Fetal Alcohol Syndrome in Adults: Symptoms & Treatment Options

What Is Fetal Alcohol Syndrome?

FASDs is a fairly common condition that impacts 1-5% of the population in the United States and western European countries.³ According to the Centers for Disease Control and Prevention (CDC), FASDs are a group of conditions occurring in a person who was exposed to alcohol before birth, in utero. Symptoms of fetal alcohol syndrome in adults include physical problems and problems with behavior and learning.⁴

With FASDs occurring along a continuum, the severity of the condition varies in correlation with the amount of alcohol consumed throughout the pregnancy. The more consumed, the more severe the condition. Note that although some believe that “having an occasional glass of wine” during the third trimester is less problematic, research indicates that there’s no “safe time” to drink while pregnant.⁴

Fortunately for those struggling with alcohol consumption prior to and early into the pregnancy, stopping any time along the way minimizes severity, although the condition may already prove imminent.

Diagnosis of Fetal Alcohol Syndrome in Adults

Given that FASDs occur along a continuum, some individuals may be minimally impacted with symptomatology that’s present but less readily identifiable. While a child with a more severe condition may be readily diagnosed, those with less identifiable symptoms can go years wondering why they struggle in certain areas without being able to pinpoint a specific condition.

There’s also a likelihood that if the mother continues struggling with alcohol post pregnancy, that she has not taken appropriate action to have her child assessed for the condition. In these cases especially, individuals may go through childhood and adolescence without any awareness of their condition, further increasing the many ways families are affected by alcoholism.

FASDs may be diagnosed by various professionals including a primary care physician, mental health counselor, social worker, psychologist, and psychiatrist.

Although there is no single test to screen for FASDs, providers may assess the following:⁵

• Abnormal facial features, such as a smooth philtrum
• Short stature
• Low body weight
• Central nervous system problems, such as a small head size
• Problems with hyperactivity, attention, aggression, impulsivity and coordination
• Difficulty communicating, socializing and learning
• Known alcohol intake by the mother during pregnancy

Most sought after symptomatology may be readily observed, although known intake of alcohol by the mother during pregnancy may prove unavailable in certain circumstances.

Symptoms of Fetal Alcohol Syndrome In Adults

Adults with FASDs vary in their presentation of symptoms depending on how much alcohol their mother consumed during pregnancy.  This is why it can be  difficult to diagnose FASD in less severe cases. But even with minimal symptoms present, adults will struggle in various ways that complicate their everyday lives.

Secondary fetal alcohol syndrome symptoms in adults, which are those not readily present at birth, range from mild to severe but include the following:⁶

• Mental health problems
• Disrupted school experience (suspension, expulsion, and/or drop-out)
• Involvement with the law (trouble with authorities, charged and/or convicted of a crime)
• Confinement (inpatient treatment for mental health and/or alcohol/drug problems, or incarceration for crime)
• Alcohol and/or drug problems
• Poor academic achievement and school failure
• Sexually deviant behaviour
• Problems with employment
• Dependent living

Not all symptoms need to be present for a diagnosis; however, the more symptoms present and the higher level of severity, the more likely one is to have FASDs.

Because adults have already undergone puberty and reached their primary physical stature and appearance, physical traits and symptoms may be less pronounced than in childhood. Another consideration is that by adulthood, without a prior FASD diagnosis, specific physical characteristics may be normalized to one’s appearance. Regardless, there are physical characteristics present that may indicate a diagnosis.

Though each characteristic itself is not a specific indicator of the condition, the more characteristics present and well-pronounced, the more likely one is to have FASDs.

Physical characteristics and signs of fetal alcohol syndrome in adults include:⁷

• Large or malformed ears
• Underdeveloped fingernails or toenails
• Short neck
• Poor eye-hand coordination
• Hearing problems
• Joint and bone abnormalities
• Short eye slits
• Droopy eyelids
• Widely spaced eyes
• Nearsightedness
• Crossed eyes
• Short upturned nose
• Low and/or wide bridge of the nose
• Flat or smooth area between the nose and lip
• Thin upper lip
• Flat midface
• Small underdeveloped jaw

Further, evidence of central nervous system (CNS) abnormalities occurs with neurological hard or soft signs (as age appropriate) among the following:⁸

• Impaired fine motor skills
• Neurosensory hearing loss
• Poor tandem gait
• Poor eye-hand coordination

Mental & Neurological Symptoms

Beyond physical characteristics that are commonly present in adults with FASDs, there are many mental and neurological symptoms that can be present. . Many are a direct result of physical complications. Generally, these include  possible intellectual disabilities, difficulty completing tasks, impulsivity, poor social skills, low IQ, and so on. Again, severity of symptoms varies by where one falls along the continuum.

Mental symptoms of fetal alcohol syndrome in adults include:

• Developmental delays
• Attention deficit
• Poor organization skills
• Problems with memory
• Poor mathematical skills
• Difficulty with abstract concepts
• Difficulty learning from past experiences
• Difficulty understanding cause and effect
• Speech delays, stuttering and stammering⁷

Accordingly, there’s an increased likelihood of individuals developing secondary diagnosable mental health conditions such as major depressive disorder, generalized anxiety disorder, attention deficit/hyperactivity disorder (ADHD), and personality disorders. From a clinical standpoint, it’s important to decipher the origins of said disorders to FASDs rather than something else.

Behavioral & Social Issues

Consequent to mental and neurological symptoms are behavioral and social issues. Although physical characteristics of FASDs may prove more readily apparent than anything else, behavioral and social issues are observable in social settings, leading toward interpersonal complications. Generally, complications here include issues with social skills, impulse control, concept of time, and adapting to change.

Adults with fetal alcohol syndrome may face these social and behavioral issues:^7,8

• Hyperactivity
• Stubbornness
• Impulsiveness
• Passiveness
• Fearlessness
• Irritability
• Sleep difficulties
• Teasing or bullying of others
• Hypersensitivity to sound and touch
• Difficulty with change
• Organizational difficulties
• Poor self-image
• Overstimulation difficulties
• Depression or withdrawal
• Problems with truancy
• Problems with sexuality

Again, the symptoms must be specific to FASDs and not another condition, although secondary diagnoses may lead toward or complicate the above mentioned.

Fetal Alcohol Syndrome Treatment For Adults

There are many treatment options for adults presenting with FASDs; however, the condition is incurable. The earlier the intervention, the better. Accordingly, protective factors such as early diagnosis, involvement in special education and social services, a loving, nurturing, and stable home environment, and absence of violence throughout childhood are the most effective.⁹

With later diagnoses, especially those occurring in adulthood, there are still treatment options. Many physical and mental health providers may treat the condition, although specialists may focus on more specific symptoms. Accordingly, an interdisciplinary team may prove most effective.

Primary treatment options include:⁹

• Medical care and medication (e.g., stimulants, antidepressants, neuroleptics, and anti-anxiety drugs)
• Behavior and education therapy
• Alternative approaches

The Benefits of Therapy

Given that FASDs is a chronic condition without any known cure, the benefits of therapy are profound, allowing one to become much more functional. Benefits may include building social skills, meeting behavioral/educational goals, dealing with day-to-day challenges of this disorder, etc. As with therapy for any other condition, individual motivation makes a difference.

Therapeutic efforts must be intentional and consistent for long-term success. Therapy is effective for people who suffer from this syndrome as well as their caregivers who may be experiencing caregiver burnout. If you are seeking a therapist for yourself or a loved one, it can be helpful to search an online therapist directory.

Physical symptoms may be addressed by consulting with a medical doctor. Concerns specific to physical characteristics may be addressed with various medical professionals, such as plastic surgeons. Ultimately, treatment will depend upon the severity of the condition and personal desires for change.

Therapy can help people impacted by fetal alcohol spectrum disorders in the following ways:

• Set appropriate boundaries
• Be aware of the their strengths
• Understand the impact of any abuse
• Help them cope with loss
• Address any negative self-perception associated with an FASD
• Focus on self-esteem and personal issues
• Address resistance, denial, and acceptance
• Weigh individual vs. group counseling
• Consider a mentor approach
• Assess comprehension on an ongoing basis¹⁰

Final Thoughts

FASDs in the United States and Western European countries are not uncommon. Knowing the signs and symptoms in adults can help you get treatment. Remember, you are not alone. Therapeutic and medical help can make all the difference in your life. Should you suspect any issues, seek assistance as soon as possible.