People diagnosed with either fetal alcohol syndrome or fetal alcohol effect are more likely to escape social and interpersonal problems if they are diagnosed early in life and raised in a stable and nurturing environment, according to an article in the August 12th issue of the Journal of Developmental and Behavioral Pediatrics.

The current work involved evaluation of histories and current circumstances of 415 subjects. Of all factors that might positively or negatively affect a child with fetal alcohol exposure, early diagnosis and stable home environment were the two factors are most important in helping children avoid later negative experiences including confinement for criminal violations and other reasons, trouble with the law, inappropriate sexual behavior, alcohol or drug problems, and disrupted education.

“Our interviews with the caregivers of our study subjects, who ranged in age from 6 to 51 years, showed that the odds of escaping these adverse life experiences are improved two-to-four-fold by being diagnosed with fetal alcohol syndrome or fetal alcohol effect at an early age and by being raised in a good stable environment,” Ann Streissguth, MD, lead author of the study, said. “This is the first study to show that despite the prenatal brain damage caused by their mothers’ consumption of alcohol during pregnancy, these children can grow up to have relatively more successful lives.”

Fetal alcohol syndrome is characterized by structural or functional brain damage, growth deficiency and a unique pattern of facial features. Individuals with fetal alcohol effect have some brain damage but often lack the physical and growth characteristics. Both are birth defects with lifelong implications that can occur in children whose mothers drink alcohol during pregnancy. These children often have problems with learning, memory, attention and problem solving, as well as physical disabilities.

Streissguth and her colleagues designed a life history interview, which they administered with the caregivers or other knowledgeable informants about the life span experiences of 415 patients with one of the disorders and a median IQ 86. From these interviews and previous clinical experience, the researchers designated five adverse life outcomes and 18 associated risk or protective factors in the environment that might influence these negative outcomes.

For adolescents and adults, the life span prevalence was 61 percent for disrupted school experiences, 60 percent for trouble with the law, 50 percent for confinement (in detention, jail, prison or a psychiatric or alcohol/drug inpatient treatment), 49 percent for inappropriate sexual behavior on repeated occasions, and 35 percent for alcohol or drug problems.

“Unfortunately, many people feel that a fetal alcohol syndrome or fetal alcohol effect diagnosis is hopeless, and that maybe it’s better to just let these children grow up without knowing that they have this disability,” Streissguth noted. “In this study, we have done life history interviews on patients who were diagnosed in the 1970s, ‘80s, and ‘90s. These two positive factors, living in a stable, nurturing environment and having a diagnosis at an early age, are now documented for the first time as having a strong influence on what was previously assumed by many people to be an unchangeable situation.”