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Competency 1: Introduction to FASD

Fetal Alcohol Spectrum Disorders: Terminology and Prevalence Rates, Continued

Prevalence

Experts are unsure exactly how many individuals in the United States have an FASD. Studies by the Centers for Disease Control and Prevention (CDC) have reported prevalence rates of FAS alone from 0.2 to 1.5 cases per 1,000 births across various populations.15-18 Other studies using a variety of methods have produced estimates ranging from 0.5 to 2.0 cases per 1,000 live births.19,21 Such rates are comparable with or above other common developmental disabilities such as Down syndrome or spina bifida.22

Studies of a variety of populations may yield even higher FAS prevalence estimates. For example, some Native American communities with high levels of alcohol use have FAS rates as high as 3 to 5 per 1,000 children.21-24

Some experts estimate that an FASD occurs in 10 in 1,000 live births.21 Thus, of 4 million infants born each year, an estimated 40,000 will be born with an FASD.

Because of the challenges of establishing accurate and timely prevalence information, the number of cases of fetal alcohol spectrum disorders could be greater than current data indicate. These challenges include:

  • Lack of specific and uniformly accepted diagnostic criteria. Only recently have diagnostic guidelines been published for FAS. No uniform guidelines exist for other types of fetal alcohol spectrum disorders. Thus, health providers are hampered in their efforts to screen and identify individuals with an FASD.
  • FAS diagnosis is based on clinical examination of features, but not all children with FAS look or act the same. Because each symptom has a broad range of possible diagnoses, a clinician might miss or misdiagnose an FASD. For instance, physicians are aware of the high prevalence of attention deficit/hyperactivity disorders but might not link attention problems to an FASD.
  • Lack of knowledge and misconceptions among primary care providers. Few know about the full range of neurobehavioral symptoms that result from prenatal exposure to alcohol. Few know about the full range or progressive nature of the neurobehavioral symptoms that result from prenatal exposure to alcohol.

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