Responding to the Unique Complexities of Fetal Alcohol Spectrum Disorder

Katherine Flannigan; Jacqueline Pei; Kaitlyn McLachlan; Kelly Harding; Mansfield Mela; Jocelynn Cook; Dorothy Badry; Audrey McFarlane

doi:10.3389/fpsyg.2021.778471

Responding to the Unique Complexities of Fetal Alcohol Spectrum Disorder

Front Psychol. 2022 Jan 25:12:778471. doi: 10.3389/fpsyg.2021.778471. eCollection 2021.

Authors

Katherine Flannigan¹, Jacqueline Pei^{1

2}, Kaitlyn McLachlan^{1

3}, Kelly Harding^{1

4}, Mansfield Mela^{1

5}, Jocelynn Cook^{1

6

7}, Dorothy Badry^{1

8}, Audrey McFarlane¹

Affiliations

¹ Canada Fetal Alcohol Spectrum Disorder Research Network, Vancouver, BC, Canada.
² Department of Educational Psychology, University of Alberta, Edmonton, AB, Canada.
³ Department of Psychology, University of Guelph, Guelph, ON, Canada.
⁴ Department of Psychology, Laurentian University, Sudbury, ON, Canada.
⁵ Department of Psychiatry, University of Saskatchewan, Saskatoon, SK, Canada.
⁶ Society of Obstetricians and Gynaecologists of Canada, Ottawa, ON, Canada.
⁷ Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, ON, Canada.
⁸ Faculty of Social Work, University of Calgary, Calgary, AB, Canada.

Abstract

Fetal alcohol spectrum disorder (FASD) is a multifaceted disability, characterized not only by brain- and body-based challenges, but also high rates of environmental adversity, lifelong difficulties with daily living, and distinct sociocultural considerations. FASD is one of the most common neurodevelopmental disabilities in the Western world and associated with significant social and economic costs. It is important to understand the complexities of FASD and the ways in which FASD requires unique consideration in research, practice, and policy. In this article, we discuss our perspectives on factors that distinguish FASD from other disabilities in terms of complexity, co-occurrence, and magnitude. We provide an overview of select literature related to FASD as a socially rooted disability with intergenerational impacts and multiple layers of stigma. These social issues are intertwined with notable experiences of adversity across the lifespan and high rates of co-occurring health concerns for individuals with FASD, all of which present unique challenges for individuals, caregivers, families, service providers, and policy makers. Understanding these factors is the first step in developing and implementing specialized initiatives in support of positive outcomes for individuals with FASD and their families. Future directions are proposed for advancing research, practice, and policy, and responding to the unique complexities of FASD.

Keywords: complex needs; fetal alcohol spectrum disorder (FASD); neurodevelopmental disability; practice and policy issues; research advances.