Prenatal alcohol exposure can lead to serious birth defects and developmental disabilities and is one of the leading preventable causes of mental retardation. Since the syndrome was identified approximately 30 years ago, advances have occurred in FAS diagnosis, surveillance, prevention and intervention, but a substantial amount of work remains. (Center for Disease Control and Prevention MMWR 2002)
The term FAS was first identified in literature in 1973 by Doctors Smith and Jones at the University of Washington. There are many points when a diagnosis may be initiated; a clinician may have suspicions during early newborn visits; a parent or foster care provider may notice delays in normal development; a social service provider or an educator determines deficits in educational achievement or social skills.
Benefits of an Accurate Diagnosis
Early diagnosis and treatment for FASD can help children reach their fullest potential, lessen secondary disabilities and problems, and help families better understand and cope. These secondary disabilities include: mental health issues, disrupted school experience, trouble with the law, confinement, inappropriate sexual behavior, and alcohol and drug problems.
From 1992–1996 a long-term study was conducted at the University of Washington (Streissguth, et al) to examine outcomes among individuals with prenatal alcohol exposure. A number of factors were identified that protect individuals with an FASD from additional (secondary) disabilities, including:
As educators, case managers, physicians, judges, counselors and adoptive families, it is necessary to become more aware and more responsive to the needs of children and families affected by Fetal Alcohol Spectrum Disorders. There are key questions to consider and documentation to prepare in referring individuals for services.
The DSM-IV-TR by American Psychiatric Association (2000) is the most widely used criteria to diagnose Fetal Alcohol Syndrome.
In preparation for obtaining a diagnosis or beginning treatment it is important to note that a multi-disciplinary team may assess, interview or examine the individual. This may result in one diagnostic session or multiple visits. Team members may include:
The goal of identifying individuals with FASD is to improve the delivery of appropriate services to those individuals and their families. As the 2004 CDC Fetal Alcohol Syndrome Guidelines for Referral and Diagnosis correctly states, "Diagnosis is never an endpoint for any individual with a developmental disability and his or her family.” If diagnostic teams or physicians specializing in FASD are not available in your community, the first appointment made can be with a developmental pediatrician and/or a genetic center. The following tools are available to assist physicians with diagnostic protocols and procedures.
Thorough assessment includes: