Secondary Conditions

Fetal alcohol spectrum disorders (FASDs) often lead to other disorders, called “secondary conditions.” Secondary conditions are problems that a person is not born with, but might get as a result of having an FASD. These conditions can be improved or prevented with appropriate treatments for children and adults with FASDs and their families.

Following are some of the secondary conditions that have been found to be associated with FASDs.^{1, 2}

Mental Health Problems

Several studies have shown an increased risk for cognitive disorders (e.g., problems with memory), mental illness, or psychological problems among people with FASDs.

The most frequently diagnosed disorders are:

• Attention problems, including attention-deficit/hyperactivity disorder (ADHD)
• Conduct disorder (aggression toward others and serious violations of rules, laws, and social norms)
• Alcohol or drug dependence
• Depression

Other psychiatric problems, such as anxiety disorders, eating disorders, and posttraumatic stress disorder, have also been reported for some patients.

Disrupted School Experience

Children with FASDs are at a higher risk for being suspended, expelled, or dropping out of school. Difficulty getting along with other children, poor relationships with teachers, and truancy are some of the reasons that lead to their removal from the school setting. Many children with FASDs remain in school but have negative experiences because of their behavioral challenges.

In a 2004 study, disrupted school experience was reported for 14% of school children and 61% of adolescents and adults with FASDs. About 53% of the adolescents with FASDs had been suspended from school, 29% had been expelled, and 25% had dropped out.

Trouble with the Law

Teenagers and adults with FASDs are at a higher risk for having interactions with police, authorities, or the judicial system. Difficulty controlling anger and frustration, combined with problems understanding the motives of others, result in many people with FASDs being involved in violent or explosive situations. People with FASDs can be very easy to persuade and manipulate, which can lead to their taking part in illegal acts without being aware of it. Trouble with the law is reported overall for 14% of children and 60% of adolescents and adults with FASDs.

Inappropriate Sexual Behavior

People with FASDs are at higher risk for showing inappropriate sexual behavior, such as inappropriate advances and inappropriate touching. If the person with an FASD is also a victim of violence, the risk of participating in sexually inappropriate behavior increases. Inappropriate sexual behaviors increase slightly with age from 39% in children to 48% in adolescents and 52% in adults with FASDs.

Alcohol and Drug Problems

Studies suggest that more than a third of people with FASDs have had problems with alcohol or drugs, with more than half of them requiring inpatient treatment.

References

1. Streissguth, A.P., Bookstein, F.L., Barr, H.M., Sampson, P.D., O’Malley, K., Young, J.K. Risk factors for adverse life outcomes in fetal alcohol syndrome and fetal alcohol effects. Developmental and Behavioral Pediatrics. 2004;5(4):228-238.
2. Streissguth, A.P., Barr, H.M., Kogan, J. & Bookstein, F. L., ‘Understanding the Occurrence of Secondary Disabilities in Clients with Fetal Alcohol Syndrome (FAS) and Fetal Alcohol Effects (FAE),’ Final Report to the Centers for Disease Control and Prevention (CDC), August, 1996, Seattle: University of Washington, Fetal Alcohol & Drug Unit, Tech. Rep. No. 96-06, (1996).

Dependent Living and Problems with Employment Over 21 Years

Adults with FASDs generally have difficulty sustaining employment or living independently in their communities.