Fetal alcohol syndrome (FAS) and attention deficit hyperactivity disorder (ADHD) have similar symptoms and often occur together. Certain environmental factors, like prenatal alcohol exposure and difficult childhood experiences, may contribute to this link.

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FAS is classified under fetal alcohol spectrum disorder (FASD), a collective term for several conditions caused by prenatal (before birth) alcohol exposure. FAS is considered one of the most severe forms of FASD.

ADHD is a neurodevelopmental condition. Its exact causes aren’t clear but stem from changes in your brain’s structure and function during early childhood.

FAS and ADHD are frequently diagnosed together. Read on to learn more about their similarities and differences.

Learn more about fetal alcohol syndrome and ADHD.

FAS and ADHD are distinct and different conditions. No direct cause-and-effect relationship has been established between them, but they do share certain symptoms and environmental factors, and they very frequently occur together.

A review and meta-analysis study from 2016 found that more than half of people living with FASD also experienced ADHD.

FAS and ADHD similarities include certain environmental risk factors and symptoms.

Environmental factors

Environmental factors are external influences that affect a condition’s development.

ADHD and FAS share the common risk factor of prenatal alcohol exposure. Prenatal alcohol exposure occurs when a birthing parent consumes alcohol during pregnancy.

Prenatal alcohol exposure is always the underlying cause of FAS and is a possible contributing factor to ADHD. In both conditions, prenatal alcohol exposure can cause changes to an infant’s developing brain.

Children born with FAS may also be more likely to experience environmental factors known as adverse childhood events, like abuse or neglect, which may increase their chances of developing ADHD.

Overlapping symptoms

ADHD and FAS can both affect areas of the brain essential to executive function. Conditions that affect your executive function can cause similar symptoms.

Both FAS and ADHD, for example, can feature symptoms of varying severity related to:

These symptoms can contribute to social and behavioral similarities. Children living with FAS and ADHD may find learning and social situations challenging, for example, or they may engage in behaviors that may have harmful effects without thinking about the consequences.

ADHD and FAS might appear very similar at first glance, but important differences in their causes, processes, and symptoms set them apart.

Different disease process

ADHD and FAS differ in the underlying causes and processes associated with each condition’s development.

In FAS, prenatal alcohol exposure directly it. In ADHD, prenatal alcohol exposure might be a contributing factor, but not all people with ADHD were exposed to alcohol before birth.

The underlying causes of ADHD aren’t well understood and may vary between individuals. ADHD appears to involve a complex dynamic between genetics, environmental exposures, and other neurobiological factors.

Different symptoms

FAS causes symptoms beyond hyperactivity, impulsivity, and inattention. FAS is the leading cause of intellectual disability or below-average intellectual function. Intellectual disability is possible but less common in ADHD.

FAS is also associated with certain physical growth and trait patterns, such as:

  • a smooth philtrum (a smooth groove between the upper lip and nose)
  • thin upper lip
  • narrowed eye openings
  • low birth weight
  • microcephaly (smaller-than-average head)
  • shorter-than-average height
  • structural abnormalities to internal organs and systems

ADHD is not linked to any specific physical trait or growth pattern.

Preventable vs. unknown prevention

FAS is 100% preventable by avoiding alcohol consumption during pregnancy.

Currently, there’s no known way to prevent ADHD.

The reasons a person may have FAS and ADHD together aren’t clear, but shared risk factors like prenatal alcohol exposure and difficult childhood events likely play a role.

In other words, some of the same factors that cause FAS may also increase the risk of having ADHD.

Due to overlapping symptoms, it can be challenging to tell apart behaviors in individuals with FAS and behaviors in individuals with ADHD.

Determining whether someone has both conditions requires expert evaluation. It may involve a multidisciplinary team of healthcare professionals.

Children with FAS and ADHD will experience lasting symptoms related to hyperactivity, inattention, and impulsivity, such as:

  • missing details or making careless mistakes
  • difficulty staying focused during long-format activities
  • finding it difficult to organize tasks or do them in sequence
  • distractibility
  • forgetfulness
  • constant fidgeting
  • excessive talking
  • interrupting conversations
  • being constantly in motion
  • not wanting to wait for their turn

Doctors may diagnose ADHD when an individual’s symptoms meet the diagnostic criteria for ADHD and go beyond what’s typically seen in people with FAS.

Treatment for FAS and ADHD depends on your individual support needs, but both conditions may involve:

  • behavioral interventions
  • educational supports
  • parental training
  • occupational therapy
  • speech therapy
  • environmental modifications
  • medication

If you’re a caregiver for a child living with FAS and ADHD, you can help by:

  • supporting the child when they need assistance
  • learning about FAS and ADHD
  • using encouragement and praise to reinforce desired behaviors
  • learning and using positive coping skills and stress management in your own daily life
  • setting clear boundaries, rules, and expectations for the child
  • following through with at-home recommendations from the child’s medical team
  • creating opportunities for the child to engage positively with peers
  • encouraging the child to develop a sense of control and choice by helping them set attainable goals
  • working with the child’s teacher or school to help determine what interventions or accommodations are needed
  • regularly assessing how you support the child and making changes as needed
  • attending routine appointments with the child’s healthcare professionals to monitor growth and development

Finding help for a child who has FAS and ADHD

The following websites can help you learn more about FAS and ADHD and find resources and support in your area:

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Can ADHD be caused by fetal alcohol syndrome?

Currently, there’s no evidence to suggest that FAS directly causes ADHD.

Can alcohol cause ADHD in a fetus?

Prenatal alcohol exposure increases a child’s chances of having ADHD but has not been identified as a sole cause of ADHD.

What are the signs and symptoms of FASDs?

Characteristic physical growth and trait patterns of FAS and FASD include:

  • a smooth philtrum (a smooth groove between the upper lip and nose)
  • thin upper lip
  • narrowed eye openings
  • low birth weight
  • microcephaly (smaller-than-average head)
  • shorter-than-average height
  • structural abnormalities to internal organs and systems

FAS and ADHD are separate conditions that often occur together. While the exact link between them isn’t fully understood, factors associated with FAS, like prenatal alcohol exposure and increased risk of adverse childhood experiences, may increase the likelihood of ADHD.

Behavioral interventions, educational supports, and environmental modifications can help children with FAS and ADHD develop new skills that boost their overall well-being.