I am a retired physician who specialized in FASD; the parent of a son, 37, who has FASD.
Following is my topic.
THE MYTH OF FAS
It is a myth that FAS is the most severe/worst form of FASD.
The most that can be said is that some with FAS may be the most neurologically affected [27%].
These are the facts
1- only 10%-15% of those diagnosed with FASD will have the facial features [FAS]
2- only approximately 27% of individuals with the facial features [FAS] will have an I.Q. below 70.
3- of the remaining 73% of those with the facial features [FAS] the range of I.Q. will vary from the low to high average.
4- of those who do not have the facial features [ARND] 9% will have an I.Q. below 70.
5- all those diagnosed FASD [FAS and ARND] will have degrees and combinations of impairment of the various domains of brain function, as demonstrated in the neurological assessments used in the process of the diagnosis.
6- While the I.Q. is a measure of the individual’s overall intellect it is not a measure of the individual’s ability to function in society; for this all domains of brain function need to be assessed separately. In particular, Executive and Adaptive Functioning appear to be universally impaired in FASD [FAS and ARND], no matter the level of I.Q.
7-The degree of functional impairment can only be assessed by neuropsychological testing, not be the presence or absence of facial features.
The myth that FAS is the most severe form of FASD causes confusion and erroneous conclusions.
It is not just a matter of semantics. In a recent appeal case the expert witness for the crown stated that the appellant was not severely affected since he did not have the facial features.
Streissguth A.P. et.al. The Occurrence of Secondary Disabilities in Clients with Fetal Alcohol Syndrome [FAS] and Fetal Alcohol Effects [FAE]. Final Report. University of Washington School of Medicine Department of Psychiatry and Behavioural Sciences. 1996.