Fetal alcohol syndrome: Implications for psychologists

Fetal alcohol syndrome (FAS) is currently recognized as the most common known cause of mental retardation, affecting from 1 to 3 per 1000 live-born infants. This article describes diagnostic issues, etiology, and prevalence of FAS. The current underdiagnosis of FAS and difficulties in its early identification are discussed. The available evidence on the psychological characteristics of individuals with FAS also is reviewed. Although mental retardation and hyperactivity are core features of FAS, few studies have investigated the psychological characteristics of children with FAS and for how their development may be further undermined by the disorganized environments in which many of them are raised. Recommendations for the careful study of individuals with FAS are given. Treatment approaches have not been designed or evaluated with reference to this population; however, appropriate approaches to psychological assessment and intervention are suggested. The importance of early diagnosis of FAS to ensure access to appropriate early intervention is emphasized. Studies evaluating primary prevention programs are reviewed, showing that women who drink heavily can respond to supportive counseling, with positive results for pregnancy outcome. FAS is recognized as a major public health problem that is entirely preventable.