scholarly journals Fetal alcohol spectrum disorder: neurodevelopmentally and behaviorally indistinguishable from other neurodevelopmental disorders

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Shannon Lange ◽  
Kevin Shield ◽  
Jürgen Rehm ◽  
Evdokia Anagnostou ◽  
Svetlana Popova
Keyword(s):  
Neurodevelopmental Disorders ◽  
Predictive Value ◽  
Fetal Alcohol Spectrum Disorder ◽  
Child Behavior Checklist ◽  
Attention Problems ◽  
Spectrum Disorder ◽  
World Health ◽  
Typically Developing ◽  
Fetal Alcohol ◽  
Fetal Alcohol Spectrum

Abstract Background The lack of universally accepted diagnostic criteria and the high rate of psychiatric comorbidity make it difficult to diagnose Fetal Alcohol Spectrum Disorder (FASD). In an effort to improve the diagnosis of FASD, the current study aimed to identify a neurodevelopmental profile that is both sensitive and specific to FASD. Methods A secondary analysis was conducted on data obtained from the Canadian component of the World Health Organization International Study on the Prevalence of FASD. Data on neurodevelopmental status and behavior were derived from a battery of standardized tests and the Child Behavior Checklist for 21 children with FASD, 28 children with other neurodevelopmental disorders, and 37 typically developing control children, aged 7 to 11 years. Two latent profile analyses were performed to derive discriminative profiles: i) children with FASD compared with typically developing control children, and ii) children with FASD compared with typically developing control children and children with other neurodevelopmental disorders. The classification function of the resulting profiles was evaluated using the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Confidence intervals (CIs) were approximated using 10,000 bootstrapped samples. Results The neurodevelopmental profile of FASD tested consisted of impairments in perceptual reasoning, verbal comprehension, visual-motor speed and motor coordination, processing speed (nonverbal information), attention and executive function, visuospatial processing, and language, in combination with rule-breaking behavior and attention problems. When children with FASD were compared with typically developing control children, a 2-class model fit the data best and resulted in a sensitivity of 95.2% (95% CI: 84.2–100.0%), specificity of 89.2% (95% CI: 78.4–97.5%), PPV of 83.3% (95% CI: 66.7–96.2%), and NPV of 97.1% (95% CI: 90.3–100.0%). When children with FASD were compared with typically developing control children and children with other neurodevelopmental disorders, the neurodevelopmental profile correctly identified only 56.9% (95% CI: 45.1–69.2%) of typically developing children and children with other neurodevelopmental disorders as not having FASD, and thus the profile was found not to be specific to children with FASD. Conclusion The findings question the uniqueness of children with FASD with respect to their neurodevelopmental impairments and behavioral manifestations.

Prevalence of externalizing disorders and Autism Spectrum Disorders among children with Fetal Alcohol Spectrum Disorder: systematic review and meta-analysis

2018 ◽  
Vol 96 (2) ◽  
pp. 241-251 ◽  
Author(s):  
Shannon Lange ◽  
Jürgen Rehm ◽  
Evdokia Anagnostou ◽  
Svetlana Popova
Keyword(s):  
Autism Spectrum Disorders ◽  
Neurodevelopmental Disorders ◽  
Fetal Alcohol Spectrum Disorder ◽  
Externalizing Disorders ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Fetal Alcohol ◽  
Oppositional Defiant ◽  
Spectrum Disorders ◽  
Fetal Alcohol Spectrum

Owing to their central nervous system impairments, children with Fetal Alcohol Spectrum Disorder (FASD) commonly exhibit externalizing behaviours such as hyperactivity, impulsivity, and (or) delinquency. The purpose of this study was to estimate the prevalence of neurodevelopmental disorders with prominent externalizing behaviours, namely Attention-Deficit Hyperactivity Disorder (ADHD), Conduct Disorder (CD), Oppositional Defiant Disorder (ODD), as well as Autism Spectrum Disorders (ASD) among children with FASD. A comprehensive systematic literature search was performed, followed by disorder-specific random-effects meta-analyses. Of the disorders investigated, ADHD was found to be the most common co-morbid disorder among children with FASD (52.9%), followed by ODD (12.9%), CD (7.0%), and ASD (2.6%). When compared with the general population of the USA, these rates are notably higher: 15 times higher for ADHD, 2 times higher for ASD, 3 times higher for CD, and 5 times higher for ODD. The results call attention to the need for identifying a distinct neurodevelopmental profile to aid in the accurate identification of children with FASD and the discrimination of FASD from certain idiopathic neurodevelopmental disorders.

scholarly journals A guideline for the prevention and management of Fetal Alcohol Spectrum Disorder in South Africa

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Babatope O. Adebiyi ◽  
Ferdinand C. Mukumbang ◽  
Anna-Marie Beytell
Keyword(s):  
South Africa ◽  
Fetal Alcohol Spectrum Disorder ◽  
Service Providers ◽  
Alcohol Problems ◽  
Spectrum Disorder ◽  
World Health ◽  
Fetal Alcohol ◽  
Specific Policy ◽  
Delphi Approach ◽  
Fetal Alcohol Spectrum

Abstract Background Fetal Alcohol Spectrum Disorder (FASD) is a public health problem globally, with South Africa having the highest recorded prevalence of all countries. Government programmes to prevent and manage FASD remain limited because of the lack of a specific policy. Herein, we developed a guideline to inform policy on the prevention and management of FASD in South Africa. Methods We applied a modified version of the World Health Organization’s approach to guideline development in three phases. In the first phase, we designed the initial guideline prototype. To do this, we conducted an in-depth interview with policymakers and a focus group with relevant service providers on policy requirements for FASD, a document review of policies on FASD and a scoping review of various interventions for FASD. In phase 2, we refined the initially formulated guideline prototype through a discursive approach with seven local and international experts on FASD. Phase 3 involved refining the prototype using a modified Delphi approach. Forty-three and forty-one experts participated in rounds 1 and 2 of the Delphi approach, respectively. The acceptable consensus for each included policy statement was 85%. Results We identified three aspects of the proposed guideline, which are the approaches and guiding principles, the prevention measures and the management measures. The guideline proposes that a FASD policy should consider lifespan needs, be culturally diverse, collaborative, evidence-based, multi-sectoral and address social determinants of health contributing to FASD. The essential components of FASD prevention policy consist of awareness and education of the dangers of drinking alcohol, access to treatment for alcohol problems and training of service providers. The management components include capacity building related to diagnosis, educating parents regarding the needs and management, appropriate referral pathways, training of teachers regarding classroom management and support for parents and individuals with FASD. Conclusion FASD in South Africa deserves urgent attention. Developing a specific policy to guide programmes could enhance and coordinate the efforts towards preventing and managing FASD. The guideline has the potential to assist policymakers in the development of a comprehensive and multi-sectoral policy for prevention and management of FASD, considering the consensus obtained from the experts.

scholarly journals Global prevalence of alcohol use and binge drinking during pregnancy, and fetal alcohol spectrum disorder

2018 ◽  
Vol 96 (2) ◽  
pp. 237-240 ◽  
Author(s):  
Svetlana Popova ◽  
Shannon Lange ◽  
Charlotte Probst ◽  
Gerrit Gmel ◽  
Jürgen Rehm
Keyword(s):  
Alcohol Use ◽  
Binge Drinking ◽  
Fetal Alcohol Spectrum Disorder ◽  
Prenatal Alcohol Exposure ◽  
Heavy Drinking ◽  
Alcohol Exposure ◽  
Spectrum Disorder ◽  
World Health ◽  
Fetal Alcohol ◽  
Fetal Alcohol Spectrum

Alcohol use during pregnancy is an established cause of fetal alcohol spectrum disorder (FASD), with heavy drinking during pregnancy being explicitly linked to fetal alcohol syndrome (FAS). This paper presents recent estimates of the prevalence of: (i) any amount of alcohol use during pregnancy; (ii) one or more binge drinking episode(s) (4 or more standard drinks on a single occasion) during pregnancy; (iii) FAS; and (iv) FASD among the general population globally and by World Health Organization region. It is apparent, based on the presented estimates, that alcohol use and binge drinking occur frequently among pregnant women in many countries and as a result, FASD is a prevalent alcohol-related developmental disability. Urgent action is required around the globe to eliminate prenatal alcohol exposure and prevent future children, adolescents, and adults from having FASD.

scholarly journals Profile of Mothers of Children with Fetal Alcohol Spectrum Disorder: A Population-Based Study in Canada

2020 ◽  
Vol 17 (21) ◽  
pp. 7986
Author(s):  
Svetlana Popova ◽  
Shannon Lange ◽  
Valerie Temple ◽  
Vladimir Poznyak ◽  
Albert E. Chudley ◽  
...  
Keyword(s):  
Alcohol Consumption ◽  
Drug Use ◽  
Fetal Alcohol Spectrum Disorder ◽  
Population Based ◽  
Spectrum Disorder ◽  
Control Group ◽  
Typically Developing ◽  
Fetal Alcohol ◽  
Pregnancy Recognition ◽  
Fetal Alcohol Spectrum

Objective: To compare the characteristics of mothers of children with Fetal Alcohol Spectrum Disorder (FASD) with mothers of typically developing control children. Methods: The study utilized a cross-sectional, observational design, using active case ascertainment. Biological mothers were interviewed using a standardized retrospective questionnaire to collect data on demographics, living environment, pregnancy history, nutrition, alcohol and other drug use prior to and following pregnancy recognition. Results: A total of 173 mothers were interviewed. Of these, 19 had a child who was diagnosed with FASD, five had a child who had received a deferred FASD diagnosis, and 37 had children who were selected into the control group as typically developing children. The remaining 112 mothers had children who did not meet diagnostic criteria for FASD. The mothers of children with FASD did not differ significantly from mothers of the control group children with respect to age, ethnicity, marital status, and employment status at the time of pregnancy. However, mothers of children with FASD had lower levels of education (p < 0.01) and were more likely to have received financial support (p < 0.05) at the time of pregnancy, to have smoked tobacco (p < 0.001), and to have used marijuana or hashish (p < 0.01) prior to pregnancy recognition, compared with mothers of control children. All mothers of children with FASD reported alcohol consumption prior to pregnancy recognition; however, only 10.5% reported alcohol consumption following pregnancy recognition. None of the mothers interviewed reported any drug use following pregnancy recognition. Conclusions: Population-based preventive interventions, including repeated screening, monitoring, and education regarding the effects of alcohol use, as well as other substances, before and during pregnancy, are needed to eliminate risk for FASD and other negative consequences on child and maternal health.

Sign in / Sign up

Export Citation Format

Share Document