Balancing the story of fetal alcohol spectrum disorder: A narrative review of the literature on strengths

Alcohol Clin Exp Res. 2021 Dec;45(12):2448-2464. doi: 10.1111/acer.14733. Epub 2021 Nov 16.


For many years, researchers have explored the complex challenges experienced by individuals with fetal alcohol spectrum disorder (FASD). This research has been important for documenting the brain- and body-based impacts of prenatal alcohol exposure and the psychosocial vulnerabilities and environmental adversities frequently associated with FASD. It has also supported advocacy efforts and highlighted the necessity of providing FASD services and supports. However, with the focus on deficits and needs, there is a considerable gap in the literature on the strengths and successes of individuals with FASD. The lack of strengths-based FASD research has likely perpetuated the stress and stigma experienced by individuals with FASD and their families. Thus, there is a critical need to shift the direction of the field. Here we provide a narrative review of the literature on strengths in FASD. Our goals are to: (1) understand the state of strengths-based research related to individuals with FASD across the lifespan, and (2) describe positive characteristics, talents, and abilities of individuals with FASD that may be cultivated to promote their fulfillment and well-being. We identified a total of 19 studies, most of which were conducted to explore the lived experiences of adults with FASD. This preliminary but critical body of evidence highlights the intrinsic strengths of individuals with FASD, including strong self-awareness, receptiveness to support, capacity for human connection, perseverance through challenges, and hope for the future. Despite the importance of this emerging evidence, appraisal of the literature indicates a need for more intentional, methodologically rigorous, participatory, and theory-driven research in this area. Findings from this study, including the identified gaps in the literature, can be used to inform research, practice, and policy to meaningfully advance the field of FASD and promote positive outcomes in this population.

Keywords: character strengths; fetal alcohol spectrum disorder; literature review; positive psychology; prenatal alcohol exposure.

Publication types

  • Review

MeSH terms

  • Alcohol Drinking / epidemiology
  • Evidence-Based Medicine*
  • Female
  • Fetal Alcohol Spectrum Disorders / diagnosis
  • Fetal Alcohol Spectrum Disorders / epidemiology*
  • Humans
  • Practice Guidelines as Topic
  • Pregnancy
  • Prenatal Exposure Delayed Effects / diagnosis
  • Prenatal Exposure Delayed Effects / epidemiology*