Recognising and addressing the scale of FASD in the UK foster care system

As part of Foetal Alcohol Syndrome Disorder (FASD) awareness month, we asked developmental psychologist Dominic McSherry from Ulster University to share more about his research into FASD. Here he tells us why it is so important to continue to raise awareness and improve support for foster families caring for affected children.


For the last two decades I’ve been researching the lives of children in care and their families in Northern Ireland, with a particular focus on health and wellbeing, trying to understand the factors that impact this throughout childhood and into adulthood. Our understanding of these issues has been informed by two studies that I’ve been very fortunate to lead: the 'Mind your Health' study in 2015 and ‘Care pathways and outcomes study’ from 2000 to 2022. 

The findings from both these studies have confirmed two things: 

  1. That there are a range of challenging health difficulties, often very common, that children in foster care and their foster families have to deal with on a daily basis. 
  2. That there is a lack of understanding of how much these health difficulties may be related to FASD.  

We saw in both our studies that even though many children showed multiple health issues that could all be related to FASD (behavioural issues, learning difficulties, eye/sight problems, ADHD/ADD, stomach/digestive problems, issues with speech or language and coordination problems), barely any children had a FASD diagnosis.  

‘There are none so blind as those who will not see’

The interviews also indicated that many foster carers were not familiar with FASD terminology, and that FASD was not being considered as a potential reason for the difficulties their children were experiencing. This is a situation that is common across the UK.  

However, given that we know that maternal alcohol misuse can be a mitigating factor when children enter the care system (in England and Wales for example, this is an issue in 70 per cent of care proceedings), this appears quite counter-intuitive.  

One reason for this might be that very little is known about FASD, both in the foster care system and wider society in general, and very little information about it is made available. This leads to FASD often not being considered as the possible cause of the multiple health related difficulties that are commonly recorded for children in care. 

Unfortunately the invisibility is not surprising however, given that to date we still have not had a UK-wide prevalence study for FASD. 

Concerns and possible solutions 

If it is the case that large numbers of children within the care system are either being misdiagnosed or not diagnosed at all, when indeed they have a Foetal Alcohol Spectrum Disorder, this would raise major concerns in term of their health and wellbeing. Particularly given that FASD is associated with more than 400 comorbid conditions and a significantly increased risk of adverse outcomes across the lifespan including substance misuse, mental health problems and antisocial behaviour if not managed properly. 

In response to these concerns, I am currently working with colleagues in the FASD hub at Salford University, supported by a number of partner organisations such as The Fostering Network and Adoption UK. Together, we are developing a proposal for a research study that will, for the first time, specify how prevalent FASD is among the population across the UK and Ireland. It will also highlight the wellbeing of the families affected and explore the extent to which their needs are being met by current service provision.  

We believe that if there isn’t a greater societal recognition of the impact of the misuse of alcohol during pregnancy on children, then many thousands of children and families will continue to be failed by our health and social care systems. And this must be avoided at all cost.  


More information on FASD, the symptoms, prevalence and how to manage it can be found here

author Follow this blogger