Fetal alcohol syndrome: How does it happen and how dangerous is it?

Recently, in an interview with Channel 12's weekend news, Ron Kaufman and his wife Sarit were revealed as the parents of an adopted child with fetal alcohol syndrome.

Sagi, age 10, was diagnosed not long after being adopted from Russia as suffering from the syndrome that leads to severe tantrums and violent outbursts that require lifelong monitoring and treatment.

What exactly is this syndrome, and can it be treated?

First, it's important to explain that the mission of child and youth psychiatrists is to diagnose, treat and alleviate the condition of kids or adolescents who suffer from various mental problems. Most of these occur due to a combination of environmental and hereditary factors so they can't be prevented, but they can be diagnosed early in order to start treatment. 

Only one developmental mental syndrome is completely preventable and that's fetal alcohol syndrome.

Any exposure to alcohol during pregnancy, especially in the first trimester (the first three months of pregnancy), can cause FAS. In fact, fetal alcohol syndrome is the most common cause of developmental intellectual disability in children, which in the past was called "mental retardation," and its frequency is one in a hundred births.

FAS is more common in populations where drinking alcohol is prevalent, especially due to a poor socio-economic situation such as in eastern Europe. Its prevalence in such populations may reach 5% or more. 

FAS is manifested by a wide range of developmental, mental and behavioral problems in kids who were exposed to alcohol during their fetal development in the womb.

FAS is characterized by difficulty in executive functions i.e. organizing, attention and concentration deficits, and difficulties in judgment and decision-making, intellectual disabilities, communication disorders, deficits in sensory and emotional regulation, and behavioral disorders at various levels up to severe and violent outbursts.

It can also cause problems with judgment and clarity. In its severe form, the syndrome will also manifest itself in certain facial characteristics like small close-set eyes, a deep nasal cavity, a small snub nose, and a very narrow upper lip. The more the fetus is exposed to a higher amount of alcohol, the worse FAS is.

Is treatment available?

Treatment of FAS focuses on alleviating the plight of the child and family through emotional therapy and guidance to improve emotional/behavioral regulation and decision-making, whether through placement in a special social educational framework or through medication to improve attention or balance and stabilize behavior. 

In severe cases, it's necessary to hospitalize children in a psychiatric ward for kids and adolescents and sometimes to move kids to an out-of-home therapeutic educational setting, as well. 

The syndrome can be diagnosed already in early childhood based on deficits in communication and in the toddler's behavior, and if it's known that the mother drank and if possible, the amount.

Several medical centers in Israel diagnose and treat FAS, including Schneider Center for Pediatrics in Petah Tikva and Hadassah Hospital in Jerusalem. From the moment of diagnosis, it's only possible to alleviate a child's condition and try to help them reach the maximum of their capabilities, but FAS can't be resolved completely.

Children suffering from FAS will experience significant lifelong educational and social problems and are at high risk of addiction, involvement in accidents and shortened life expectancy.

The writer is a specialist in child and adolescent psychiatry at Maccabi Health Services North District.