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Sonoma County Gazette
Fetal Alcohol Spectrum Disorders for Sonoma County

Facts: Fetal Alcohol Spectrum
Disorders for Sonoma County

Aug 30, 2017


By Kathryn Page

Roughly 4 percent of us have some degree of brain damage from exposure to alcohol in the womb (1); such exposure is the single largest known cause of intellectual disability(2), although there is a wide range of severity(3) . Most have IQ’s in the normal range, but self-regulation, memory and reasoning are impaired. Behavior looks like “irresponsibility” in adults, “disobedience” in children. The vast majority of the victims will have none of the recognizable facial features of Fetal Alcohol Syndrome(4). With or without facial features, the damage generally falls into the following categories(5):

• Symptoms of Attention Deficit/Hyperactivity Disorder (disorganization, impulsivity, distractibility and hyperactivity—or occasionally underactivity)

• Neuromotor impairment (balance, coordination, oversensitivity or undersensitivity to stimuli, poor perception of sounds, visual input or social cues)

• Executive functioning (the ability to judge, plan, empathize, estimate, delay gratification)

• Speech problems (sometimes generally delayed, often a much better talker than listener

If not properly identified and treated, FASD results in the following “secondary disabilities”, at the rates indicated:


• Mental Illness: 90%

• Expulsion or Dropout from School: 60%

• Trouble with the Law: 60%

• Inappropriate Sexual Behavior: 50%

• Dependent Living (inability to live on one’s own) 80%

But: FASD is almost never even considered, let alone diagnosed. So these secondary disabilities continue to burgeon unabated. The extra cost to the public for each person with FASD over the lifetime is in fact incalculable, but estimates range between $2 and $4 million. In Sonoma County, then, FASD is costing roughly $1.5 a year.* This figure would decrease dramatically with diagnosis and intervention, let alone prevention.

Drinking during pregnancy is common, and any amount can be dangerous:

• One out of ten babies born in the Sonoma region 1992 had alcohol in their systems at the time of birth—this doesn’t count the babies exposed during the rest of the pregnancy.(7)

• One drink can cause impaired cell adhesion: migrating brain cells slip off their destination.(8)

• 1-2 drinks a day doubles the chances of low birth weight. (9)

• The number of children with discernible mental handicaps doubles with one drink a day.(10)

This damage is 100% preventable.

• Women who drink should avoid getting pregnant; pregnant women who drink must be effectively supported to stop drinking.

• Children with brain damage from prenatal exposure to alcohol must be identified and treated in order to avoid wasted lives and future generations of alcohol-exposed babies.

“Fetal alcohol exposure is the single largest factor setting up physical and neurological conditions that predispose American babies to aggressive and violent behavior”. (11)

* 2015 population = 502K.  4% have FASD = 20,080.  $3M per person with FASD = $60B over the lifetimes of these people. Given a life expectancy of 40 years for people with FASD, annual cost = $1.5 billion per year. With a county growth rate of 1% per year, this adds another $150M per year.

1. Brown, R.; Coles, C.D.; Smith, I.E.; Platzman, K.A.; Silverstein, J.; Erickson, D.; and Falek, A. (1991), “Effects of Prenatal Alcohol Exposure at School Age, “ Neurotoxicology and Teratology 13:369-376.

2. Astley, S.J. & Clarren, S.K (1999). Diagnostic guide for fetal alcohol syndrome and related conditions: The 4-digit diagnostic code, 2nd edition. Seattle, WA: University of Washington.

3. Sampson, P.D., Streissguth, A.P., Bookstein, F.L., Little, R.E., Clarren, S.K., DeHaene, P., Hanson, J.W., & Graham, J.M. (1997).” Incidence of fetal alcohol syndrome and prevalence of alcohol-related neurodevelopmental disorder.”  Teratology, 56,.

4. Institute of Medicine (IOM), Stratton, K.R., Howe, C.J., & Battaglia, F.C. (Eds.) (1996). Fetal alcohol syndrome: Diagnosis, epidemiology, prevention and treatment. Washington DC: National Academy Press.

5. Streissguth, A.P., Barr, H.M., Kogan, J., & Bookstein, F.L. (1996). Understanding the occurrence of secondary disabilities in clients with fetal alcohol syndrome and fetal alcohol effects. Final report to the Centers for Disease Control and Prevention (CDC), August, 1996 (Tech. Rep. No. 96-06). Seattle, WA: University of Washington.

6. Vega, W.., Noble, A., Kolody, Bohdan, Porter, P., Hwang, J., & Bole, A. (1993) Profile of Alcohol and Drug Use During Pregnancy in California, 1992. Perinatal Substance Exposure Study Summary of Procedures and Findings. State of California, Health and Welfare Agency, Department of Alcohol and Drug Programs, Interagency Agreement No. 91-00252. Publication No. ADP 93-570.

7. Charness, M. et al (1994) “Ethanol inhibits neural cell-cell adhesion”. J. Biol. Chem 269: 9304-9309.

9. Little, R.E. (1977),” Moderate Alcohol Use during Pregnancy and Decreased Infant Birth Weight”, Am. J. Public Health Vol. 67, No. 12

10. Jacobson, J.L., and Jacobson, S. W. (January 1, 1994), “Prenatal Alcohol Exposure and Neurobehavioral Development,” Alcohol Health and Research World, National Institute on Alcohol Abuse and Alcoholism 18 (1):30-36.

11. Rich, S., and Dean, C.W. (1996), “a Previously Unexamined Source of Delinquency: Fetal Alcohol Effects: An Emerging Paradigm,”, presented to the Academy of Criminal Justice Sciences Conferences, Las Vegas, Nevada.


Sep 3, 2017
Big whoops--(my fault) annual cost to Sonoma County is $1.5 billion. Yes this is unbelievable, but i challenge anyone to check my math. See the end of the citations. These folks are THE MOST EXPENSIVE--using emergency assistance way more often, CPS and foster care, incarceration and so on. Most effective prevention of the next affected generation? Take care of those who are already affected.
- kathryn page
Sep 3, 2017
One other thing: The photo of a classic FAS face may lead readers to think fetal alcohol damage is limited to those with abnormal features--far from it! Most people with FASD are totally normal. It is Fetal Alcohol SYNDROME, truly a small number, that goes with those features.
- kathryn page

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