A new CAMH-led pilot is helping young people understand the risks of alcohol use during pregnancy and how to prevent Fetal Alcohol Spectrum Disorder (FASD). Supported by the Public Health Agency of Canada’s National Strategic Projects, the FASD Prevention School-Based Program was designed and evaluated by the Institute for Mental Health Policy Research (IMHPR) at CAMH, led Senior Scientist Dr. Lana Popova, with support from CAMH Indigenous-led centre Shkaabe Makwa and guidance from a steering committee of educators, community leaders, people with lived experience, and health professionals.
FASD is a lifelong neurodevelopmental disorder caused by prenatal alcohol exposure. It can lead to central nervous system damage, physical health challenges, learning difficulties, and social problems. Research led by CAMH has found that 10 per cent of women in the general population consume alcohol during pregnancy and 3.3 per cent engage in binge drinking. Even small amounts can increase risk. A CAMH population-based study estimated that at least 3 per cent of Canadians have FASD, which translates to 1.2 million people in Canada. However, the prevalence in some communities is much higher: up to 20 per cent. In addition to the benefits for individuals’ quality of life, preventing new cases could save more than $6 billion annually in direct and indirect costs.
The school program was developed in response to persistent gaps in education, awareness, ongoing misinformation, and rising rates of alcohol use in youth and young adults. Latest data from the CAMH-led Ontario Student Drug Use and Health Survey shows that more than two-thirds of Grade 12 students had consumed alcohol in the past year, with significant rates of binge drinking. Broader public health trends - including increased alcohol availability, the effects of the COVID-19 pandemic on youth mental health, and a rise in alcohol-related emergency visits among women and young adults - reinforce the urgent need for FASD prevention education. For many, alcohol use during pregnancy occurs in the context of unplanned pregnancies, social influences, intergenerational trauma, stigma, and systemic barriers to health care and education. Educating young people before they reach childbearing age is a critical step in FASD prevention.
This five-year pilot created and tested an adapted curriculum for students in Grades 7–12. Building on a U.S. model, the lessons were modified for use in Ontario and included two versions: one for mainstream urban and rural schools, and a distinct version co-developed with First Nations partners for schools serving First Nations communities, integrating Anishinaabe teachings and perspectives. Lessons combined factual content with interactive approaches such as role-playing, discussion, and multimedia resources, while promoting inclusion and acceptance of individuals living with FASD. The program was implemented in 12 Ontario schools, reaching 644 students.
The evaluation of the intervention yielded promising results. In urban schools, intervention students significantly increased their knowledge of FASD and the risks of alcohol use during pregnancy, and were more likely to say prevention was personally important to them. In schools serving students from First Nations communities, students also demonstrated improved knowledge and greater recognition of the importance of alcohol- and drug-free pregnancies. Rural schools, which only participated as controls, showed mixed effects of testing and, in some cases, a decrease in FASD knowledge, underscoring the value of the structured FASD prevention intervention.
Across all settings, intervention students not only understood more about FASD but also felt better prepared to make healthy choices and support their peers. Teachers and students alike gave positive feedback, with many recommending the curriculum be integrated into Ontario’s Health curriculum.
The project produced a toolkit that documents adaptation, implementation, and evaluation of the FASD prevention education curriculum. This resource supports sustainability and provides a roadmap for scaling the program across other provinces and territories. Because the curriculum is adaptable and culturally responsive, it also has potential for international use in countries seeking to prevent FASD.
“By equipping children and adolescents with accurate, age-appropriate, and culturally relevant information about the harms of prenatal substance use before they reach their childbearing years, we can help prevent future cases of serious disabilities such as FASD and reduce the stigma experienced by affected individuals and their families,” said Principal Investigator Dr. Lana Popova.
CAMH researchers emphasize that prevention is both impactful and cost-effective: preventing one case of FASD is estimated to cost only a fraction of the lifelong supports required for individuals and families. Looking ahead, next steps include refining the curriculum based on teacher and student feedback, expanding implementation through education partners, and continuing to collaborate with First Nations communities through Shkaabe Makwa to ensure cultural grounding.
Read the full report entitled FASD prevention school-based program for children and adolescents in select urban, rural and First Nation schools in Ontario, Canada (also available in French). Click here to view the Report Appendix and Curriculum documents.
