Fifty years after it was first coined, the diagnosis of fetal alcohol spectrum disorder (FASD) now does more harm than good and should be dropped, according to a group of Canadian doctors led by University of Alberta developmental pediatrician Sabrina Eliason. In a viewpoint article published in The Lancet Child and Adolescent Health , the doctors argue that the FASD diagnosis perpetuates racist stereotypes, fails to recognize other potential causes for developmental differences and does not necessarily lead to the individual supports children and their families need. Eliason is an assistant professor of pediatrics who leads clinics for patients with FASD, autism and other neurological disorders at Edmonton's Glenrose Rehabilitation Hospital.
She's also past president of the developmental pediatrics section of the Canadian Pediatric Society, where she set up a working group of experts from across the country to discuss their experiences and seek change. Eliason acknowledges that the FASD label was at first useful in supporting the development of specialized services for children, and it also inspired a massive public health campaign around the risks of alcohol use in pregnancy. "But now, in the context of our evolving understanding of genetics, the impacts of trauma and concepts of health equity and the intersectionality of racism, poverty, and gender issues, it's time to re-evaluate how we use that diagnosis," Eliason asserts.
"We need to seriously consider not using the ter.