Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Sep 1;2(3):165-174.
doi: 10.1007/s40474-015-0057-3.

Improving Recognition of Children Affected by Prenatal Alcohol Exposure: Detection of Exposure in Pediatric Care

Ami C Bax  1 , Carrie D Geurts  1 , Tatiana N Balachova  1
Affiliations

Improving Recognition of Children Affected by Prenatal Alcohol Exposure: Detection of Exposure in Pediatric Care

Ami C Bax et al. Curr Dev Disord Rep. .

Abstract

Early identification of fetal alcohol spectrum disorders (FASDs) is important for providing services and preventing secondary disabilities. Recent studies indicate that many FASDs are undiagnosed, partly because there is a need to improve detection of prenatal alcohol exposure (PAE). The aims of this review are to characterize existing practices for assessing PAE in pediatric care, identify the most efficient, promising methods of detecting PAE, and recognize the knowledge and practice gaps. This review indicates that maternal self-reports remain the most common method utilized in routine clinical practice and highlights promising methods of PAE identification, including a single binge drinking question. The review yields few studies describing existing strategies to assess PAE in pediatric practice and identifies knowledge gaps that need to be addressed for improving recognition of FASDs in pediatric practice.

Keywords: Alcohol use; Fetal alcohol spectrum disorders; Fetal alcohol syndrome; Neurobehavioral Disorder Associated with Prenatal Alcohol Exposure (ND-PAE); Pregnancy; Prenatal alcohol exposure; Women.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Standard-sized drink equivalents. [67](With permission from: National Institute on Alcohol Abuse and Alcoholism. A Pocket Guide for Alcohol Screening and Brief Intervention. 2005. Rockville, MD: National Institutes of Health, 2005.) Available at http://pubs.niaaa.nih.gov/publications/Practitioner/PocketGuide/pocket_guide.htm. Produced by the American College of Gynecologists and Obstetricians [ACOG] .
Figure 2
Figure 2
Suggested algorithms for assessing prenatal alcohol exposure: action plan. aPAE: prenatal alcohol exposure; bND-PAE: neurobehavioral disorder associated with prenatal alcohol exposure; cSBI: screening and brief intervention/referral to treatment. (Data adapted with permission from: Balachova T. Screening for prenatal alcohol exposure. Alcohol Related Neurodevelopmental Disabilities and Prenatal Alcohol Exposure Workgroup Meeting, American Academy of Pediatrics, Elk Grove Village, February 24, 2014) [68].
See this image and copyright information in PMC

References

    1. Streissguth AP, Bookstein FL, Barr HM, et al. Risk factors for adverse life outcomes in fetal alcohol syndrome and fetal alcohol effects. Developmental and Behavioral Pediatrics. 2004;25(4):228–38. - PubMed
    1. Fox DJ, Pettygrove S, Cunniff C, et al. Fetal alcohol syndrome among children aged 7-9 years - Arizona, Colorado, and New York, 2010. MMWR Morbidity and Mortality Weekly Report. 2015;64(3):54–7. [Although FAS surveillance is challenging, the CDC FAS Surveillance Network strives to provide routine updates on the estimated prevalence of FAS in the U.S, which according their studies, has remained at 0.3/1000 children] - PMC - PubMed
    1. May PA, Baete A, Russo J, et al. Prevalence and characteristics of fetal alcohol spectrum disorders. Pediatrics. 2014 Nov;134(5):855–66. doi:10.1542/peds.2013-3319. [Results of this study estimated that approximately 2% to 5% of children in the U.S. and Western Europe are affected by FAS and FASDs] - PMC - PubMed
    1. May PA, Gossage JP, Kalberg WO, et al. Prevalence and epidemiologic characteristics of FASD from various research methods with an emphasis on recent in-school studies. Developmental Disabilities Research Reviews. 2009;15(3):176–92. doi:10.1002/ddrr.68. - PubMed
    1. Chasnoff IJ, Wells AM, King L. Misdiagnosis and missed diagnoses in foster and adopted children with prenatal alcohol exposure. Pediatrics. 2015;135(2):264–70. doi:10.1542/peds.2014-2171. [This study reports the high rates of FASD under-diagnosis and misdiagnosis in foster and adopted youth] - PubMed

LinkOut - more resources