# Life outcomes in adults living with FASD in a rural South African community: A follow-up study

## TL;DR

This study examines the life outcomes of adults with FASD in a rural South African community, finding some negative impacts but less stark differences than expected due to shared community challenges.

## Contribution

The study provides the first evidence on FASD life outcomes in South Africa, highlighting the influence of rural social contexts on perceived disability impacts.

## Key findings

- Adults with FASD were less likely to be in relationships and had worse educational outcomes compared to peers.
- None of the FASD participants completed secondary school successfully, and they were more likely to experience violence.
- Differences in employment, health, and independent living were not significant between FASD and control groups.

## Abstract

Even though adults with foetal alcohol spectrum disorder (FASD) are at risk of negative life outcomes, there is no published evidence of this in South Africa, which has the highest estimated FASD prevalence rate globally.

The purpose of the study was to describe and compare the life outcomes of adults with FASD and adults without FASD in a South African rural community, 16 years after diagnosis.

Participants were examined and interviewed regarding their biographical information, knowledge of FASD, information on their family, relationships, home circumstances, education, work and medical history.

Adults with FASD were less likely to be in a relationship and more likely to have poor educational outcomes and to be exposed to violence as victim or perpetrator than their peers who did not have FASD. None of the participants with FASD completed secondary school successfully. No differences were found for independent living, employment, health, substance use and legal outcomes, between the foetal alcohol syndrome (FAS) or partial foetal alcohol syndrome (PFAS) and control group.

While significant differences existed in certain aspects, differences are not as stark as one would expect between individuals with FASD and controls.

This study highlights the importance of considering the social context in which a FASD diagnosis is made. The comparative negative impact of an FASD diagnosis and the associated challenges on life outcomes may be less pronounced in rural communities where everyone has fewer opportunities and resources. This can also make the unique needs of persons with disabilities less visible.