04/17/2024
What are the differences between FASD and ADHD ?
There are many similarities between fetal alcohol spectrum disorders (FASD) and attention- deficit/hyperactivity disorder (ADHD). Both disorders can affect brain function, development and behavior. While many of the effects of FASD and ADHD are similar, research suggests that the parts of the brain that are most affected differ between the two disorders.1 Because of this, FASD has been linked with more executive function issues than ADHD.2 Executive function includes things like self-control, reasoning, problem solving and planning. 3
People can have both FASD and ADHD at the same time. Studies have found that people with FASD are 10 times more likely to have ADHD.4 Other studies have found that about half of children with FASD also have ADHD.5 If someone has both FASD and ADHD, it is important that their care team considers both diagnoses when planning and implementing treatment.
Treatment responses for people with ADHD and FASD are different from those who only have ADHD.6 For example, people with FASD and ADHD may react differently to stimulant medication than those who only have ADHD. 7
How are FASD and ADHD similar?
In both disorders:
Drinking alcohol during pregnancy can be the cause.8, 9
However, ADHD can also be caused by genes, to***co or drug use during pregnancy, brain injury, and other things. FASD is only caused by drinking during pregnancy.
The effects are typically lifelong.10, 11 Brain structure may be affected.12, 13 Early intervention can help. 14, 15
Effects can include hyperactivity, impulsive behavior and short attention span.16, 17, 18, 19, 20, 21
Those affected may have sensitivity to light, touch, taste, smell or sound.22, 23
There may be a link to microcephaly, which is when the head and brain are much smaller than expected.24, 25
Those affected may have difficulty in school.26, 27
Both disorders are listed in the ICD-10 (International Statistical Classification of Diseases and Related Health Problems) and the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5).28, 29, 30, 31
How are FASD and ADHD different?
Sources:
1. Jacobson JL, Dodge NC, Burden MJ, Klorman R, Jacobson SW. Number processing in adolescents with prenatal alcohol exposure and ADHD: differences in the neurobehavioral phenotype. Alcohol Clin Exp Res. 2011;35(3):431–442.
2. Kingdon D, Cardoso C, McGrath JJ. Research review: Executive function deficits in fetal alcohol spectrum disorders and attention- deficit/hyperactivity disorder: A meta-analysis. The Journal of Child Psychology and Psychiatry. 2016;57(2):116-131.
3. Diamond A. Executive functions. Annu Rev Psychol. 2013;64:135–168.
4. Kambeitz, C., Klug, M.G., Greenmyer, J. et al. Association of adverse childhood experiences and neurodevelopmental disorders in people with fetal alcohol spectrum disorders (FASD) and non-FASD controls. BMC Pediatr. 2019;19:498.
5. Reid N, Shelton D, Warner J, O’Callaghan F, Dawe S. Profile of children diagnosed with a fetal alcohol spectrum disorder: A retrospective chart review. Drug and Alcohol Review. 2017;36:677-681.
6. Young S, Absoud M, Blackburn C, Branney P, Colley B, Farrag E, Fleisher S, et al. Guidelines for identification and treatment of individuals with attention deficit/hyperactivity disorder and associated fetal alcohol spectrum disorders based upon expert consensus. BMC Psychiatry. 2016;16:324.
7. Peadon E, Elliott EJ. Distinguishing between attention-deficit hyperactivity and fetal alcohol spectrum disorders in children: Clinical guidelines. Neuropsychiatric Disease and Treatment. 2010;6:509-515.
8. Burd L, Blair J, Dropps K. Prenatal alcohol exposure, blood alcohol concentrations and alcohol elimination rates for the mother, fetus and newborn. Journal of Perinatology. 2012;32(9):652-659.
9. National Institute of Mental Health. Attention-deficit/hyperactivity disorder (ADHD): The basics. https://www.nimh.nih.gov/health/publications/attention-deficit-hyperactivity-disorder-adhd-the-basics/index.shtml
10. Noor S, Milligan ED. Lifelong Impacts of Moderate Prenatal Alcohol Exposure on Neuroimmune Function. Frontiers in Immunology. 2018.
11. Faraone SV, Larsson H. Genetics of attention deficit hyperactivity disorder. Molecular Psychiatry. 2019;24:562-575.
12. Lebel C, Roussotte F, Sowell ER. Imaging the impact of prenatal alcohol exposure on the structure of the developing human brain. Neuropsychol Rev. 2011;21:102-118.
13. Bayard F, Nymberg Thunell C, Abé C, et al. Distinct brain structure and behavior related to ADHD and conduct disorder traits. Molecular psychiatry. 2018.
14. Hagan JF, et al. Neurobehavioral disorder associated with prenatal alcohol exposure. Pediatrics. 2016;138(4):e20151553.
15. Smith E, Koerting J, Latter S, et al. Overcoming barriers to effective early parenting interventions for attention-deficit hyperactivity disorder ( ADHD): parent and practitioner views. Child: Care, Health & Development. 2015;41(1):93-102.
16. Peadon E, Elliott EJ. Distinguishing between attention-deficit hyperactivity and fetal alcohol spectrum disorders in children: clinical guidelines. Neuropsychiatr Dis Treat. 2010;6:509–515.
17. Sarver D, Rapport M, Kofler M, Raiker J, Friedman L. Hyperactivity in Attention-Deficit/Hyperactivity Disorder (ADHD): Impairing deficit or compensatory behavior? Journal of Abnormal Child Psychology. 2015;43(7):1219-1232.
18. Pei J, Leung WSW, Jampolsky F, Alsbury B. Experiences in the Canadian criminal justice system for individuals with Fetal Alcohol Spectrum Disorders: Double jeopardy?. Canadian Journal of Criminology & Criminal Justice. 2016;58(1):56-86.
19. Francx WCL, Zwiers MP, Mennes MJJ, et al. White matter microstructure and developmental improvement of hyperactive/impulsive symptoms in Attention-Deficit/Hyperactivity Disorder. Journal of Child Psychology and Psychiatry and Allied Disciplines. 2015;56:1289- 1297.
20. Gross AC, Deling LA, Wozniak JR, Boys CJ. Objective measures of executive functioning are highly discrepant with parent-report in fetal alcohol spectrum disorders. Child Neuropsychology. 2015;21(4): 531-538.
21. Christakou A, Murphy CM, Chantiluke K, et al. Disorder-specific functional abnormalities during sustained attention in youth with Attention Deficit Hyperactivity Disorder (ADHD) and with autism. Molecular Psychiatry. 2013;18(2):236-244.
22. Masotti P, Longstaffe S, Gammon H, Isbister J, Maxwell B, Hanlon-Dearman A. Integrating care for individuals with FASD: results from a multi-stakeholder symposium. BMC Health Services Research. 2015;15(1):1-12.
23. Shimizu VT, Bueno OFA, Miranda MC. Sensory processing abilities of children with ADHD. Brazilian journal of physical therapy. 2014;18:343-352.
24. Treit S, Zhou D, Chudley AE, et al. Relationships between Head Circumference, Brain Volume and Cognition in Children with Prenatal Alcohol Exposure. PLoS ONE. 2016;11(2):1-15.
25. Aagaard K, Bach CC, Henriksen TB, Larsen RT, Matthiesen NB. Head circumference at birth and childhood developmental disorders in a nationwide cohort in Denmark. Paediatr Perinat Epidemiol. 2018;32(5):458-466.
This brochure provides information about attention-deficit/hyperactivity disorder (ADHD) in children and teens including symptoms, how it is diagnosed, causes, treatment options, and helpful resources.