Respectful Language

It is important that everyone working with children and young people with FASD and their families frame their understanding about FASD in a ‘no blame and no shame’ context. We know that complex trauma is a powerful risk factor for alcohol use in many communities across the world.

The World Health Organisation (WHO) describes social determinants as the non-medical factors that influence health outcomes (WHO 2023). These include: access to resources including health and education, poverty, homelessness, food insecurity and racism.

Women should not be judged, shamed or stigmatised about alcohol use during pregnancy. Rather, we all should be empowered with knowledge about the harm alcohol causes.

The language we use when talking about children with FASD should be respectful, and promote compassion and understanding. It is important that all accommodations and strategies that address the range of complex issues at play is strengths-based and begins with the strong belief that women do not intentionally harm their babies.

The Manitoba FASD Coalition comprises a group of Canadians concerned about the relationship between stigma and FASD. They have developed a guide to respectful language to provide alternative words or phrases to those commonly used in society, and this has been adapted below for the Australian context.

Responding to and naming FASD

Professor Elizabeth Elliott AO
Distinguished Professor in Paediatrics and Child Health at the University of Sydney

Video length: 2m 45s

Explore below the respectful language to be used when referring to FASD.

Select the + symbol to expand each item.


When referring to a person with FASD

Use "person/individual with FASD" rather than:

+ Suffering with FASD
Many people who have FASD find these words offensive because they imply that they are not living happy, productive lives. People with disabilities prefer others to focus on their strengths and positive attributes. People with fasd don’t perceive themselves in negative ways and are not looking for people to feel sorry for them.
+ Damaged by FASD
As above, many people who have FASD find these words offensive because they imply that they are not living happy, productive lives. People with disabilities prefer others to focus on their strengths and positive attributes. People with fasd don’t perceive themselves in negative ways and are not looking for people to feel sorry for them.
+ Living with FASD
The FASD community has removed ‘living with’ to reflect the language used to describe other disabilities/conditions.
+ FASD kids
The FASD community prefers to use ‘person-first’ language. This means that we talk about a person who has a disability (as well as many other traits) rather than presenting the disability as the whole of who they are.
+ (Innocent) victims or injured
These words imply that there has been a perpetrator, and is very negative towards mothers and is loaded with judgement. This language may jeopardise both a woman’s willingness to seek help and a child’s future relationships with their mother

Use "affected or impacted by" rather than:

+ Afflicted by
The term ‘afflicted’ presumes that the person does not lead a happy, productive life. ‘Affected by’ presents a more neutral tone to this disability.

Use "support person/circle/ network/coach" rather than:

+ External brain
The term ‘external brain’ was coined many years ago to give people an understanding that someone with fasd may require coaching from others at times to help with certain brain functions, like memory, problem-solving, managing money or everyday living. However, it has since been rejected by some as being offensive because it implies that they need a whole new brain to be ‘normal’. A ‘support person’ is a more accurate and neutral term.

Use "cognitive or neuro- developmental disability" rather than:

+ Mentally disabled
‘Cognitive disability’ or ‘neurodevelopmental disability’ is a more respectful terminology to describe people who may have cognitive challenges or a low IQ.

When referring to women who use alcohol during pregnancy

Use "confirmed alcohol use" rather than:

+ Admitted to alcohol use
The term ‘admitted’ implies that this is a confession of wrongdoing, and has a morally judgemental overtone. The term ‘confirmed’ is neutral.

Use "women who use alcohol or drugs" rather than:

+ Alcoholics/addicts
Research tells us that women do not intentionally seek to drink to harm their unborn child. Some women may be unaware of their pregnancy when drinking heavily. Some women have addictions and mental health challenges and find quitting extremely difficult, despite pregnancy. Some women have partners or other influences who pressure them to drink. Alcohol use is often a symptom of a person’s trauma. Shaming women with these words does not promote prevention or empower women, but rather makes them afraid to seek support.
+ Women who choose to drink
As above, research tells us that women do not intentionally seek to drink to harm their unborn child. Some women may be unaware of their pregnancy when drinking heavily. Some women have addictions and mental health challenges and find quitting extremely difficult, despite pregnancy. Some women have partners or other influences who pressure them to drink. Alcohol use is often a symptom of a person’s trauma. Shaming women with these words does not promote prevention or empower women, but rather makes them afraid to seek support.

Use "parents/caregivers" rather than:

+ Bad parents
As above, research tells us that women do not intentionally seek to drink to harm their unborn child. Some women may be unaware of their pregnancy when drinking heavily. Some women have addictions and mental health challenges and find quitting extremely difficult, despite pregnancy. Some women have partners or other influences who pressure them to drink. Alcohol use is often a symptom of a person’s trauma. Shaming women with these words does not promote prevention or empower women, but rather makes them afraid to seek support.

Do not use these terms. There are no replacements!

+ Poor choices
As above, research tells us that women do not intentionally seek to drink to harm their unborn child. Some women may be unaware of their pregnancy when drinking heavily. Some women have addictions and mental health challenges and find quitting extremely difficult, despite pregnancy. Some women have partners or other influences who pressure them to drink. Alcohol use is often a symptom of a person’s trauma. Shaming women with these words does not promote prevention or empower women, but rather makes them afraid to seek support.
+ Irresponsible
As above, research tells us that women do not intentionally seek to drink to harm their unborn child. Some women may be unaware of their pregnancy when drinking heavily. Some women have addictions and mental health challenges and find quitting extremely difficult, despite pregnancy. Some women have partners or other influences who pressure them to drink. Alcohol use is often a symptom of a person’s trauma. Shaming women with these words does not promote prevention or empower women, but rather makes them afraid to seek support.
+ Child abuser
As above, research tells us that women do not intentionally seek to drink to harm their unborn child. Some women may be unaware of their pregnancy when drinking heavily. Some women have addictions and mental health challenges and find quitting extremely difficult, despite pregnancy. Some women have partners or other influences who pressure them to drink. Alcohol use is often a symptom of a person’s trauma. Shaming women with these words does not promote prevention or empower women, but rather makes them afraid to seek support.

When referring to FASD in general

Use "preventable" rather than:

+ 100% preventable
Note:Use 'preventable' with caution too: Think carefully about the context and audience in which the term ‘preventable’ is being used as it can have negative effects.
Saying ‘100% preventable’ oversimplifies a complex issue. While theoretically possible, totally eradicating alcohol use during pregnancy is unlikely. This oversimplification removes all context in a woman’s life and defines the issue as a single, easy choice, which is not possible for many women with high alcohol use or dependency. In turn, this erodes society’s understanding and compassion for such a complex set of factors.

Use "it is recommended not to drink during pregnancy" rather than:

+ Just one drink can cause FASD
In Australia the accepted health messaging is that alcohol should be avoided during pregnancy. There is no clinical evidence that having one drink during an entire pregnancy causes significant harm. However, there is also no clinical evidence proving lower levels of alcohol use during pregnancy is safe.

Use "a balanced strengths-based approach focusing on how supports/adaptations have made good things possible" rather than:

+ Focusing mostly on challenges
The public understands that people with fasd have many different challenges. It is best to take a strengths-based approach, using positive reinforcement and focusing on abilities and positive outcomes.

Use "focus on neurodevelopmental disability" rather than:

+ Focus on facial differences
Everyone diagnosed with FASD has a neurodevelopmental disability, the effects of which can vary from person to person. Only about 20% of individuals with fasd have any physical signs, such as facial differences. Focusing on those with physical differences implies that they have a more severe form of fasd, which is not accurate.

Use "FASD with three sentinel facial features or FASD with fewer than three sentinel facial features" rather than:

+ FAS, PFAS, ARND, FAE
A FASD diagnosis requires evidence of severe impairment of brain function in at least three of ten specified neurodevelopmental areas. All acronyms other than fasd are no longer used for diagnostic purposes.

Use "secondary challenges/effects/risks" rather than:

+ Secondary disabilities
A‘Secondary disabilities’ is a term that was first used several decades ago to describe the adverse life experiences that were documented to occur in individuals, particularly adults, with fasd at a disproportionately higher rate (e.g. substance abuse or mental health disorder), and were thought to be secondary to the functional disabilities in people with fasd. New evidence suggests that mental health concerns and addictions may be primary disabilities associated with prenatal alcohol exposure. Concerns like disengaging with school and contact with the juvenile justice system are more likely to occur in any individual who has not been provided with adequate supports and understanding.

Use "FASD is caused by prenatal alcohol exposure/when a fetus is exposed to alcohol in utero/before birth" rather than:

+ FASD is caused by maternal alcohol use/ maternal alcohol exposure/maternal drinking
When describing or defining fasd, the least stigmatising approach is to move the emphasis away from the behaviour of the birth mother and shift the emphasis towards the substance and harm caused by alcohol.