Five Facts Social Workers Need to Know About Preventing Fetal Alcohol Spectrum Disorders (FASDs)
Social workers across practice settings provide services to individuals, including pregnant people, who are consuming alcohol at risky levels. Reducing problematic alcohol use is crucial to preventing fetal alcohol spectrum disorders (FASDs)—neurodevelopmental disabilities and birth defects that can occur in a baby exposed to alcohol before birth. FASDs represent a range of behavioral, intellectual, and physical disabilities across the lifespan, and might affect up to 5% of school children nationwide. Accurate figures regarding FASD prevalence is hampered by underreporting and persistent challenges in diagnosis.
This Fetal Alcohol Spectrum Disorders (FASD) Awareness Month, social workers can deepen their understanding of FASDs and how to prevent them. A key tool in FASD prevention is universal alcohol screening, brief intervention, and referral to treatment (SBIRT), an evidence-based, highly effective modality for evoking a client’s motivation to address risky substance use.
To get started, here are five facts about FASDs social workers need to know.
One: FASDs are a leading preventable cause of lifelong behavioral, intellectual, and physical disabilities in the U.S.
FASDs are preventable if a baby is not exposed to alcohol before birth. Despite redoubled efforts over the past 30 years to prevent prenatal alcohol exposure, nearly 1 in 7 pregnant people report current alcohol use, and about 1 in 20 report binge drinking in the past 30 days.
People with FASDs are at high risk for difficulty in school, including learning disabilities, sensory issues, and behavior problems. They are also at risk for trouble with the law, substance use disorders, and mental health disorders. As social workers know well, these risks can impact individuals and families at every age and stage of life, making prevention, early identification, and intervention crucial.
Two: FASDs are identified in higher rates in Black, Indigenous and People of Color (BIPOC) and low-socioeconomic class communities, and pregnant BIPOC people with substance use disorders are less likely to seek and receive substance use treatment.
As with other health conditions, there are racial/ethnic disparities in FASD prevention and care.
Three: There is no known no safe time, safe amount, and no safe type of alcohol use during pregnancy.
Alcohol use at any time during pregnancy can harm a developing baby. There is also no known safe amount of alcohol or safe type of alcohol to drink while pregnant, since all types of alcohol can be harmful, including wine, beer, and liquor. Though some babies might not be affected by prenatal alcohol exposure, it is impossible to know which babies will be affected.
Four: Social workers are uniquely positioned to support FASD prevention efforts.
As one of the nation’s key providers of mental and behavioral health services, social workers play a key role in preventing FASDs through universal alcohol screening, brief intervention, and referral to treatment (SBIRT). Via SBIRT, clients complete a short screening tool. This is followed by a guided conversation (“brief intervention”) with a health professional skilled in SBIRT, and referral to treatment when appropriate. SBIRT is a crucially important public health and behavior change modality and part of a robust social work practice portfolio.
In recognition of social work’s essential role in addressing prenatal alcohol use, NASW Foundation, together with the Health Behavior Research and Training Institute at The University of Texas at Austin Steve Hicks School of Social Work, are collaborating on the FASD National Partners Network. This Centers for Disease Control and Prevention (CDC)-funded initiative is the only one of its kind that includes social work at the center of prevention practice— along with family medicine, obstetrics-gynecology, pediatrics, nursing, and medical assisting.
Five: Alcohol SBIRT is a highly effective prevention tool—but it remains underused.
Based on more than 30 years of research, the U.S. Preventive Services Task Force has recommended alcohol SBI for all adults, including pregnant people, in primary healthcare settings. Despite the evidence, alcohol SBIRT remains underutilized. A recent study found that 80% of pregnant people were asked about recent alcohol use at their last healthcare visit, but just 16% who reported current drinking were advised to stop or cut back on drinking. These findings highlight the significant opportunity for social workers to integrate alcohol SBIRT into routine practice to help prevent and reduce alcohol use during pregnancy.
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Article by Diana Ling, MA, Senior Program Manager; and Anna Mangum, MSW, MPH, Senior Health Strategist; Health Behavior Research and Training Institute, Steve Hicks School of Social Work, The University of Texas at Austin.
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This initiative, Engaging Social Workers in Preventing Alcohol- and Other Substance-Exposed Pregnancies, is supported by the Centers for Disease Control and Prevention of the U.S. Department of Health and Human Services as part of a financial assistance award totaling $560,000 with 100 percent funded by CDC/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement by, CDC/HHS, or the U.S. Government.
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