Foster Children and Orphans Facing Fetal Disorders

Fetal alcohol disorders among children more common in foster care and similar child care systems

/ Author:  / Reviewed by: Robert Carlson, M.D Beth Bolt, RPh

(RxWiki News) Children not living with biological or adopted parents often already face greater challenges than other children. But events before their birth may add to those challenges.

A recent study found that fetal alcohol spectrum disorders tend to be much more common among children in foster care, orphanages and similar child care systems.

"Fetal alcohol spectrum disorder," or FASD, is the name for the various conditions that can affect a child whose mother drank alcohol during pregnancy.

Children with fetal alcohol spectrum disorders may have special needs.

Therefore, caretakers, foster parents and future adoptive parents of these children should be aware of how common the condition is so they can be prepared to meet these children's needs.

"Learn what you can about foster children's medical history."

This study, led by Shannon Lange, MPH, of the Centre for Addiction and Mental Health in Toronto, Canada, looked at how common fetal alcohol spectrum disorders were among children in foster care or child welfare systems.

The researchers looked through databases of other research studies to find all the papers related to how common fetal alcohol syndrome (FAS) or fetal alcohol spectrum disorders were among children in different child care systems.

Fetal alcohol syndrome is a specific diagnosis within fetal alcohol spectrum disorders, which includes a wide range of conditions and disabilities that are all traced back to a mother's alcohol intake during pregnancy.

According to the Centers for Disease Control and Prevention, the following are among the symptoms of FASD:

  • abnormal facial features
  • small head size, shorter-than-average height and/or low body weight
  • poor coordination
  • poor memory
  • hyperactive behavior and/or difficulty paying attention
  • difficulty in school, especially in math and/or learning disabilities
  • speech and language delays
  • intellectual disability or low IQ
  • poor reasoning and judgment skills
  • sleep and sucking problems as a baby
  • vision or hearing problems
  • problems with the heart, kidneys or bones

The researchers identified a total of 34 studies from which they extracted and analyzed data.

The data came from eight countries: the US (11 studies), Brazil, Chile, Canada, Israel, Russia, Spain, Sweden and three Eastern European countries combined (Romania, Moldova and Ukraine).

Child care systems can include foster care, orphanages, child welfare systems or other institutions which house children who do not live with biological or legally adoptive parents.

The researchers determined that fetal alcohol syndrome occurs among about 6 percent of all children in child care systems. Fetal alcohol spectrum disorders affect approximately 17 percent of all children in child care systems.

According to the US Centers for Disease Control and Prevention, approximately 1 to 3 children out of every 2,000 born in the US will have fetal alcohol syndrome (a rate of 0.05 to 0.15 percent).

These findings mean that children in child care systems such as foster care or orphanages are almost three times more likely to have a fetal alcohol disorder of some kind.

"The vast majority of existing studies report that the prevalence of FAS and FASD in child care settings in various countries is extremely high," the researchers reported.

The study's findings were limited by the fact that they combined data from different countries and the various studies were not all conducted using the same methods.

Yet they also noted that the prevalence of these fetal alcohol disorders among children in child care systems might be underestimated since not all children's prenatal histories are available.

It is not always possible to diagnosis a child with fetal alcohol spectrum disorders without knowing if the mother drank during pregnancy, and that information might not be available for all children in these systems.

The symptoms of fetal alcohol spectrum disorder may overlap with the symptoms of other developmental or mental disorders.

The researchers pointed out the importance of understanding how common fetal alcohol disorders are among children for several reasons.

According to the authors, "Specifically, in the context of child care settings, early FASD diagnosis can:

  1. Help establish appropriate placements,
  2. Allow foster/adoptive parents to be better prepared to meet their child’s needs and improve parenting by increasing their understanding of the deficits and behavioral problems displayed by individuals with FASD,
  3. Reduce the likelihood of multiple failed placements, and
  4. Increase awareness and understanding of both caregivers and caseworkers of the consequences of prenatal alcohol exposure."

This study was published September 9 in the journal Pediatrics. The research was funded internally, and the authors reported no conflicts of interest.

Review Date: 
September 6, 2013
Last Updated:
September 9, 2013