The incidence of FASD exceeds 10% of our children. FASD is the full spectrum of disorders caused by prenatal exposure to alcohol. The incidence of Fetal Alcohol Syndrome (with the classic facial features) is about 1%. Facial features are determined around the third week of pregnancy, so if the mother was not drinking at that time, the facial features can be quite normal, but the neurological damage can be as severe.
Based on Statistics Canada's "Canadian Community Health Survey" and their Birth and Population statistics for the concurrent period, It is likely that 37% of babies have been exposed to multiple episodes of binge drinking (5+ drinks per session) during pregnancy. An additional 42% have been multiply exposed to 1 to 4 drinks per session during pregnancy.
Prenatal alcohol exposure has been linked to more than 60 disease conditions, birth defects and disabilities. Damage is a diverse continuum from mild intellectual and behavioural issues to profound disabilities or premature death. Prenatal alcohol damage varies due to volume ingested, timing during pregnancy, peak blood alcohol levels, genetics and environmental factors.
Cascade Ethanol interacts with more than 1000 different genes and cell events, including cell signalling, transport and proliferation. Alcohol supresses serotonin production. Serotonin suppression causes loss of neurons and glia, inducing excessive cell death during normal programmed death (apoptosis) or triggering apoptosis at inappropriate times leading to smaller or abnormal brain structures with fewer connections between brain cells, leading to fewer cells for dopamine production, leading to problems with addiction, memory, attention and problem solving, and more pronounced conditions such as schizophrenia.
Approximately 20% of Canadian school age children are receiving special education services, most for conditions of types known to be caused by prenatal alcohol exposure.
As FASD is a diverse continuum, issues range from almost imperceptible to profound. It is somewhere in the middle that the issues attract the attention of parents, educators, medical and social work professionals, and eventually the justice system. Most of the issues that attract sufficient attention are behavioural and performance issues.
It is probable that 10% to 15% of children are significantly enough affected by prenatal alcohol exposure to require special education. As they become adults, FASD does not disappear but the issues of youth translate into ongoing problems in family relationships, employment, mental health and justice conflicts. The cost to the individuals affected, their families and society are enormous and as a society, we cannot afford to ignore them.