Fetal Alcohol Spectrum Disorders Awareness Month: Developmental delays in understanding emotions prominent in FASD-affected children

The damaging effects of drinking alcohol during pregnancy are well known. The U.S. Surgeon General and the Centers for Disease Control and Prevention (CDC) have previously emphasized that no amount of alcohol consumption can be considered safe during pregnancy. Alcohol can harm a fetus at any stage during pregnancy, sometimes even before a woman realizes she is pregnant. Prenatal alcohol exposure is known to cause lifelong cognitive impairments and behavioral problems, including fetal alcohol spectrum disorders (FASDs).

FASD is a group of developmental disorders which can cause impairments in controlling impulses, planning tasks, regulating emotions and developing social skills. A past study published in BMC Psychiatry indicates that 3.3 million women in the United States, representing 7.3 percent women of childbearing age, are at risk for alcohol-exposed pregnancies. Prenatal alcohol exposure results in the occurrence of FASD in nearly 1 percent live births. It is estimated that there are 40,000 new cases of FASD in the U.S. every year.

The National Organization on Fetal Alcohol Syndrome (NOFAS), observes September as the FASD Awareness Month to raise awareness about prenatal alcohol exposure risks and draw attention to FASD-affected children and adults. The purpose behind observing the month is to emphasize that no amount of alcohol is safe during pregnancy. The efforts are directed at spreading awareness about the risks of alcohol addiction and making resources available to them.

Weaker emotional understanding leads to social problems

Subtle behavioral and learning disabilities are often undiagnosed or misdiagnosed as autism or attention deficit disorder (ADD). FASD appears to be a leading cause of attention-deficit/hyperactivity disorder (ADHD). Researchers from the University of Rochester and the University of Washington have found that children with FASDs also face significant developmental delays in understanding emotions.

For the study, researchers evaluated emotional understanding (EU) in 56 FASD-affected children aged 6-13. The results, published in the Journal of Population Therapeutics and Clinical Pharmacology in May 2017, establish that FASD-affected children show “striking delays” in EU – as much as 2 to 5 years even in those with an average IQ – compared to typically non-FASD affected peers. The study was funded by the CDC and the National Institute on Alcohol Abuse and Alcoholism (NIAAA).

EU is the awareness of how emotional processes work with regard to oneself and others. It includes an understanding of the reasons and outcomes of emotions, and also being aware of regulating and coping mechanisms for one’s feelings. Christie L. Petrenko, assistant professor at the University of Rochester’s Mt. Hope Family Center and lead coordinator of the study, explains that several children with FASD face acute difficulties in their emotion management and regulation, thereby experiencing delays in EU. Weak or delayed understanding exposes many FASD-affected children to lifelong challenges.

According to Petrenko, having well-developed EU skills helps individuals in more effectively navigating emotional and social spheres. Better EU skills enhance the ability to be compatible with others and adhere to social norms. Individuals with weaker EU may have poor awareness levels of how their emotions and behavior impact others, leading to social problems. Moreover, FASD-affected children often experience more negative emotions than their peers. They may feel poorly about themselves, especially if supportive responses from adults on managing strong emotions is lacking.

FASD treatment should focus on improving emotional understanding

Although there is no cure for FASDs, early interventions can impart important developmental skills to children, from the time they are born till they turn three. Such approaches can include therapies to help children talk, walk and interact with others. The researchers recommend that FASD treatments should focus on improving EU. Petrenko adds: “When paired with skill building in emotion regulation and support from adults, such interventions could improve the adaptive functioning of kids with FASD.”

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