoken language is typical
  • Some do not develop spoken language
  • Spontaneously talkative
  • Robotic, formal speech
  • Echolalia not common
  • Echolalia-repeating words or phrases
  • Stereotyped movements not seen
  • Stereotyped movements
  • Ritualistic behaviors not commonly seen
  • Ritualistic behaviors
  • Repetitive body movements not seen; may have fine and gross motor coordination and/or balance problems
  • Repetitive body movements e.g., hand flapping, and/or abnormal posture e.g., toe walking
  • Social and outgoing
  • Remaining aloof; preferring to be alone
  • Difficulty with change and transitions
  • Inflexibility related to routines and rituals
  • Can share enjoyment and laughter
  • Lack of spontaneous sharing of enjoyment
  • Can express a range of emotion
  • Restricted in emotional expression
  • Funny; good sense of humor
  • Difficulty expressing humor
  • Microcephaly more common
  • Macrocephaly more common
  • Considered a medical disorder in the ICD.  Not in the DSM-IV
  • Considered a mental disorder in the DSM-IV

For Expecting Parents

I drank alcohol before I knew I was pregnant. Now what?

First, don’t panic!  The best thing to do, is stop consuming alcohol as soon as you find out you are pregnant. It is never too late to stop drinking. The sooner you stop consuming alcohol, the better it will be for both you and your baby. Then make sure you are getting regular prenatal care and maximizing other good health practices like not smoking, eating healthy and getting plenty of sleep. If you drank any amount of alcohol while you were pregnant, talk with your child’s health care provider as soon as possible and share your concerns.

Half of all pregnancies are unplanned.  And many women do not know they are pregnant for several weeks or even months. There are many factors that determine if a fetus will be impacted by prenatal alcohol exposure. Often it is not just how much alcohol a woman consumes, but when she drank, her nutrition, genetics, age etc. The best advice is to not consume any alcohol during pregnancy if you are planning on becoming pregnant or are having unprotected sex.

If you are a mother of a child who was exposed to alcohol prenatally and would like to connect with other moms, please contact us.

For national support, visit the National Organization on Fetal Alcohol Syndrome (NOFAS) Circle of Hope at http://www.nofas.org/circleofhope/. The Circle of Hope are groups where women with incredible strength join together to share their stories, shed the shame and support each other through the challenges of raising children with Fetal Alcohol Spectrum Disorders (FASD).

“We do not know what, if any, amount of alcohol is safe. But we do know that the risk of a baby being born with any of the fetal alcohol spectrum disorders increases with the amount of alcohol a pregnant woman consumes, as does the likely severity of the condition. And when a pregnant woman consumes alcohol, so does her baby. Therefore, it’s in the child’s best interest for a pregnant woman to simply not consume alcohol”.

In addition, studies indicate that a baby could be affected by expsosure to alcohol while pregnant even within the earliest weeks after conception, and before a woman knows that she is pregnant. For that reason, the U.S. Surgeon General is recommending that women who may become pregnant also abstain from alcohol.

Find some resources for expectant mothers.

Why should I worry about alcohol use if I am not pregnant and not trying to get pregnant?

If you consume alcohol and do not use contraception (birth control) when you have sex, you might get pregnant and expose your baby to alcohol before you know you are pregnant.

Nearly half of all pregnancies in the United States are unplanned. And many women do not know they are pregnant right away. So, if you are not trying to get pregnant but you are having sex, talk to your health care provider about using contraception consistently.

Can an FASD be passed along through breast milk?

Alcohol in breast milk is not linked to FASD.  However, when a woman who is breastfeeding consumes alcohol, some of that alcohol does enter her breast milk. Research shows that alcohol in the milk can harm a child’s development, sleep, and learning.  For this reason, breastfeeding women should be very cautious about consuming alcohol, if they choose to consume alcohol at all.  According to the new 2010 Dietary Guidelines for Americans published by the USDA, a mother may consume a single alcoholic drink if she then waits a least 4 hours before breastfeeding.

Can a partner cause an FASD?

If my partner consumes alcohol will they cause the baby to have an FASD? No.

FASD is only caused when a woman consumes alcohol when she is pregnant.  However, a partner can be supportive of the mother by encouraging her not to consume alcohol while she is pregnant and by abstaining from alcohol themselves as a show of support for the mother.

If a woman has an FASD, will her children have it, too? Is FASD hereditary?

No. FASD cannot be “passed on” from a mother to a child like having brown eyes can be passed on. The only way for women with an FASD to have a child with an FASD is for that woman to consume alcohol when she is pregnant. Also, just because a woman has one child with an FASD does not mean she will have another with an FASD. As long as a pregnant woman does not consume alcohol, her child will not be born with FASD.

For Professionals & Community

Does Indiana NOFAS provide training?

Indiana NOFAS provides many different types of training throughout the year that are open to the public, and Indiana NOFAS also does private trainings for individual agencies or organizations.  If you are interested in having someone from Indiana NOFAS come to your agency and speak, please contact us using this form.

Indiana NOFAS charges a fee of $150/hour to do trainings, plus mileage of .55 per mile for round trips of 100 miles or more. However, if your agency cannot afford the set fee, please still contact us. There are a certain amount of trainings we do throughout the year that are free, and we are willing to work within your budget. Once you have contacted Indiana NOFAS with your request, we will get back to you to confirm your information.

How is FASD Diagnosed?

There are a handful of methods to diagnose FASD:

  • 4 – digit code (Universty of Washington)
  • CDC (Center for Disease Control) method
  • Modified Institute of Medicine method
  • Combination method (MN approach)

Each method obtains information about four health parameters:

  1. Growth
  2. Facial features
  3. Brain development and functioning
  4. Exposure to alcohol in utero

The data obtained regarding these four parameters are ranked by degree of expression in the individuals being examined. That ranking is them compared to the defined criteria for FASD, and a diagnosis is given based on the evidence.

All of the methods of FASD diagnosis assess these same four health parameters. The difference in the methods is how they define the criteria for each of the three diagnostic categories, FAS, pFAS, and ARND. This can result in different diagnoses from one method to the next, although the medical evidence is the same. One method also subdivides the three categories into many smaller categories, giving a more specific description of the individual’s diagnosis.

As more research is done about FASD, diagnosis is becoming more standard. The CDC and FASD experts continue to work on honing one diagnostic model.

Screening & Diagnosis

What are some of the symptoms to watch for?

Only trained professionals can make an FASD diagnosis. FASD is often misdiagnosed because many of the characteristics look the same as mental health disorders.

Signs to look for that may indicate the need for an FASD assessment include:

  • Sleeping and sucking problems as a baby
  • Hearing or vision problems
  • Difficulty in school; especially in math
  • Poor coordination and fine motor skills
  • Sensitivity to light, touch, sound
  • Tremulousness (uncontrollable twitching or tremors)
  • Hyperactive behavior
  • Difficulty paying attention
  • Impulsivity
  • Poor memory
  • Poor reasoning and judgment skills
  • Perceptual Problems
  • Difficulty reading the social cues of others
  • Difficulty retrieving CNS information when stressed
  • Diminished Intelligence
  • Better expressive language than receptive language
  • Facial features (small eye openings, smooth philtrum, thin upper lip

Why is an FASD diagnosis important?

Getting an FASD diagnosis is important for both the individual being assessed, as well as their family.

Identifying individuals who may be affected by an FASD is the first step in getting them connected to the support they will need to reach their full potential.  A diagnosis helps to identify the strengths and deficits of the individual.  As a result, a meaningful and more effective intervention plan for relevant services and support can be created.  And for the family, a diagnosis can provided an overall greater understanding, acceptance and more realistic expectations.

Read an inspirational personal diagnosis story by Linda Rosenblaum, “What Can Testing Tell Us?”

What is the FASD diagnostic process like?

Unfortunately, there is not one medical test (like a blood test) to confirm a diagnosis under the FASD umbrella. FASD can be diagnosed by a team of professionals assessing four specific areas:

  • Growth issues
  • Brain function and structure
  • Facial features
  • Prenatal alcohol history

Depending on the clinic, the diagnostic process can take 3-6 hours and includes:

  1. History (Clinic Care Coordinator)
    A comprehensive history of the problem and any evidence of prenatal alcohol exposure is discussed.
  2. Physical Exam (Medical Provider)
    Measurements of the head, face and growth are taken along with a complete physical exam.
  3. Neurodevelopmental Assessment (Psychologist, Speech Therapist and Occupational Therapist)
    Comprehensive testing is done to evaluate 10 different brain functions including memory, executive functioning and motor skills.
  4. Diagnosis (Diagnostic Team)
    All assessments are reviewed by the diagnostic team and evaluated to see if they meet the criteria for a diagnosis under the FASD umbrella.
  5. Evaluation Report (Diagnostic Team)
    A summary of the findings is prepared along with any specific recommendations for follow up support and treatment. Information about CINOFAS is distributed.

What to do with FASD diagnostic results?

Remember, getting an FASD diagnosis is not about “labeling” a child. It is rather an opportunity for your child and family to get the services and support needed to be successful.

  1. Share the diagnosis with your child’s school to assist with the development of an Individualized Education Plan (IEP).
  2. Share this information with your child’s doctor to receive more appropriate medical and mental health services.
  3. Contact your county social service office to see what supports and services are available.

Check out our Resource Directory for more information