Psych · Intellectual disability — neurodevelopmental
Foetal alcohol spectrum disorder
Also known as FASD · Fetal alcohol spectrum disorder · Fetal alcohol syndrome · Foetal alcohol syndrome · Partial fetal alcohol syndrome · Alcohol-related neurodevelopmental disorder · ARND · ND-PAE · Prenatal alcohol exposure
Exam-exhaustive fellowship reference on foetal alcohol spectrum disorder — diagnostic systems (Hoyme, Cook/Canadian, 4-digit code, DSM-5-TR ND-PAE), sentinel facial features, neurobehavioural profile, differentials (ADHD, ASD, ID, trauma), multidisciplinary assessment, comorbidity-focused management without a disease-modifying drug, secondary disability prevention, forensic interface, and primary prevention. FRANZCP-primary, globally tagged.
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Meet the patient
A 9-year-old boy sits in your clinic carrying three prior labels — ADHD, oppositional, "naughty" — and a school threatening suspension. His foster carer mentions, almost as an afterthought, that his birth mother "drank." He is small for his age, his philtrum is smooth, and he cannot hold a three-step instruction long enough to get to lunch.[6][19]
The examiner's question is never "what tablet?" It is: "What do you look for, what do you exclude, and what do you actually do for this brain?" This topic is the answer.[12][18]
You have read the opening of this topic. The complete unit — every section and its primary-source references — is part of the Psychiatry Fellowship fellowship atlas.
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- [1]Hoyme HE, Kalberg WO, Elliott AJ, et al. Updated Clinical Guidelines for Diagnosing Fetal Alcohol Spectrum Disorders Pediatrics, 2016.PMID 27464676
- [2]Cook JL, Green CR, Lilley CM, et al. Fetal alcohol spectrum disorder: a guideline for diagnosis across the lifespan CMAJ, 2016.PMID 26668194
- [3]Popova S, Lange S, Shield K, et al. Comorbidity of fetal alcohol spectrum disorder: a systematic review and meta-analysis Lancet, 2016.PMID 26777270
- [4]Lange S, Probst C, Gmel G, Rehm J, Burd L, Popova S Global Prevalence of Fetal Alcohol Spectrum Disorder Among Children and Youth: A Systematic Review and Meta-analysis JAMA Pediatr, 2017.PMID 28828483
- [5]May PA, Chambers CD, Kalberg WO, et al. Prevalence of Fetal Alcohol Spectrum Disorders in 4 US Communities JAMA, 2018.PMID 29411031
- [6]Jones KL, Smith DW Recognition of the fetal alcohol syndrome in early infancy Lancet, 1973.PMID 4127281
- [7]Mattson SN, Roesch SC, Fagerlund A, et al. Toward a neurobehavioral profile of fetal alcohol spectrum disorders Alcohol Clin Exp Res, 2010.PMID 20569243
- [8]Mattson SN, Bernes GA, Doyle LR Fetal Alcohol Spectrum Disorders: A Review of the Neurobehavioral Deficits Associated With Prenatal Alcohol Exposure Alcohol Clin Exp Res, 2019.PMID 30964197
- [9]Astley SJ, Clarren SK Diagnosing the full spectrum of fetal alcohol-exposed individuals: introducing the 4-digit diagnostic code Alcohol Alcohol, 2000.PMID 10906009
- [10]Popova S, Lange S, Probst C, Gmel G, Rehm J Estimation of national, regional, and global prevalence of alcohol use during pregnancy and fetal alcohol syndrome: a systematic review and meta-analysis Lancet Glob Health, 2017.PMID 28089487
- [11]O'Connor MJ, Paley B Psychiatric conditions associated with prenatal alcohol exposure Dev Disabil Res Rev, 2009.PMID 19731386
- [12]Williams JF, Smith VC; Committee on Substance Abuse Fetal Alcohol Spectrum Disorders Pediatrics, 2015.PMID 26482673
- [13]Chudley AE, Conry J, Cook JL, Loock C, Rosales T, LeBlanc N Fetal alcohol spectrum disorder: Canadian guidelines for diagnosis CMAJ, 2005.PMID 15738468
- [14]Weyrauch D, Schwartz M, Hart B, Klug MG, Burd L Comorbid Mental Disorders in Fetal Alcohol Spectrum Disorders: A Systematic Review J Dev Behav Pediatr, 2017.PMID 28460370
- [15]Riley EP, Infante MA, Warren KR Fetal alcohol spectrum disorders: an overview Neuropsychol Rev, 2011.PMID 21499711
- [16]Petrenko CL, Tahir N, Mahoney EC, Chin NP Prevention of secondary conditions in fetal alcohol spectrum disorders: identification of systems-level barriers Matern Child Health J, 2014.PMID 24178158
- [17]Flannigan K, Coons-Harding KD, Anderson T, et al. A Systematic Review of Interventions to Improve Mental Health and Substance Use Outcomes for Individuals with Prenatal Alcohol Exposure and Fetal Alcohol Spectrum Disorder Alcohol Clin Exp Res, 2020.PMID 33119894
- [18]Wozniak JR, Riley EP, Charness ME Clinical presentation, diagnosis, and management of fetal alcohol spectrum disorder Lancet Neurol, 2019.PMID 31160204
- [19]Streissguth AP, Bookstein FL, Barr HM, Sampson PD, O'Malley K, Young JK Risk factors for adverse life outcomes in fetal alcohol syndrome and fetal alcohol effects J Dev Behav Pediatr, 2004.PMID 15308923
- [20]Famy C, Streissguth AP, Unis AS Mental illness in adults with fetal alcohol syndrome or fetal alcohol effects Am J Psychiatry, 1998.PMID 9546004