FASD and the Child Protective Services System

2002-2005 Teresa Kellerman


There are many significant misunderstandings about Fetal Alcohol Spectrum Disorders (FASD) in the service provider arena, including child protective services, that pose obstacles to effective intervention. 


Most experts in various areas that are connected to the Child Protective Services system lack a thorough education about Fetal Alcohol Syndrome (FAS) and related disorders and their ignorance of the nature of FASDrenders much of their advice useless for a large number of families needing support services as they come through the system.


The child protective services system may provide the first contact within the system and the first opportunity for effective intervention for a family trying unsuccessfully to cope with a child who is affected by prenatal exposure to alcohol and other drugs.  But most social workers do not understand enough to be helpful to the families who need help the most.


Parents of children with FASD report that their difficulties dealing with professionals who do not understand FASD is more stressful than coping with the child's behavior problems.


Fetal Alcohol Syndrome and related disorders are probably the most common but least recognized problem among families in the child protective services system.  The mistaken belief that only alcoholic women have babies with FASD close our eyes to recognizing the many affected children who do not have obvious physical symptoms.  The mistaken belief that "milder" Fetal Alcohol Effects (FAE) is less serious than full FAS closes our eyes to helping the children who are at highest risk, those with normal intelligence and no physical symptoms but who carry the label "difficult child" and who are at high risk of abuse and neglect. 


The lack of recognition that many of the parents in abuse/neglect cases might be alcohol affected themselves (but with no obvious physical symptoms) renders typical treatment programs or court orders ineffective in helping them attain success in parenting.


Research I have studied indicates that alcohol is a major factor in most cases of child abuse and neglect, as well as cases of domestic violence.  Research also indicates that when the father in the family is a heavy drinker, the mother tends to increase her drinking to match his drinking behavior.  Mothers who abuse alcohol when their children are young are likely to have engaged in excessive drinking years before it becomes an obvious problem, years when she may have been pregnant with the children we see today.  Women who drink during pregnancy almost always deny that they drank during pregnancy, saying they quit when they found out they were pregnant, when in reality they didn't realize they were pregnant until damage was already done, they cut down but still drank enough to cause brain damage, or they were just in denial and can't report their drinking behavior honestly.  More mothers in the system were drinking during pregnancy than we realize.  More children are affected than we recognize.  It is estimated that 1 out of every 100 babies born today are significantly affected by prenatal exposure to alcohol in ways that will interfere with their ability to function successfully in life.  Most of these children are not recognized as alcohol exposed, but they may be diagnosed as ADHD or learning disabled, or just as "problem children."  These children are at high risk of being abused physically and sexually, of dropping out of school later, of getting in trouble with the law, and are at extremely high risk of having alcohol/substance abuse problems as adults (60%).  They are at risk of having clinical depression as adults, with a suicide attempt rate of 23%.  One of the primary protective factors from these secondary problems is a stable home environment and early recognition of alcohol-affected children and effective intervention through appropriate support services.


What I'm trying to say is that FASD is probably the number one health issue, the number one social problem that our society is facing today.  But no one realizes it.  There is so much denial and misunderstanding, that progress in the area of prevention is extremely slow.


It is my opinion that child protective services should be our primary focus of education on FAS and related disorders, as this is where the most effective intervention can begin.

      Of families in the Arizona dependency system, 90% have parents who abuse alcohol and other drugs  (William Stanton, Governors Administrative Office of the Courts)

      Of women of childbearing age, over half drink alcohol (SAMHSAs national survey on drug use and health)

      Of all pregnancies, half are unplanned (Alan Guttmacher Institute)

      Of those mothers who drink alcohol one year after the birth of a child, almost all were drinking at the same rate at the time they got pregnant.  (SAMHSAs national survey on drug use and health)

      Of all mothers in Arizona who are asked after they give birth whether they drank alcohol during pregnancy, only 1 in 100 admit that they did.  (Arizona Department of Health)

      Of all women in their first trimester who were asked if they drank alcohol during the past month, 23% admitted that they had.  (SAMHSAs national survey on drug use and health)

      Foster parents who are familiar with symptoms of FASD report that they suspect at least 75% of their foster children may have FASD.  (FasAdopt support group survey)

      Most children with FASD appear to be normal at birth and in the early years.

      Only 11% of children with FASD have symptoms that will warrant a diagnosis by age six.  (Ann Streissguth 1996 study on FASD and secondary disabilities)

      Only 15% of children with FASD have mental retardation.   (Ann Streissguth 1996 study on FASD and secondary disabilities)

      Twice as many babies are born with full FAS than with Down Syndrome.  (National Organization on Fetal Alcohol Syndrome)

      Ten times as many babies are born with an alcohol related disorder.  (National Organization on Fetal Alcohol Syndrome)

      Half of all mothers who give birth to a baby with FAS are alcohol affected themselves.

      Children of parents who abuse alcohol are at high risk of abuse and neglect. (Bays, J. "The care of Alcohol- and Drug-Affected Infants". Pediatric Annals, Vol. 21, Aug. 1992, pp. 485-495. )

      Children with the less visible forms of FASD are at higher risk of becoming victims of abuse, neglect, injury, SIDS, and early death.  (FASD Center for Excellence)

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