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September | October 2012

A First Drink Before a First Breath: Fetal Alcohol Spectrum Disorders

September 9 was International Fetal Alcohol Spectrum Disorders (FASD) Awareness Day. OJJDP and its partnering agencies are working to increase public understanding about the physical, mental, emotional, and behavioral challenges faced by youth with FASD.

FASD is an umbrella term for a range of disabilities of varying severity that affect children whose mothers drank alcohol during pregnancy. The disabilities are irreversible, although early diagnosis and treatment can be of considerable help to children with this condition. FASD is the leading known cause of preventable cognitive impairment in the United States, and its prevalence has been estimated as high as 1 of every 100 live births.

OJJDP's Underage Drinking Enforcement Training Center estimates that the cost to the United States in 2010 of babies born with FASD to mothers ages 15 to 20 was more than $1.3 billion.

Youth with FASD can be of average intelligence and have good verbal skills. However, they often have poor social skills, lack impulse control, and have difficulty managing conflict. This can lead to rejection from peer groups and association with other socially isolated children, which increases the risk of delinquent behavior. Children who are affected by FASD are at increased risk for involvement with the juvenile justice system.

Children with FASD tend to come from unstable family environments, and many end up in foster care, a factor that further increases their chances of entering the juvenile and criminal justice systems. The National Organization on Fetal Alcohol Syndrome reports that up to 70 percent of children in foster care have FASD.

Sixty-one percent of adolescents with FASD have been in legal trouble. Thirty-five percent of those with FASD who are older than age 12 have been incarcerated at some point in their lives.

Although a few juvenile court judges have helped their courts identify and aid children with FASD, standard juvenile justice interventions currently do not take FASD-related disabilities into account. Most attorneys and judges are unfamiliar with the effects of FASD and the special needs of this population. Thus, youth and adults with FASD often do not receive appropriate treatment and care in the justice system.

That is all beginning to change—thanks to the Justice Issues Working Group, a component of the Interagency Coordinating Committee on Fetal Alcohol Spectrum Disorders (ICCFASD).

Created in 1996, ICCFASD seeks to improve communication and collaboration between agencies to address pressing issues related to FASD, including health, education, developmental disability, research, justice, and social services. OJJDP has been a member of ICCFASD since the late 1990s.

Over the past 15 months, the OJJDP-led Justice Issues Working Group has moved swiftly with the American Bar Association (ABA) Center on Children and the Law, the National Council of Juvenile and Family Court Judges, and other partners to raise awareness about FASD among legal and judicial professionals and begin developing strategies that more effectively meet the needs of FASD-affected individuals:

  • At OJJDP's October 2011 National Conference for Children's Justice and Safety, attended by more than 2,000 researchers, policymakers, and practitioners, the working group held sessions on the legal and health-related implica­tions of FASD, the impact of maternal alcohol abuse on newborns, and the implica­tions for the child welfare and juvenile justice systems.
  • In February 2012, the working group collaborated with the ABA Commission on Youth at Risk and Center on Children and the Law to organize a 4-hour continuing legal education training session on FASD at the ABA midyear meeting in New Orleans, LA. Medical, law, and justice experts presented information about FASD's impact on the lives of youth and families and the implications for juvenile, criminal, and child and family law. Howard Davidson, director of the Center on Children and the Law, described the development of a policy resolution on FASD to be introduced at the August 2012 ABA annual meeting in Chicago.

    At the annual meeting, the ABA House of Delegates unanimously passed the resolution, which urges legal professionals to receive training to better identify and assist FASD-affected children and adults in the justice system. The resolution also recommends the passage of legislation and adoption of policies at all levels of government to address the effects of FASD and to better assist individuals with FASD.
  • The ABA Section of Litigation (Children's Rights Litigation Committee) hosted the Webinar, "Fetal Alcohol Syndrome Disorders: What You Need To Know To Help Your Clients." Speakers discussed how courts should treat individuals with FASD, and what services and special accommodations these individuals should receive. A CD recording of the Webinar may be ordered on the ABA Web site.
  • OJJDP awarded a $30,000 fiscal year 2012 grant to the National Council of Juvenile and Family Court Judges to conduct, in collaboration with the Justice Issues Working Group, a survey of the judiciary to identify needs related to FASD in the courtroom, develop a technical assistance bulletin based on the survey results, and work with judges to create a judicial bench card to raise awareness about and address issues related to youth with FASD.

"It is so important that we open up a discussion about FASD, that we raise awareness, and that we all learn more about how we can better serve the needs of kids with FASD," said OJJDP Acting Administrator Melodee Hanes. "We need to be better informed about the factors that dispose these kids to come into contact with the justice system, how to effectively represent these youth in court, and how to most appropriately handle these youth if they should enter the juvenile justice system."


To learn more about FASD, visit the Web sites of the Centers for Disease Control and Prevention and the National Organization on Fetal Alcohol Syndrome. For more information on legal issues associated with FASD, visit the Web site of the ABA Center on Children and the Law. Information about FASD initiatives at the National Institute on Alcohol Abuse and Alcoholism is also available online.