Prognosis

Fetal alcohol spectrum disorder (FASD) is lifelong condition. There is no curative treatment. Prognosis depends on the severity of congenital anomalies, the need for surgical and medical treatments, the age at which therapy is introduced, and the efficacy of treatment. Affected children are susceptible to a range of disabilities that are secondary to neurodevelopmental problems.[40] Children can be helped to fulfil their potential by use of targeted educational and behavioural interventions.

When examining the risk of adverse outcomes, there is evidence that prognosis can be improved by early diagnosis.[40] Diagnosis before the age of 12 years decreases the risk of a range of adverse adult outcomes between 2- and 4-fold.[40] Other protective factors include living in a stable, nurturing home and not being exposed to physical or sexual abuse or domestic violence.[40]

Social functioning

Only 14% of young adults live independently, whereas 27% live in institutions and 35% in assisted-living settings.[87] Adults with FASD are more likely to be unemployed,[88] and only 13% of adults have held an ordinary job by the age of 21 years.[87]

Education outcomes are poor and influence a range of other outcomes, including employment. Of adolescents, 53% have been suspended from school, 29% have been expelled, and 25% have dropped out of school.[40] Only 13% of young adults have had a high school education;[87] 96% of children and adolescents have received special education.[89]

Inappropriate sexual behaviour increases with age to 52% in adults.[40] Common problems in adolescents and adults are promiscuity (26%) and inappropriate sexual advances (18%).[40]

Around 60% of adolescents and adults have had contact with the law, and 35% have been incarcerated for a crime.[40] However, one study noted that the levels of criminal offenses were similar to the control population.[88]

Hospital admission rates for alcohol use and psychiatric disorders are higher in adults with FASD.[88]

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