FASD carries very high costs for the affected individual, the family and society. A study conducted by Canadian researchers in 2009 estimated that the annual costs associated with FASD at the individual level were $21,642. Direct costs included medical, education, social services, out-of-pocket costs; and indirect costs included productivity losses. Severity of the individual's condition, age, and relationship of the individual to the caregiver (biological, adoptive, foster) were significant determinants of costs. The cost of FASD annually to Canada of those from day of birth to 53 years old was $5.3 billion (Stade, B. et al. 2009).