Materiały źródłowe

• #1 About Fetal Alcohol Spectrum Disorders (FASDs) | Fetal Alcohol Spectrum Disorders (FASDs) | CDC

  https://www.cdc.gov/fasd/about/index.html

  FASDs are a group of conditions that can occur in a person who was exposed to alcohol before birth. […] Fetal alcohol spectrum disorders (FASDs) are a group of conditions that can occur in a person exposed to alcohol before birth. […] FASDs are preventable if a developing baby is not exposed to alcohol. […] Different FASD diagnoses are based on particular symptoms and include: […] Diagnosing FASDs can be hard because there is no medical test, like a blood test, for these conditions. […] To diagnose FASDs, healthcare providers look for: […] If you think there could be a problem, ask your healthcare provider for a referral to a specialist (someone who knows about FASDs).

• #2 Fetal Alcohol Spectrum Disorders (FASD) Screening: MedlinePlus Medical TestLock

  https://medlineplus.gov/lab-tests/fetal-alcohol-spectrum-disorders-fasd-screening/

  Fetal alcohol spectrum disorders (FASDs) are a group of conditions that can happen in a child who was exposed to alcohol before birth (called prenatal alcohol exposure). These conditions can affect each person in different ways and can range from mild to severe. People with FASDs can have lifelong effects, including physical, emotional, and behavioral problems. […] The screening is used to find out if your child has an FASD. There is no cure for FASDs, but early diagnosis and treatment may help reduce some of the symptoms and help your child reach their full potential. […] A screening may be needed if you drank alcohol during your pregnancy and/or your child has symptoms of an FASD. Symptoms may include a mix of physical problems, intellectual disabilities, and problems coping with daily living.

• #3 Fetal alcohol syndrome – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/fetal-alcohol-syndrome/diagnosis-treatment/drc-20352907

  Diagnosing fetal alcohol syndrome involves an exam from a healthcare professional with expertise in the condition. Early diagnosis and services can help improve your child’s ability to function. […] Making a diagnosis involves: […] Watching for symptoms of fetal alcohol syndrome in your child’s early weeks, months and years of life. Your child’s healthcare professional looks at your child’s physical appearance for changes typical of fetal alcohol syndrome. […] If fetal alcohol syndrome is suspected, your pediatrician or other healthcare professional will likely refer your child to an expert with special training in fetal alcohol syndrome. This may be a developmental pediatrician, a neurologist or another expert. The expert does an evaluation to rule out other conditions with similar symptoms to help make a diagnosis.

• #4 Fetal Alcohol Syndrome (FAS): Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/15677-fetal-alcohol-syndrome

  Fetal alcohol syndrome (FAS) is a condition that develops in a fetus when a pregnant woman drinks alcohol during pregnancy. […] It can be difficult to diagnose fetal alcohol syndrome. There isn’t a direct test for FAS, and pregnant women may not give a complete history of all alcohol intake during pregnancy. […] Pediatric providers can often make a diagnosis of FAS based on the size of a child, specific physical signs and symptoms that develop through childhood, including: History of alcohol use by the child’s mother during pregnancy. […] Symptoms of FAS can resemble those found in other disorders, including: Autism spectrum disorder (ASD). […] If you did drink any amount of alcohol during pregnancy, it’s important to know that your healthcare provider and your baby’s pediatrician need to know to help you plan for your child’s future.

• #5 Fetal alcohol spectrum disorder: Signs and symptoms – Canada.ca

  https://www.canada.ca/en/public-health/services/diseases/fetal-alcohol-spectrum-disorder/symptoms.html

  Fetal alcohol spectrum disorder is often called a hidden disorder because the majority of people with it have no outward signs of disability. […] Getting a diagnosis can be difficult. There is no single test that can cover the disorder’s wide range of signs and symptoms. […] A team of health professionals gathers information and carries out tests to diagnose someone. […] A diagnosis can help people get relevant and targeted services and supports, including financial support where available. […] An early diagnosis and appropriate interventions and support result in more positive outcomes for people with the disorder.

• #6 FASD Diagnosis in Australia – Help for Children & Adults

  https://www.nofasd.org.au/parents-caregivers-family/support/understanding-fasd-diagnosis/

  FASD is often referred to as the invisible disability as it often goes undetected or misdiagnosed. Assessment and diagnosis of FASD is important as it may provide answers for families and improve access to services that can improve life outcomes. […] Research has found that early diagnosis of FASD is a protective factor. A diagnosis of FASD will help anyone who is working with your child to better […] International studies tell us that early diagnosis and interventions for FASD are linked with better long-term outcomes for the child and the family who support them. […] If FASD is suspected, an accurate diagnosis can: Help parents/carers better understand their child and their behaviour, challenges AND strengths; Help the child/adolescent or adult better understand themselves and validate their experience; Connect to appropriate supports, therapy and funding services; Build connections and aid communication among clinicians, caregivers, educators, and families.

• #7 Fetal alcohol spectrum disorder

  https://www.nhs.uk/conditions/fetal-alcohol-spectrum-disorder/

  If the condition is not diagnosed early and your child does not receive appropriate support, they’re more likely to experience bigger challenges associated with the condition. […] A doctor or health visitor will need to know if your child was exposed to alcohol during pregnancy to help make a diagnosis of FASD. […] This usually involves physical examinations and blood tests to rule out genetic conditions that have similar characteristics to FASD.

• #8 FASD Diagnosis in Australia – Help for Children & Adults

  https://www.nofasd.org.au/parents-caregivers-family/support/understanding-fasd-diagnosis/

  Diagnostic assessment for Fetal Alcohol Spectrum Disorder (FASD) can be conducted with people of all ages. However diagnostic assessment is most commonly conducted with children under the age of 18 years. Ideally a child should have a diagnostic assessment as early as possible. […] Detailed information on the FASD diagnostic assessment for individuals and caregivers is included on the FASD Hub Australia website, alongside the Australian Guide to the diagnosis of FASD, which provides the most up to date advice for clinicians undertaking FASD assessment. […] NOFASD Australia maintains an up-to-date directory of FASD-informed specialists and diagnostic clinics. FASD Hub Australia also maintains a directory of Paediatricians and Clinics for FASD diagnosis.

• #9 Fetal alcohol spectrum disorder: a guideline for diagnosis across the lifespan

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4754181/

  The development of clinical capacity for FASD diagnosis remains difficult, because the diagnosis requires a medical evaluation and neurodevelopmental assessment conducted by a multidisciplinary team. […] A literature review and broad consultation process was undertaken to revise the 2005 guideline for diagnosing FASD. […] Recommendations are focused on the diagnostic process and are geared toward members of multidisciplinary diagnostic teams in Canada, who have received the required expertise and experience through specialized training. […] The guideline provides recommendations on the screening, referral and support for pregnant or postpartum women and for individuals at risk of FASD; the medical assessment, including family history, maternal alcohol history, physical examination and differential diagnosis; the sentinel facial features; the neurodevelopmental assessment; the nomenclature and diagnostic criteria; and the diagnostic team and special considerations in the neurodevelopmental assessment of infants and young children. […] Making a diagnosis of FASD requires a multidisciplinary team and involves a complex physical and neurodevelopmental assessment. […] Diagnosis of FASD is critical to improve outcomes for affected individuals and families, and to inform pre-pregnancy counselling to prevent future cases.

• #10 Fetal Alcohol Spectrum Disorders | Riley Children’s Health

  https://www.rileychildrens.org/health-info/fetal-alcohol-spectrum-disorders

  Fetal alcohol spectrum disorders (FASDs) describe the range of problems that can occur if babies are exposed to alcohol while in the womb. Fetal alcohol spectrum disorders are the leading cause of cognitive disability in the United States. […] Your child’s doctor may diagnose FASD if your child has symptoms typically associated with FASDs and was exposed to alcohol in the womb. Child development specialists at Riley at IU Health perform extensive evaluations to help determine whether your child has intellectual disabilities, behavior problems or other conditions related to FASD. During these evaluations, your child’s care team will perform a physical exam, take a detailed medical history and perform psychological testing. […] After your child’s evaluation, you will receive a detailed report on his or her specific condition or conditions, suggestions for therapy and information on resources near your home that can help your child.

• #11 Guide to the referral and diagnostic process | Resources | Learning With FASD

  https://learningwithfasd.org.au/resources/referral-guide/main/

  Research shows that timely diagnosis and early intervention is essential to ensure the best outcomes for people with FASD across a range of life goals, including mental health and education. […] The referral process begins with the identification of concerns in an educational context and extends to the implementation of appropriate supports once a diagnosis has been made by a multidisciplinary team comprising medical and Allied Health professionals. […] A multidisciplinary assessment is required for an accurate diagnosis due to the complexity and range of issues related to prenatal alcohol exposure. […] FASD can sometimes be difficult to differentiate from other neurodevelopmental disorders, as the symptoms of FASD overlap with the symptoms of other disorders such as Autism Spectrum Disorder (ASD) and Attention Deficit Hyperactivity Disorder (ADHD). […] The sooner a child with FASD receives an accurate diagnosis, the earlier interventions and accommodations can be put in place to support the child and their parents or caregivers.

• #12 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Fetal-Alcohol-Spectrum-Disorders-FASD-Diagnosis.aspx

  As FASD has a complex set of symptoms, its diagnosis requires a multidisciplinary approach for which a set of guidelines are formulated. […] The assessment process needs to be carried out by a diagnostic team comprising of a coordinator nurse or social worker, physician trained in diagnosis of FASD, psychologist, occupational therapist, and speech-language therapist. […] Screening for alcohol usage is conducted for all post-partum and pregnant women using validated tools like TWEAK, T-ACE, CAGE, and SMAST. Counseling is given to women who are at risk of heavy usage of alcohol. […] Diagnosing FASD involves a general neurologic and physical examination, which includes suitable measurements of head and growth. […] The main purpose of dysmorphology assessment is to identify the features associated with prenatal alcohol exposure as well as dysmorphic features in children.

• #13 Fetal alcohol spectrum disorder – Wikipedia

  https://en.wikipedia.org/wiki/Fetal_alcohol_spectrum_disorder

  Each diagnostic system requires an assessment of four key features: growth, facial features, central nervous system, and alcohol exposure. To determine any FASD condition, a multi-disciplinary evaluation is necessary to assess each of the four key features for assessment. Generally, a trained physician will determine growth deficiency and FAS facial features. While a qualified physician may also assess central nervous system structural abnormalities or neurological problems, usually central nervous system damage is determined through psychological, speech-language, and occupational therapy assessments to ascertain clinically significant impairments in three or more of the Ten Brain Domains. […] A positive finding on all four features is required for a diagnosis of FAS, and the four diagnostic systems essentially agree on criteria for fetal alcohol syndrome (FAS). However, there are differences among systems when full criteria for FAS are not met. Prenatal alcohol exposure and central nervous system damage are the critical elements of the spectrum of FASD, and a positive finding in these two features is sufficient for an FASD diagnosis in all FASD systems. But different researchers and systems may use a wide variety of terminology to describe an individual’s FASD condition, as the nomenclature is still evolving. Most individuals with deficits resulting from prenatal alcohol exposure do not express all features of FAS and fall into other FASD conditions.

• #14 Australian Guide to Diagnosis of FASD – FASD Hub Australia | FASD Hub

  https://fasdhub.org.au/fasd-information/australian-guide-to-diagnosis-of-fasd/

  This Guide has been produced to assist clinicians in the diagnosis, referral and management of Fetal Alcohol Spectrum Disorder (FASD). […] The Australian Guide to the Diagnosis of FASD was developed to facilitate and standardise the diagnosis of FASD in Australia. It provides clinicians with diagnostic criteria for Fetal Alcohol Spectrum Disorder (FASD), which were agreed following review of existing guidelines and consultation with clinical experts. […] The diagnosis of FASD is complex, and ideally requires a multidisciplinary team of clinicians to evaluate individuals for prenatal alcohol exposure, neurodevelopmental problems and facial abnormalities in the context of a general physical and developmental assessment. […] A diagnosis of FASD requires evidence of prenatal alcohol exposure and severe impairment in three or more domains of central nervous system structure or function.

• #15 Australian Guide to Diagnosis of FASD – FASD Hub Australia | FASD Hub

  https://fasdhub.org.au/fasd-information/australian-guide-to-diagnosis-of-fasd/

  A diagnosis of FASD can be divided into one of two sub-categories: FASD with three sentinel facial features and FASD with less than three sentinel facial features. […] The aetiological role of alcohol is most clearly established in the presence of all three characteristic facial abnormalities. In this situation a diagnosis of FASD with three sentinel facial features can be made even when prenatal alcohol exposure is unknown, provided there is also severe neurodevelopmental impairment. […] The clinical cut-off for severe impairment is defined either as a global score, or a major subdomain score on a standardised validated neurodevelopmental scale that is 2 or more standard deviations below the mean (2 SD), or less than the 3rd percentile (3rd PC). […] Information collected during the diagnostic assessment should be reviewed, ideally in a multi-disciplinary team context, to evaluate the strength of evidence to support a diagnosis of FASD with 3 sentinel facial features or a diagnosis of FASD with less than 3 sentinel facial features. […] The FASD Diagnostic Assessment Form and the Summary Form summarise the clinical findings required to make a diagnosis of FASD.

• #16 Fetal Alcohol Spectrum Disorders (FASD) Screening: MedlinePlus Medical TestLock

  https://medlineplus.gov/lab-tests/fetal-alcohol-spectrum-disorders-fasd-screening/

  There is no single test for FASDs. But your provider may check for intellectual disabilities and developmental delays, look for certain physical features such as a small head, small eyes, and thin upper lip, see if your child’s weight and height are below normal, look for behavioral symptoms such as short attention span and problems with impulse control, and check your child’s coordination, vision, and hearing. […] If your child is diagnosed with an FASD, your provider may recommend several treatment options. There is no cure for these disorders, but the following may greatly improve a child’s development and quality of life. […] If you are pregnant or trying to get pregnant and cannot stop drinking, it’s important to get help. Even if you are pregnant, it is never too late to stop drinking.

• #17 Fetal Alcohol Syndrome and Fetal Alcohol Spectrum Disorders | AAFP

  https://www.aafp.org/pubs/afp/issues/2017/1015/p515.html

  Characteristic facial dysmorphology associated with FASD includes short palpebral fissures (10th percentile or less for age and racial norms), a thin vermilion border of the upper lip, and a smooth philtrum. […] Two of the three characteristic features are required for the diagnosis of FAS or PFAS. […] Neurobehavioral disabilities in FASD include deficient global intellectual ability and cognition, and poor behavior, self-regulation, and adaptive skills. […] Alcohol-related neurodevelopmental disorder is diagnosed with documented prenatal alcohol exposure and neurobehavioral impairment in at least two domains in the absence of other defining characteristics for FAS.

• #18 Fetal Alcohol Spectrum Disorder (FASD)

  http://library.oumedicine.com/90,P02122

  Most often, a healthcare provider can diagnose FASD based on the person’s history and how the baby looks. […] The provider will examine the baby to look for changes in the face, eyes, and upper lip. […] A newborn may show signs of alcohol withdrawal. […] There is no single test to diagnose FASD.

• #19 Guidelines Update: Diagnosing Fetal Alcohol Spectrum Disorder – Neurology Advisor

  https://www.neurologyadvisor.com/features/guidelines-update-diagnosing-fetal-alcohol-spectrum-disorder/

  The new guidelines include a step-by-step diagnostic algorithm for use in the clinical setting, as well as a special emphasis on neurobehavioral impairment. […] New guidelines published in Pediatrics present updated recommendations for the diagnosis of FASD. […] The authors note that although certain circumstances permit the diagnosis of FAS or PFAS without firm documentation of gestational alcohol use positive confirmation of alcohol exposure must be available for the diagnosis of ARND or ARBD to be assigned. […] If 2 of the 3 cardinal facial characteristics are present (short palpebral fissures, smooth philtrum, and/or thin vermilion border of the upper lip) the child is classified as having a positive dysmorphology facial evaluation for FASD, the authors wrote. […] Neurodevelopmental assessment and neuropsychology evaluation is an essential diagnostic step considering that impairment of brain structure and/or function represents the primary fetotoxic effects of alcohol.

• #20 Getting a diagnosis – National FASD

  https://nationalfasd.org.uk/about-fasd/getting-a-diagnosis/

  For any FASD diagnosis you may be asked for the following: […] Diagnosis at the earliest possible stage allows for early intervention and treatment programmes and a better overall outcome for an individual with FASD. […] The assessment and diagnosis/descriptor of FASD can help the individual, their family, and service providers to understand the challenges associated with a lifelong disability that requires accommodations and supports to maximise success. […] It is important that, when diagnosing FASD, healthcare professionals foster an environment that supports those affected, while avoiding blame, social stigmatisation and feelings of guilt in the parents. […] According to SIGN 156, a diagnosis/ descriptor of FASD is made only when there is evidence of pervasive and long-standing brain dysfunction, which is defined by severe impairment in three or more of the following neurodevelopmental areas of assessment: […] SIGN 156 states: The diagnostic /descriptive criteria for FASD are the same for adults as for younger individuals. […] Increasingly clinical commissioning groups are developing diagnostic pathways that allow people affected by FASD to have their needs assessed.

• #21 4 Diagnosis and Clinical Evaluation of Fetal Alcohol Syndrome | Fetal Alcohol Syndrome: Diagnosis, Epidemiology, Prevention, and Treatment | The National Academies Press

  https://nap.nationalacademies.org/read/4991/chapter/6

  Historically FAS has been defined by growth deficiency, a pattern of facial anomalies, and indicators of brain dysfunction. […] A variety of behavioral and cognitive features have been proposed as indicators of brain dysfunction in FAS. […] Other indicators of the effects of alcohol on the brain may be provided through neuroimaging techniques such as computed tomography (CT) or magnetic resonance imaging (MRI). […] The indicators used to diagnose FAS were first codified in neonates, infants, and young children, but were then found to vary across the life span. […] The term fetal alcohol effects, as described below, was originally developed to describe abnormalities observed in animal studies, but was quickly adopted by clinicians. […] The committee studied the previous diagnostic criteria and felt that some of the issues confusing the clinical and research communities could be resolved with fairly minor changes in the diagnostic categories and criteria.

• #22 Fetal Alcohol Spectrum Disorders and differential diagnosis – Breda Genetics srl

  https://bredagenetics.com/fetal-alcohol-spectrum-disorders-and-differential-diagnosis/

  There is no treatment for FAS and the therapies implemented are only supportive. However, it has been shown that early diagnosis can reduce the occurrence of secondary disabilities such as isolation, lack of independent life and problems with work. […] The diagnosis of FAS must be “of exclusion”, that is, it must occur only after having discarded all the other possible causes of the patient’s phenotype, in the presence of a suspected or confirmed prenatal exposure to alcohol. For this reason it is important, after having performed the diagnostic tests for images, the audiometric and visual tests and having evaluated the case from a multi-specialized point of view (psychological, neurological and pediatric) to perform genetic tests such as the Array-CGH or the karyotype.

• #23 Fetal alcohol spectrum disorder – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/1141

  Fetal alcohol spectrum disorder (FASD) is considered a spectrum of disorders that includes FASD with and without sentinel facial features, fetal alcohol syndrome, partial fetal alcohol syndrome, alcohol-related neurodevelopmental disorder, and alcohol-related birth defects. […] Early diagnosis may prevent secondary disabilities, but many clinicians are unaware of, or are confused by, existing diagnostic criteria and terminology. […] Key diagnostic factors include gestation 37 weeks, low height, weight, head circumference, characteristic facial dysmorphology, presence of birth defects, developmental delay and behavioral problems, mental health problems, and sibling with similar symptoms. […] Diagnostic tests include facial photographic assessment as the 1st tests to order, and tests to consider include prenatal ultrasonography of fetus, ECG, echocardiogram, EEG, MRI/CT head, renal ultrasonography, skeletal x-ray, screening blood tests, and chromosome microarray. […] Emerging tests include functional MRI, magnetic resonance spectroscopy, and 3-dimensional facial imaging.

• #24 Fetal alcohol spectrum disorder: Clinical features and diagnosis – UpToDate

  https://www.uptodate.com/contents/fetal-alcohol-spectrum-disorder-clinical-features-and-diagnosis

  Fetal alcohol spectrum disorder (FASD) is a term that is used to describe the range of physical, behavioral, and neurodevelopmental effects that can occur in an individual who was prenatally exposed to alcohol and may have lifelong implications and high societal costs. […] This topic will discuss the clinical features and diagnosis of FASD. […] FASD is an umbrella term that encompasses the range of physical, mental health, behavioral, and cognitive effects that can occur in individuals with prenatal alcohol exposure. […] In most classification systems, FASD is not a diagnostic term but describes a group of specific conditions with mild to severe phenotypes; the conditions include fetal alcohol syndrome (FAS) and partial fetal alcohol syndrome (pFAS). […] Diagnostic criteria for FASD include criteria for specific conditions and potential diagnostic tools.

• #25 Fetal alcohol spectrum disorder: Management and prognosis – UpToDate

  https://www.uptodate.com/contents/fetal-alcohol-spectrum-disorder-management-and-prognosis

  Prenatal exposure to alcohol is a leading preventable cause of congenital anomalies and developmental disabilities. Fetal alcohol spectrum disorder (FASD) is a term that is used to describe the range of physical, behavioral, and neurodevelopmental effects that can occur in an individual who was prenatally exposed to alcohol and may have lifelong implications and high societal costs. […] The clinical features and diagnosis of FASD and alcohol use in pregnancy are discussed separately. […] FASD is an umbrella term that encompasses the range of physical, mental health, behavioral, and cognitive effects that can occur in individuals with prenatal alcohol exposure. […] In most diagnostic schema, FASD is not a diagnostic term but describes a group of specific conditions, including fetal alcohol syndrome and partial fetal alcohol syndrome.

• #26 Fetal Alcohol Syndrome: Symptoms, Causes, Treatments

  https://www.webmd.com/baby/fetal-alcohol-syndrome

  There are no medications to treat fetal alcohol syndrome specifically. But certain medicines can help with symptoms such as hyperactivity, inability to focus, or anxiety. […] A child with fetal alcohol syndrome needs to be watched closely to see if their treatment needs to be adjusted. […] Fetal alcohol syndrome (FAS) is the most severe form of fetal alcohol spectrum disorder, a range of conditions caused by exposure to alcohol in the womb. FAS symptoms include distinctive facial features, lower-than-average height and weight, and problems with brain and nervous system development. There is no single test for fetal alcohol syndrome (a lifelong condition), but early detection and treatment can greatly improve the lives of children with FAS.

• #26 Fetal Alcohol Syndrome: Symptoms, Causes, Treatments

  https://www.webmd.com/baby/fetal-alcohol-syndrome

  Fetal alcohol syndrome can have many symptoms, including: […] There is no lab test that can prove a child has fetal alcohol syndrome. Many of its symptoms can seem like attention deficit hyperactivity disorder (ADHD). […] To diagnose fetal alcohol syndrome, doctors look for unusual facial features, lower-than-average height and weight, small head size, problems with attention and hyperactivity, and poor coordination. They also try to find out whether the mother drank while they were pregnant and if so, how much. […] The symptoms of fetal alcohol syndrome can’t be cured, but early diagnosis and treatment can improve a child’s development and outlook. Research shows that children do better when they: […] Fetal alcohol syndrome can’t be cured. However, recognizing the problem early and getting treatment for symptoms of the disorder can improve outcomes for your child.

• #27 Fetal alcohol spectrum disorder – Wikipedia

  https://en.wikipedia.org/wiki/Fetal_alcohol_spectrum_disorder

  The most severe condition is called Fetal Alcohol Syndrome (FAS), which refers to individuals who have a specific set of birth defects and neurodevelopmental disorders characteristic of the diagnosis. The following criteria must be fully met for an FAS diagnosis: Prenatal or postnatal height or weight (or both) at or below the 10th percentile, all three FAS facial features present, clinically significant structural, neurological, or functional impairment of the central nervous system, and confirmed or unknown prenatal alcohol exposure. […] Partial FAS (pFAS) was previously known as atypical FAS. People with pFAS have a confirmed history of prenatal alcohol exposure, but may lack growth deficiency or the complete facial stigmata. Central nervous system damage is present at the same level as FAS. These individuals have the same functional disabilities but „look” less like FAS.

• #28 Fetal Alcohol Syndrome – Pediatrics – MSD Manual Professional Edition

  https://www.msdmanuals.com/professional/pediatrics/metabolic-electrolyte-and-toxic-disorders-in-neonates/fetal-alcohol-syndrome

  At birth, infants with fetal alcohol syndrome (FAS) can be identified by small stature and a typical set of facial traits including microcephaly, microphthalmia, short palpebral fissures, epicanthal folds, a small or flat midface, a flat elongated philtrum, a thin upper lip, and a small chin. […] Diagnosis of FAS is given to infants with characteristic findings who are born to people who used alcohol excessively during pregnancy. […] No single physical or cognitive finding is pathognomonic; lesser degrees of alcohol use cause less severe manifestations, and the diagnosis of mild cases can be difficult because partial expression occurs.

• #29 Fetal Alcohol Syndrome and Fetal Alcohol Spectrum Disorders | AAFP

  https://www.aafp.org/pubs/afp/issues/2017/1015/p515.html

  Diagnosis begins with assessment of prenatal alcohol exposure, including quantity of alcohol consumed per occasion, frequency of use, and timing of consumption during pregnancy. […] The diagnostic criteria for FAS or PFAS do not require confirmed alcohol use if characteristic findings are present. […] However, a confirmed absence of alcohol exposure rules out the diagnoses. Confirmation of alcohol exposure is required for diagnosis of alcohol-related neurodevelopmental disorder and alcohol-related birth defects. […] As previously noted, FASD comprises four distinct categories: FAS, PFAS, alcohol-related neurodevelopmental disorder, and alcohol-related birth defects. Each category is distinguished by the presence or absence of characteristic facial dysmorphology, growth retardation, central nervous system dysfunction, and neurobehavioral disabilities.

• #30 Fetal alcohol spectrum disorder – Wikipedia

  https://en.wikipedia.org/wiki/Fetal_alcohol_spectrum_disorder

  Alcohol-related neurodevelopmental disorder (ARND) is the specific diagnosis of the non-dysmorphic type of FASD, where a majority of the symptoms are witnessed. The diagnosis was initially suggested by the Institute of Medicine to replace the terms FAE (fetal alcohol effects). It focuses on central nervous system damage, rather than growth deficiency or FAS facial features. […] Neurobehavioral disorder associated with prenatal alcohol exposure (ND-PAE) is the spectrum-wide term for the psychiatric, behavioral, and neurological symptoms of all FASDs. It was introduced into the DSM-5 as a „condition for further study” and as a specified condition under, „other specified neurodevelopmental disorders” as a way to better study the behavioral aspects of all FASD disorders.

• #31 Common Diagnostic Approaches in Fetal Alcohol Spectrum Disorder

  https://www.aap.org/en/patient-care/fetal-alcohol-spectrum-disorders/diagnosis/common-diagnostic-approaches-in-fetal-alcohol-spectrum-disorder/?srsltid=AfmBOopmTbHk-frX-OVFbPfwOfLxA-XnuwglRMhnudrCajAROq_j930z

  Familiarity with diagnostic approaches for FASDs contributes to accurate diagnosis, treatment, and care for children with FASDs and their families. […] Differential diagnosis of any of the above concerns should include an evaluation for an FASD. […] Pediatricians can choose which diagnostic scheme to use to make an FASD diagnosis. […] The ND-PAE diagnosis requires evidence of more than minimal prenatal alcohol exposure. […] These updated guidelines are available in the research literature and follow the 1996 Institute of Medicine (IOM) framework. […] The four digits in the code reflect the magnitude of expression of the key diagnostic features of an FASD: (1) growth deficiency, (2) facial features, (3) neurocognitive structural and functional abnormalities, and (4) prenatal alcohol exposure.

• #32 Alcohol, Pregnancy & Fetal Alcohol Spectrum Disorders – Center for Better Beginnings

  https://betterbeginnings.org/what-we-do/patient-care/fetal-alcohol-spectrum-disorder-clinic/spectrum-2/

  Neurobehavioral Disorder Associated with Prenatal Alcohol Exposure (ND-PAE) is a new psychiatric diagnosis being considered that is included in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), the handbook used by healthcare professionals to diagnose mental disorders. ND-PAE requires evidence of both prenatal alcohol exposure and impairments in the following three areas: cognition, self-regulation, and adaptive functioning. This new diagnosis will improve understanding of the multifaceted cognitive and behavioral deficits seen in some people exposed to alcohol prenatally, and facilitate diagnosis and treatment of these individuals.

• #33 Clinical Diagnosis and Management of Fetal Alcohol Spectrum Disorder and Sensory Processing Disorder in Children

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10814837/

  Fetal alcohol spectrum disorder (FASD) is commonly misdiagnosed because of the complexity of presentation and multiple diagnostic criteria. […] The four FASD diagnostic criteria are facial dysmorphology, growth deficiency, central nervous system dysfunction, and prenatal alcohol exposure. […] FASD can be diagnosed by facial dysmorphology, growth deficiency, central nervous system dysfunction, and a history of PAE. […] FASD is often misdiagnosed due to comorbidities and varying clinical phenotypes. […] The first criterion for a FASD diagnosis is PAE, which occurs when an embryo or fetus is exposed to alcohol from a woman drinking alcohol while pregnant, either deliberately or inadvertently. […] Confirmation of PAE is necessary for all FASD diagnoses except for FAS. […] The diagnosis of FASD involves a comprehensive assessment of various factors across four categories.

• #34 Fetal Alcohol Spectrum Disorders: MedlinePlus

  https://medlineplus.gov/fetalalcoholspectrumdisorders.html

  Diagnosing FASD can be hard because there is no medical test, like a blood test, for it. The health care provider will make a diagnosis by looking at the child’s signs and symptoms and asking whether the mother drank alcohol during pregnancy. […] FASDs last a lifetime. There is no cure for FASDs, but treatments can help. These include medicines to help with some symptoms, medical care for health problems, behavior and education therapy, and parent training. A good treatment plan is specific to the child’s problems. It should include close monitoring, follow-ups, and changes when needed. […] Diagnosis before 6 years of age.

• #35 Fetal Alcohol Syndrome and Fetal Alcohol Spectrum Disorders | AAFP

  https://www.aafp.org/pubs/afp/issues/2017/1015/p515.html

  Fetal alcohol syndrome (FAS) and fetal alcohol spectrum disorders (FASD) result from intrauterine exposure to alcohol and are the most common nonheritable causes of intellectual disability. […] FAS is commonly missed or misdiagnosed, preventing affected children from receiving needed services in a timely fashion. Diagnosis is based on the presence of the following clinical features, all of which must be present: prenatal and/or postnatal growth retardation, facial dysmorphology, central nervous system dysfunction, and neurobehavioral disabilities. […] The diagnosis of fetal alcohol syndrome and partial fetal alcohol syndrome is based on defined clinical characteristics and does not require confirmed alcohol use during pregnancy. […] Any child who was exposed to alcohol pre-natally or presents with growth retardation, facial dysmorphology, central nervous system dysfunction, or neurobehavioral disabilities—the key manifestations of FASD—should prompt consideration of FASD.

• #36 Introduction / Diagnosing FASD and Mental Disorders – Understanding the Similarities and Differences between Fetal Alcohol Spectrum Disorder and Mental Health Disorders

  https://www.justice.gc.ca/eng/rp-pr/csj-sjc/esc-cde/rr13_10/p1.html

  People can be diagnosed as having full FAS with a confirmed or unconfirmed history of prenatal alcohol exposure because of the three distinctive features (growth deficiency, facial anomalies, and central nervous system dysfunction) which do not co-occur in other disorders. […] For a diagnosis of pFAS or ARND there must be a confirmed history of prenatal alcohol exposure. Obtaining a history of prenatal alcohol exposure can be extremely challenging, especially for adults being evaluated for FASD. […] Assessing for FASD requires both physical and cognitive evaluations. Therefore, it is recommended that it be made by a multidisciplinary team comprised of specialists such as pediatricians/physicians, psychiatrists, psychologists, speech-language pathologists, and occupational therapists, all of whom should be specifically trained in making FASD diagnoses.

• #37 Fetal Alcohol Syndrome Differential Diagnoses

  https://emedicine.medscape.com/article/974016-differential

  Prompt and accurate diagnosis of fetal alcohol syndrome or fetal alcohol spectrum disorder (FASD) is important. […] The best time to diagnose fetal alcohol syndrome or FASD is at birth, but most cases are not diagnosed until school age. This delay is mostly because clinicians do not routinely and thoroughly gather information about maternal alcohol use in pregnancy and partly because the diagnosis may be difficult to make in the newborn period. […] Furthermore, the characteristic facial features tend to become decreasingly recognizable as the child reaches adolescence, making diagnosis difficult after this age. […] For the reasons listed above, obtaining a careful history is of primary concern, followed by an appropriate examination of the child for characteristic features, consultation with a specialist if warranted, and referral for intervention and treatment for both the mother and child if a diagnosis is made.

• #38

  https://www.gov.uk/government/publications/fetal-alcohol-spectrum-disorder-health-needs-assessment/fetal-alcohol-spectrum-disorder-health-needs-assessment

  However, classification of the terms has been changing as academics and clinicians around the world develop the evidence base. […] Currently, the National Institute of Health (NIH) via the National Institute on Alcohol Abuse and Alcoholism (NIAAA) is sponsoring an international approach to develop research diagnostic criteria for FASD. […] The 2019 SIGN guidance lists the range of expertise required to obtain a diagnosis: neonatologist, paediatrician or physician with competency in assessment of FASD, child development specialists with the skillset to conduct physical and functional assessments. […] Early diagnosis of FASD creates better opportunities to intervene earlier and reduces the rate of secondary disabilities and issues such as exclusion from school. […] Diagnosis remains important even beyond childhood, although this can be difficult to obtain. […] A systematic review by Popova et al identified 428 co-morbidities. […] The neuro-developmental problems associated with FASD can create great difficulties for individuals in their childhood that persist throughout life.

• #39 Fetal Alcohol Spectrum Disorder (FASD) – Health Care for Adults with Intellectual and Developmental Disabilities

  https://iddtoolkit.vkcsites.org/health-watch-tables/fetal-alcohol-spectrum-disorder-fasd/

  It is essential to rule out such differential diagnoses, especially in the absence of confirmed prenatal alcohol exposure.1,6 […] Experts call for early diagnosis and intervention with families of alcohol-affected children to: promote their development; minimize the occurrence of secondary disabilities; identify and support previously unidentified siblings, and seek to prevent subsequent pregnancies affected by alcohol.7 […] Specific diagnostic guidelines for FASD are reviewed at www.healthychildren.org/English/health-issues/conditions/chronic/Pages/Fetal-Alcohol-Spectrum-Disorders.aspx. […] Consider referral for assessment to an appropriate resource for your community, preferably a multidisciplinary FASD team. […] Most individuals with FASD have an invisible disorder and 50% meet current definitions of developmental/intellectual disability.11

• #40 Florida Center for Early Childhood Fetal Alcohol Spectrum Disorders Clinic | The Florida Center

  https://www.thefloridacenter.org/what-we-do/fetal-alcohol-spectrum-disorders-clinic/

  The process is an all-day event, as each FASD team member individually evaluates the client. After a thorough evaluation, the team convenes and presents their individual findings. […] Problems associated with FASD tend to intensify as children move into adulthood. These can include mental health problems, troubles with the law and the inability to live independently. The younger the child is diagnosed and appropriate interventions and services are initiated for the child/family, the higher the probability they will live independently and function well in society. Early diagnosis and intervention contribute to positive long-term outcomes that can lead to a more productive life.

• #41 Clinical Diagnosis and Management of Fetal Alcohol Spectrum Disorder and Sensory Processing Disorder in Children

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10814837/

  FASD is diagnosed by healthcare providers based on the presence or absence of criteria. […] Given that single parent families are becoming ever more common in the USA and Western countries, maternal knowledge of prior paternal alcohol exposure may not always be readily available adding an additional layer of complication to interpreting FASD in a child and making management decisions. […] The implementation of early intervention measures aims to enhance outcomes, including the advancement of activities replicating daily living skills and the mitigation of potential secondary conditions such as academic underachievement, deficiencies in social skills, and overall performance in various age-appropriate environments. […] Early diagnosis, the effectiveness of the intervention, and adherence to the plans are a few factors that may significantly affect the child’s prognosis.

• #42 Fetal Alcohol Spectrum Disorder (FASD) – Health Care for Adults with Intellectual and Developmental Disabilities

  https://iddtoolkit.vkcsites.org/health-watch-tables/fetal-alcohol-spectrum-disorder-fasd/

  However, The diagnosis can lead to a paradigm shift in attitude and perception towards the affected individual from one of a difficult individual or sociopath to that of an individual who is neurologically impaired and who needs appropriate assistance with specific management and treatment.11 […] Because a history of prenatal alcohol exposure may be difficult to obtain for adults, consider the possibility in persons who have experienced one or more of the following: premature maternal death related to alcohol use; living with an alcoholic parent; abuse or neglect; involvement with child protective services agencies; a history of transient caregiving situations; foster or adoptive placements13.

• #43 4 Diagnosis and Clinical Evaluation of Fetal Alcohol Syndrome | Fetal Alcohol Syndrome: Diagnosis, Epidemiology, Prevention, and Treatment | The National Academies Press

  https://nap.nationalacademies.org/read/4991/chapter/6

  In addition to the gatekeeping functions described for any diagnosis, identifying children with FAS or possible alcohol-related effects provides additional benefits to the mother, the child, and society. […] The early identification of a child with FAS can be theoretically used as a marker that will lead to interventions with the mother for her own treatment and for the prevention of births of subsequent children with FAS. […] The committee-revised diagnostic criteria aim to increase clarity, rigor, and consistency by expanding the traditional designations of fetal alcohol syndrome and other possible alcohol-related effects.

• #44 Fetal Alcohol Syndrome: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/974016-overview

  Adverse fetal, neonatal, and pediatric effects occur with maternal alcohol consumption during pregnancy. The diagnosis of fetal alcohol syndrome (FAS) is based on findings in the following three areas: (1) characteristic facial anomalies, (2) growth retardation, and (3) CNS involvement. […] Prenatal exposure to alcohol is associated with a variable spectrum of effects referred to as fetal alcohol spectrum disorders (FASD), with fetal alcohol syndrome at the most severe end of that spectrum. […] The costs for one individual with fetal alcohol spectrum disorder are estimated to be more than $30,000 per year; cost of FASD to American society is estimated to be $205 billion each year. […] Although many factors may modify the risk, the primary and only necessary cause of fetal alcohol syndrome (FAS) or fetal alcohol spectrum disorder (FASD) is maternal alcohol consumption.

Zobacz więcej