Issue Paper: Fetal Alcohol Spectrum Disorder and Adversity

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CanFASD recently released a new issue paper exploring FASD and adversity. Below is a short summary. You can find the full issue paper here.


Prenatal alcohol exposure (PAE) can cause a range of brain- and body-based difficulties, including a heightened sensitivity to stress. Many individuals with FASD also tend to face high levels of environmental adversity throughout their lives, such as experiences that are stressful, harmful, and/or traumatic. The combination of brain-based stress sensitivity along with chronic adverse experiences can create significant challenges for individuals with FASD and their families, warranting special consideration and support.


Early life and sensitivity to stress:

  • Our brain has a specific system that influences how we experience and respond to stress
  • Fetal exposure to alcohol can change how this system develops
  • Experiences of adversity in early childhood can also influence how the brain responds to stress
  • Early interventions can improve some of the negative impacts of stress and adversity

Adverse childhood experiences and FASD:

  • Individuals with PAE and FASD experience high rates of adversity in childhood
  • Examples of common adverse experiences include neglect, loss, physical and sexual abuse, exposure to substance use and family violence, and disrupted living experiences
  • Early childhood experiences can impact development and long-term health and well-being

Susceptibility to adverse outcomes:

  • When PAE and adversity are combined, an individual’s vulnerability to stress increases
  • This combination can lead to problems such as less effective coping, difficulties with emotion-regulation, and mental health and physical health issues
  • Without effective supports, individuals with FASD are at risk of experiencing adversity throughout their lives

Implications for intervention

  • Stable and nurturing relationships and environments can minimize the harmful effects of PAE and early adversity
  • Using trauma-informed practices and approaches in service delivery can help to address some of the challenges faced by individuals with FASD
  • System-level strategies are needed to reduce the occurrence of PAE and early adversity

Take Home Message
PAE can lead to an increased sensitivity to stress, and people with FASD commonly experience adversity beginning early in life and extending into adulthood. The combination of these factors puts individuals with PAE and FASD at increased risk for negative outcomes. Acknowledging the intersection of PAE, stress, and adversity puts us in a better position to develop interventions that can improve outcomes. 

For more information, including recommendations, please read the full issue paper here.

Authors: Katherine Flannigan, Kaitlyn McLachlan, Jacqueline Pei, Nancy Poole, Kelly Harding, Kathy Unsworth, & Audrey McFarlane

Date: June 2020

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