FETAL ALCOHOL SYNDROME:
THE COST TO SOCIETY
Each baby born with Fetal Alcohol Syndrome (FAS) costs society $4 million or more during its
lifetime, and it's estimated that FAS costs the United States $6 billion annually. But even these
figures, researchers say, may be huge underestimates.
Bertis Little et al. note in a recent article that "none of these estimates has projected the mental
health costs, or that patients with FAS would be unable to be at least partially productive in the
workplace." The researchers say that "the severe behavioral problems associated with FAS in later
adolescence make many of these [people] unsuitable candidates for the usual job training
programs." In addition, they may increase their risk of running afoul of the law.
Ann Streissguth, a leading FAS researcher, has found that 6.2% of adolescents and adults with
FAS exhibit "significant levels of maladaptive behaviors" including impulsivity, lack of
consideration for others, lying, cheating, and stealing. Because of their impulsivity and impaired
judgment, individuals with FAS also are at high risk for alcohol or drug abuse. And FAS is
beginning to be recognized by the legal community as a risk factor for criminal behavior; for
instance, murderer Robert Alton Harris's final (unsuccessful) clemency hearing focused on the fact
that the jury hadn't been told he suffered from the disorder.
While FAS and FAE (Fetal Alcohol Effects, a milder but still debilitating form of alcohol-caused
damage) are common disorders, and both can cause cognitive defects, impulsive behavior, low IQ,
and reduced empathy-all risk factors for criminal behavior-no research has specifically
examined whether or not the FAS/FAE population has a significantly increased rate of crime and
delinquency. Both FAS and FAE, however, are strongly linked to social and vocational failure;
Little and colleagues note, for instance, that their study subjects "had extreme difficulty with
independent living, including poor judgment, and lived generally dysfunctional lives," while
Streissguth says that her adolescent and adult subjects exhibited increasingly inappropriate sexual
behavior, loneliness, and depression.
Little and colleagues note that FAS and FAE often go undiagnosed, citing a study revealing a
100% failure rate in diagnosing FAS in newborns at a major U.S. hospital. They say that early
diagnosis is vital, and that "it is also imperative that schools and communities be challenged to
provide more appropriate early intervention for FAS and FAE patients to prevent victimization,
dysfunctional lives, psychopathology, chronic mental illness, and homelessness."
FAS is the leading known cause of retardation, surpassing Down syndrome and spina bifida, and
may be the leading preventable cause of learning disabilities as well. About 7,500 babies are born
with FAS each year; symptoms include attention deficits, memory problems, incoordination,
impulsiveness, distractibility, emotional instability, hyperactivity, neurological and facial
abnormalities, and speech and hearing impairment. Recent research found the prevalence of FAS in
Seattle to be one in 750 births, while on some Native American reservations the rate may be as
high as one in 97 births. Researchers suspect that far more children suffer from FAE, which is
even more likely to go undetected because its victims often have normal or near-normal IQs.
"Fetal Alcohol Syndrome-diagnosis, prevention, prognosis, and management," Bertis Little,
Golder Wilson, Twila Cummens Teasley, and Laura Snell; Dallas Medical Journal, January
1995. Address: Bertis Little, Division of Prenatal Diagnosis and Clinical Genetics, Department of
Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX.
"Fetal Alcohol Syndrome in adolescents and adults," Ann Pytkowicz Streissguth et al., Journal of
the American Medical Association, April 17, 1991, Vol. 265, No. 15. Address: A. P. Streissguth,
Department of Psychiatry and Behavioral Sciences, GG-20, University of Washington School of
Medicine, 2707 N.E. Blakeley, Seattle, WA 98195.