Fetal Alcohol Spectrum Disorder (FASD). All information in this section has been supplied by NHS Ayrshire and Arran. For full documents please see further information.

Information supplied by NHS Ayrshire & Arran.


What is Fetal Alcohol Spectrum Disorder (FASD)?

The term Fetal Alcohol Spectrum Disorder (FASD) means a range of physical, emotional and developmental delays that may affect a person when they were exposed to alcohol during pregnancy.


Fetal Alcohol Syndrome (also referred to as FASD with facial features*)

  • Result of exposure to alcohol during pregnancy
  • Affects how central nervous system works
  • Distinctive Facial Features:
    • Small head
    • Small eyes
    • Smooth philtrum (area between nose and mouth)
    • Thin upper lip


Fetal Alcohol Spectrum Disorder (also referred to as FASD without facial features*)

  • Result of exposure to alcohol during pregnancy
  • Affects how the central nervous systems works
  • Absence of Distinctive Facial Features - FASD is often referred to as a 'hidden disability'


Every child is unique and has individual strengths and challenges!

* Cook et al (2016)

Nine Brain Domains Affected by FASD


There are 9 brain functions that can potentially be affected by alcohol during pregnancy.



Executive Functioning

  • May have trouble with planning, sequencing, problem solving and organisation.
  • May be impulsive.
  • Difficulty controlling emotions.
  • Challenges with transitions and change.
  • Often repeats mistakes and has difficulty understanding consequences.
  • Difficulty with abstract ideas/concepts.
  • Difficulty managing time.


Sensory and Motor

  • Maybe unable to make sense of what is going on around them.
  • May under or over react to sensory input, for example, light, noise, touch, smell and/or taste and movement.


Academic Skills

  • May have difficulty in school particularly with maths, reading, time and money.
  • May have difficulty with comprehension, organisation and abstract concepts.
  • May have difficulty with age appropriate tasks.
  • May have normal IQ.
  • Learn better with visual or ‘hands on’ approach.


Brain Structure

  • Brain and head circumference may be small.


Living & Social Skills

  • May not understand personal boundaries and have difficulty reading social cues.
  • May be socially vulnerable and easily taken advantage of.
  • May have difficulty seeing things from another’s point of view
  • Socially and emotionally immature… may behave younger than actual age.

Focus & Attention

  • Can be easily distracted, over-stimulated or impulsive.
  • May have difficulty paying attention and be over active.
  • ‘Can’t sit still’.

Cognition (Reasoning & Thinking)

  • Difficulty with attention, learning, memory, planning and organisation.
  • Difficulty with understanding complex ideas.
  • Wide range of IQ.


  • May speak well but not always understand the full meaning.
  • Delayed language milestones for age.
  • Difficulty with lengthy conversations.
  • Difficulty following instructions.
  • May be able to repeat instructions but not able to follow them through.


  • Difficulty with long and short term memory – may seem forgetful.
  • Difficulty recalling sequences or complex instructions.
  • Relatively better visual memory.
  • Easily forget steps in normal daily routine.
  • Appear to lie but are really ‘filling in the blanks’.
The degree of damage to the unborn baby will depend on its stage of development at the time of exposure to alcohol because different parts of the brain develop at different times during pregnancy.
- (FASD: Parenting a child with an invisible disability. Brown & Mather, 2014)

Developmental Age and FASD

As parents, we have expectations for our children based on their age, for example ‘Katie should be able to walk to school by herself because she is old enough’. This thinking assumes that the child is meeting their developmental milestones. Research has shown that children and teenagers with FASD are usually developmentally younger than their peers. However, we must remember that every child is unique. The diagram shows common stages of development for a teenager with FASD. In some ways the young person may be developmentally average or indeed, ahead of their peers, yet, in other areas they may be well behind. Imagine how problems could be avoided if expectations were adjusted to match a
child’s ability.