Fetal Alcohol Syndrome Symptoms and Signs
Most of the features of FAS are variable. They may or may not be
present in a given child. However, the most common and consistent features
of FAS involve the growth, performance, intelligence, head and face,
skeleton, and heart of the child.
Growth is diminished. Birth weight is lessened. Retardation of
longitudinal growth is evident on the measurements of length in infancy
and of standing height later in childhood. The growth lag is permanent.
Performance is impaired. The FAS infant is irritable. The older FAS
child is hyperactive. Fine motor skills are impaired with weak grasp, poor
hand-eye coordination, and tremors.
Intelligence is diminished. The average IQ is in the 60s. (This level
is considered mild mental retardation and qualifies a child in the U.S. as
educable mentally retarded.)
The head is small (microcephalic). This decrease may not even be
apparent to family and friends. It is evident upon comparison of the
child's head circumference to that of a normal child on a growth chart.
The usual degree of microcephaly in FAS is classified as mild to moderate.
It is primarily due to failure of brain growth. The consequences are
neither mild nor moderate.
The face is characteristic with short eye openings (palpebral fissures),
sunken nasal bridge, short nose, flattening of the cheekbones and midface,
smoothing and elongation of the ridged area (the philtrum) between the
nose and lips, and smooth, thin upper lip.
The skeleton shows characteristic changes; abnormal position and
function of joints, shortening of the metacarpal bones leading to the
fourth and fifth fingers, and shortening of the last bone (the distal phalanx) in
the fingers. There is also a small fifth fingernail and a single transverse
(simian) crease across the palm.
A heart murmur is often heard and then may go away. The basis is usually
a hole between the right and left sides of the heart between the
ventricles (the lower chambers) or less commonly, the atria (the upper
A number of other birth defects can occur in children with FAS. These
include such major birth deformities such as hydrocephalus (increased
fluid pressure on the brain that may require shunting to relieve the
pressure), cleft lip (sometimes with a cleft palate), coarctation
(narrowing) of the aorta, and meningomyelocele (spina bifida).