Fetal Alcohol Syndrome in America – A Silent Crisis

In the coming weeks, The Chronicle of Social Change will feature a five-part series on Fetal Alcohol Spectrum Disorders from Helen Ramaglia, an advocate for foster youth and a member of our Blogger Co-Op.

Part 1 – What Is A Fetal Alcohol Spectrum Disorder?

Fetal Alcohol Spectrum Disorders (FASD) is an umbrella term describing the range of effects that can occur in an individual whose mother drank alcohol during pregnancy. These effects may include physical, mental, behavioral, and learning disabilities with possible lifelong implications.

FASD is the leading known cause of mental retardation in America today. The annual cost to the U.S. of Fetal Alcohol Syndrome alone in direct and indirect cost is approximately $5.4 billion dollars, according to the Minnesota Organization on Fetal Alcohol Syndrome (MOFAS).

The term FASD is not intended for use as a clinical diagnosis. An individual would not receive a diagnosis of FASD. Diagnoses like Fetal Alcohol Syndrome (FAS), partial Fetal Alcohol Syndrome (pFAS) and Alcohol-Related Birth Defects (ARBD) fall under the umbrella of FASD.


Children and adults who suffer from these disorders frequently exhibit other physical and behavioral challenges. According to MOFAS:

• 90% of individual with an FASD also have a mental illness
• 50% of adolescents and adults displayed inappropriate sexual behavior
• 60% of people with an FASD have a history of trouble with the law. The average age children with FASD start getting in trouble with the law is 12.8 years old.
• 50% of individuals with an FASD have a history of confinement in jail, prison, residential drug treatment facility, or psychiatric hospital.
• 80% of children with an FASD are not primarily raised by a biological parent
• 70% of children in foster care are affected by some type of prenatal alcohol exposure
• 60% of adolescents with an FASD experienced significant school disruptions

Without an understanding of the physical, behavioral and cognitive challenges faced by people with FASD, typical misbehaviors can be misinterpreted as willful misconduct or deliberate disobedience, when it is often just the opposite.

There are many behavioral characteristics which differentiate FASD patients with other individuals suffering others forms of mental disabilities. Some examples, from a fact sheet compiled by the Texas Department of Family and Protective Services:

  • Individuals with FASD often speak better than they think. Socially, they tend to be very outgoing and socially engaging, yet they are frequently seen by others as intrusive, overly talkative, and generally unaware of social cues and conventions.
  • Poor social judgment and poor socialization skills are common, and many patients are hungry for attention, even if it is negative. Due to their social immaturity, they have difficulty establishing friendships, especially with children of the same age.
  • Children with FASD frequently have learning difficulties. These difficulties result from poor thinking and processing skills. Information may be known, but cannot be applied to different situations. Learning may occur in spurts. Easy learning periods may be followed by harder ones.
  • During difficult periods, children may have trouble remembering and using their learned information. Because of inconsistent learning, teachers may think they are just not trying. They may label them as lazy or stubborn.

Caregivers should adjust their expectations of behaviors of the person with FASD to the developmental stage they are at. A five-year-old with FASD is often times developmentally on par with a 2-year-old; a 10-year-old is on par with a 6 year-old; and an 18-year-old is on par with a 10-year-old.


Parents may be able to mitigate some of these behavioral issues by establishing daily routines and using clear concise language and examples, teaching skills for daily living, and rewarding children to reinforce good behavior. For older youths with a FASD, vocational training and social skills training may be helpful.

Because symptoms and abilities can vary, each person should be assessed individually to determine the best combination of interventions. In addition, people with an FASD are at greater risk for developing substance abuse problems.

Check back soon for Part 2: The Financial Impact of FASD

Helen Ramaglia is a foster alumni who became a foster/adoptive parent. She is the founder and Director of Fostering Superstars, a Congressional Award Winner for her work with foster children and is the author of “From Foster to Fabulous”. She is a popular speaker, trainer and advocate for foster children.

Want to share your opinion or analysis with colleagues in the youth services field? Join our one-of-a-kind Blogger Co-Op, and share in the benefits from your work!

Other Resources on FADS:

• Centers for Disease Control & Prevention: http://www.cdc.gov/ncbddd/fasd/index.html
• Fetal Alcohol Disorders Society: http://www.faslink.org
• Nemours Foundation (Spanish): http://kidshealth.org/parent/en_espanol/embarazo/fas_esp.html

Links to more information on FADS:

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About Helen Ramaglia 18 Articles
Helen Ramaglia is a foster alumni who became a foster/adoptive parent. She is the founder and Director of Fostering Superstars, a Congressional Award Winner for her work with foster children and is the author of “From Foster to Fabulous”. She is a popular speaker, trainer and advocate for foster children.


  1. Well written piece and much appreciated. My 5 year old son, (domestic infant adoption) has FAS and I continue to be shocked by the number of people that don’t know about FAS. I have worked in the foster care system for years and have seen an increase in the number of kiddos in foster care that have a FASD. Hopefully, more and more education and prevention can decrease those numbers.

  2. Thank you for writing this. I would say though that the use of the word “retardation” early in the article is unfortunate. I agree the term “cognitive disabilities” sounds less harsh.

    I have long suspected that my daughter [adopted from Russia] had mild FASD, and she has unfortunately exhibited a lot of these behaviors. I continue to pray she will mature and do better, and she will come home again one day. She is 22 now and I have not seen her in a couple of years. She has had bouts of addiction to drugs.

    I am a writer and I am writing a website for parents who are dealing with FASD, RAD, and other mental health issues common to adopted kids, and I will put a link to this article on there.

    If anyone reading this would feel comfortable sharing their story with me, please send me an email. Thanks.

  3. The Center for Disease Control has vowed to stop using the term “retardation” because of the long negative history around that word. It would be great if you would consider using the term “cognitive disabilities.” This term clearly expresses the difficulty individuals with FASD face without the negative baggage.

  4. Our foster care system is allowing, condoning, and paying for drug or alcohol addicted welfare paid humans to continue producing these children.

  5. This is wonderful. We in Northern California are just gathering up the heat and light necessary to form a center of diagnosis and intervention for FASD, and invite any and all of our neighbors to join us. Thank you so much for taking this on. I hope you will consider using the prevalence estimate that is gaining credence in the US, roughly 5%, representing the whole spectrum. NOFAS is saying that 70% of foster kids are affected, but we haven’t figured out where they got that yet. It’s high, in any case. Much gratitude!

  6. Thank you for this series – long overdue! To experience how these traits play out in everyday life, or to know that you are not alone if you are loving and living with FASD in your life, consider reading my new book, When Rain Hurts, available on Amazon and other places.

  7. Folks w/FASDs are more likely victims than the inappropriate actor. It sensationalizes our loved ones’ profile to put the “sex” issues before those with higher % in the research.

  8. This series is so welcome! With earliest possible identification of FASDs and all needed interventions I believe by front loading the developmental supports & spending….. we can better the outcomes for our loved ones born with fetal alcohol exposure. My own suggestion for the author is that listing the 2ndary disabilities in descending order of % may present the real risks…. while stating sexual inappropriateness early in list misrepresents our childrens’ innocence & lovingkindness. Victimization of the FASD population is no doubt more common than their being the bad actors. thnx.

  9. Fetal Alcohol Syndrome has been well-known to many on Native American reservations for decades. While it is not unique or limited to this population, the effects are particularly devastating among this ethnic group with a genetic predisposition to low alcohol tolerance. Longitudinal research suggests that the effects of alcohol on the developing fetus (regardless of ethnicity) are much more severe and long-lasting than that of illegal drugs such as cocaine.

    This is an extremely important issue/challenge with the potential impact being felt across many domains including education, health care, juvenile justice, and mental health, to name a few. It extremely important that education and prevention be at the forefront in efforts to address this far-reaching problem.

    Thank you for this excellent summary of the challenges associated with Fetal Alcohol Syndrome Disorders.

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