Advertisement

European Child & Adolescent Psychiatry

, Volume 23, Issue 10, pp 863–875 | Cite as

Fetal alcohol spectrum disorders

  • Nora Dörrie
  • Manuel FöckerEmail author
  • Inga Freunscht
  • Johannes Hebebrand
Review

Abstract

Prenatal alcohol exposure (PAE) is one of the most prevalent and modifiable risk factors for somatic, behavioral, and neurological abnormalities. Affected individuals exhibit a wide range of such features referred to as fetal alcohol spectrum disorders (FASD). These are characterized by a more or less specific pattern of minor facial dysmorphic features, growth deficiency and central nervous system symptoms. Nevertheless, whereas the diagnosis of the full-blown fetal alcohol syndrome does not pose a major challenge, only a tentative diagnosis of FASD can be reached if only mild features are present and/or maternal alcohol consumption during pregnancy cannot be verified. The respective disorders have lifelong implications. The teratogenic mechanisms induced by PAE can lead to various additional somatic findings and structural abnormalities of cerebrum and cerebellum. At the functional level, cognition, motor coordination, attention, language development, executive functions, memory, social perception and emotion processing are impaired to a variable extent. The long-term development is characterized by disruption and failure in many domains; an age-adequate independency is frequently not achieved. In addition to primary prevention, individual therapeutic interventions and tertiary prevention are warranted; provision of extensive education to affected subjects and their caregivers is crucial. Protective environments are often required to prevent negative consequences such as delinquency, indebtedness or experience of physical/sexual abuse.

Keywords

Fetal alcohol syndrome Fetal alcohol spectrum disorders Prenatal alcohol exposure 

Notes

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

References

  1. 1.
    Feldman HS, Jones KL, Lindsay S et al (2012) Prenatal alcohol exposure patterns and alcohol-related birth defects and growth deficiencies: a prospective study. Alcohol Clin Exp Res 36:670–676PubMedGoogle Scholar
  2. 2.
    Paintner A, Williams AD, Burd L (2012) Fetal alcohol spectrum disorders—implications for child neurology, part 2: diagnosis and management. J Child Neurol 27(3):355–356PubMedGoogle Scholar
  3. 3.
    Lewis SJ, Zuccolo L, Davey Smith G et al (2012) Fetal alcohol exposure and IQ at age 8: evidence from a population-based birth-cohort study. PLoS One 7:e49407PubMedPubMedCentralGoogle Scholar
  4. 4.
    Kelly Y, Sacker A, Gray R et al (2012) Light drinking during pregnancy: still no increased risk for socioemotional difficulties or cognitive deficits at 5 years of age. J Epidemiol Community Health 66:41–48PubMedGoogle Scholar
  5. 5.
    Sood B, Delaney-Black V, Covington C et al (2001) Prenatal alcohol exposure and childhood behavior at age 6 to 7 years: I. Dose–response effect. Pediatrics 108:e34–e34Google Scholar
  6. 6.
    Centers for Disease Control and Prevention (CDC) (2009) Alcohol use among pregnant and nonpregnant women of childbearing age—United States, 1991–2005. MMWR Morb Mortal Wkly Rep 58:529–532Google Scholar
  7. 7.
    O’Leary CM (2004) Fetal alcohol syndrome: diagnosis, epidemiology, and developmental outcomes. J Paediatr Child Health 40:2–7PubMedGoogle Scholar
  8. 8.
    Astley SJ (2004) Diagnostic guide for fetal alcohol spectrum disorders the 4-digit diagnostic code. http://depts.washington.edu/fasdpn/pdfs/guide2004.pdf
  9. 9.
    Hoyme HE, May PA, Kalberg WO et al (2005) A practical clinical approach to diagnosis of fetal alcohol spectrum disorders: clarification of the 1996 institute of medicine criteria. Pediatrics 115:39–47PubMedGoogle Scholar
  10. 10.
    Chudley AE, Conry J, Cook JL et al (2005) Fetal alcohol spectrum disorder: Canadian guidelines for diagnosis. Spectrum 172(5 Suppl):S1–S21Google Scholar
  11. 11.
    Stratton K, Howe C, Battaglia F (1996) Fetal alcohol syndrome: diagnosis, epidemiology, prevention, and treatment. National Academy Press, Washington, DCGoogle Scholar
  12. 12.
    Watkins RE, Elliott EJ, Wilkins A et al (2013) Recommendations from a consensus development workshop on the diagnosis of fetal alcohol spectrum disorders in Australia. BMC Pediatr 13:156PubMedPubMedCentralGoogle Scholar
  13. 13.
    Astley SJ (2006) Comparison of the 4-digit diagnostic code and the Hoyme diagnostic guidelines for fetal alcohol spectrum disorders. Pediatrics 118:1532–1545PubMedGoogle Scholar
  14. 14.
    Landgraf M, Nothacker M, Heinen F (2013) Diagnosis of fetal alcohol syndrome (FAS): German guideline version 2013. Eur J Paediatr Neurol 1–10Google Scholar
  15. 15.
    World Health Organization (1993) The ICD-10 classification of mental and behavioural disorders: diagnostic criteria for research. World Health Organization, GenevaGoogle Scholar
  16. 16.
    American Psychiatric Association (2000) Diagnostic and statistical manual of mental disorders. DSM-IV-TR: 4th edn. Text Revision, Washington, DCGoogle Scholar
  17. 17.
    American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders: DSM-5. American Psychiatric, Washington, DCGoogle Scholar
  18. 18.
    May P, Blankenship J, Marais AS et al (2013) Approaching the prevalence of the full spectrum of fetal alcohol spectrum disorders in a South African population-based study. Alcohol Clin Exp Res 37:818–830PubMedPubMedCentralGoogle Scholar
  19. 19.
    May P, Gossage JP, Kalberg WO et al (2009) Prevalence and epidemiologic characteristics of FASD from various research methods with an emphasis on recent in-school studies. Dev Disabil Res Rev 15:176–192PubMedGoogle Scholar
  20. 20.
    May P, Fiorentino D, Coriale G et al (2011) Prevalence of children with severe fetal alcohol spectrum disorders in communities near Rome, Italy: new estimated rates are higher than previous estimates. Int J Environ Res Public Health 8:2331–2351PubMedPubMedCentralGoogle Scholar
  21. 21.
    Kvigne VL, Leonardson GR, Neff-Smith M et al (2004) Characteristics of children who have full or incomplete fetal alcohol syndrome. J Pediatr 145:635–640PubMedGoogle Scholar
  22. 22.
    Lange S, Shield K, Rehm J, Popova S (2013) Prevalence of fetal alcohol spectrum disorders in child care settings: a meta-analysis. Pediatrics 132:e980–e995PubMedGoogle Scholar
  23. 23.
    Alvik A, Aalen OO, Lindemann R (2013) Early fetal binge alcohol exposure predicts high behavioral symptom scores in 5.5-year-old children. Alcohol Clin Exp Res 37:1954–1962PubMedGoogle Scholar
  24. 24.
    May PA, Gossage JP, Marais A-S et al (2008) Maternal risk factors for fetal alcohol syndrome and partial fetal alcohol syndrome in South Africa: a third study. Alcohol Clin Exp Res 32:738–753PubMedGoogle Scholar
  25. 25.
    Coyne KL, de Costa CM, Heazlewood RJ, Newman HC (2008) Pregnancy characteristics of women giving birth to children with fetal alcohol syndrome in far North Queensland. Aust N Z J Obstet Gynaecol 48:240–247PubMedGoogle Scholar
  26. 26.
    May PA, Gossage JP (2001) Estimating the prevalence of fetal alcohol syndrome. A summary. Alcohol Res Health 25:159–167PubMedGoogle Scholar
  27. 27.
    Ballard MS, Sun M, Ko J (2012) Vitamin A, folate, and choline as a possible preventive intervention to fetal alcohol syndrome. Med Hypotheses 78:489–493PubMedGoogle Scholar
  28. 28.
    Esper LA, Furtado EF (2014) Identifying maternal risk factors associated with fetal alcohol spectrum disorders: a systematic review. Eur Child Adolesc PsychiatryGoogle Scholar
  29. 29.
    Calvigioni D, Hurd YL, Harkany T, Keimpema E (2014) Neuronal substrates and functional consequences of prenatal cannabis exposure. Eur Child Adolesc Psychiatry. doi: 10.1007/s00787-014-0550-y
  30. 30.
    Odendaal HJ, Steyn DW, Elliott A, Burd L (2009) Combined effects of cigarette smoking and alcohol consumption on perinatal outcome. Gynecol Obstet Invest 67:1–8PubMedGoogle Scholar
  31. 31.
    Tiesler CMT, Heinrich J (2014) Prenatal nicotine exposure and child behavioural problems. Eur Child Adolesc PsychiatryGoogle Scholar
  32. 32.
    May PA, Tabachnick BG, Gossage JP et al (2013) Maternal factors predicting cognitive and behavioral characteristics of children with fetal alcohol spectrum disorders. J Dev Behav Pediatr 34:314–322PubMedPubMedCentralGoogle Scholar
  33. 33.
    Alati R, Davey Smith G, Lewis SJ, Sayal K, Draper ES, Golding J, Fraser R, Gray R (2013) Effect of prenatal alcohol exposure on childhood academic outcomes: contrasting maternal and paternal associations in the ALSPAC study. PLoS One 8(10):e74844Google Scholar
  34. 34.
    Sulik KK, Johnston MC, Webb MA (1981) Fetal alcohol syndrome: embryogenesis in a mouse model. Science 214:936–938PubMedGoogle Scholar
  35. 35.
    Middaugh LD, Boggan WO (1991) Postnatal growth deficits in prenatal ethanol-exposed mice: characteristics and critical periods. Alcohol Clin Exp Res 15:919–926PubMedGoogle Scholar
  36. 36.
    Chen X, Coles CD, Lynch ME, Hu X (2012) Understanding specific effects of prenatal alcohol exposure on brain structure in young adults. Hum Brain Mapp 33:1663–1676PubMedPubMedCentralGoogle Scholar
  37. 37.
    Bell SH, Stade B, Reynolds JN et al (2010) The remarkably high prevalence of epilepsy and seizure history in fetal alcohol spectrum disorders. Alcohol Clin Exp Res 34:1084–1089PubMedGoogle Scholar
  38. 38.
    Chasnoff IJ, Wells AM, Telford E et al (2010) Neurodevelopmental functioning in children with FAS, pFAS, and ARND. J Dev Behav Pediatr 31:192–201PubMedGoogle Scholar
  39. 39.
    Spohr H-L, Willms J, Steinhausen H-C (2007) Fetal alcohol spectrum disorders in young adulthood. J Pediatr 150(175–9):179Google Scholar
  40. 40.
    Astley SJ (2010) Profile of the first 1,400 patients receiving diagnostic evaluations for fetal alcohol spectrum disorder at the Washington State Fetal Alcohol Syndrome Diagnostic & Prevention Network. Can J Clin Pharmacol 17:e132–e164PubMedGoogle Scholar
  41. 41.
    Dou X, Wilkemeyer MF, Menkari CE et al (2013) Mitogen-activated protein kinase modulates ethanol inhibition of cell adhesion mediated by the L1 neural cell adhesion molecule. Proc Natl Acad Sci USA 110:5683–5688PubMedPubMedCentralGoogle Scholar
  42. 42.
    Patten AR, Brocardo PS, Christie BR (2013) Omega-3 supplementation can restore glutathione levels and prevent oxidative damage caused by prenatal ethanol exposure. J Nutr Biochem 24:760–769PubMedGoogle Scholar
  43. 43.
    Ikonomidou C (2000) Ethanol-induced apoptotic neurodegeneration and fetal alcohol syndrome. Science 287:1056–1060PubMedGoogle Scholar
  44. 44.
    Light KE, Belcher SM, Pierce DR (2002) Time course and manner of Purkinje neuron death following a single ethanol exposure on postnatal day 4 in the developing rat. Neuroscience 114:327–337PubMedGoogle Scholar
  45. 45.
    Zhou FC, Sari Y, Powrozek TA (2005) Fetal alcohol exposure reduces serotonin innervation and compromises development of the forebrain along the serotonergic pathway. Alcohol Clin Exp Res 29:141–149PubMedGoogle Scholar
  46. 46.
    Gundogan F, Elwood G, Longato L et al (2008) Impaired placentation in fetal alcohol syndrome. Placenta 29:148–157PubMedPubMedCentralGoogle Scholar
  47. 47.
    Gareri J, Brien J, Reynolds J, Koren G (2009) Potential role of the placenta in fetal alcohol spectrum disorder. Paediatr Drugs 11:26–29PubMedGoogle Scholar
  48. 48.
    Kane CJM, Phelan KD, Drew PD (2012) Neuroimmune mechanisms in fetal alcohol spectrum disorder. Dev Neurobiol 72:1302–1316PubMedPubMedCentralGoogle Scholar
  49. 49.
    Perkins A, Lehmann C, Lawrence RC, Kelly SJ (2013) Alcohol exposure during development: impact on the epigenome. Int J Dev Neurosci 31:391–397PubMedPubMedCentralGoogle Scholar
  50. 50.
    Luo J (2012) Mechanisms of ethanol-induced death of cerebellar granule cells. Cerebellum 11:145–154PubMedPubMedCentralGoogle Scholar
  51. 51.
    Archibald SL, Fennema-Notestine C, Gamst A et al (2001) Brain dysmorphology in individuals with severe prenatal alcohol exposure. Dev Med Child Neurol 43:148–154PubMedGoogle Scholar
  52. 52.
    Astley SJ, Richards T, Aylward EH et al (2009) Magnetic resonance spectroscopy outcomes from a comprehensive magnetic resonance study of children with fetal alcohol spectrum disorders. Magn Reson Imaging 27:760–778PubMedGoogle Scholar
  53. 53.
    O’Hare ED, Kan E, Yoshii J et al (2005) Mapping cerebellar vermal morphology and cognitive correlates in prenatal alcohol exposure. Neuroreport 16:1285–1290PubMedGoogle Scholar
  54. 54.
    Sowell ER, Mattson SN, Thompson PM et al (2001) Mapping callosal morphology and cognitive correlates: effects of heavy prenatal alcohol exposure. Neurology 57:235–244PubMedGoogle Scholar
  55. 55.
    Yang Y, Phillips OR, Kan E et al (2012) Callosal thickness reductions relate to facial dysmorphology in fetal alcohol spectrum disorders. Alcohol Clin Exp Res 36:798–806PubMedPubMedCentralGoogle Scholar
  56. 56.
    Dodge NC, Jacobson JL, Molteno CD et al (2009) Prenatal alcohol exposure and interhemispheric transfer of tactile information: Detroit and Cape Town findings. Alcohol Clin Exp Res 33:1628–1637PubMedPubMedCentralGoogle Scholar
  57. 57.
    Bookstein FL, Streissguth AP, Sampson PD et al (2002) Corpus callosum shape and neuropsychological deficits in adult males with heavy fetal alcohol exposure. Neuroimage 15:233–251PubMedGoogle Scholar
  58. 58.
    Fryer SL, Schweinsburg BC, Bjorkquist OA et al (2009) Characterization of white matter microstructure in fetal alcohol spectrum disorders. Alcohol Clin Exp Res 33:514–521PubMedPubMedCentralGoogle Scholar
  59. 59.
    Wozniak JR, Muetzel RL, Mueller BA et al (2009) Microstructural corpus callosum anomalies in children with prenatal alcohol exposure: an extension of previous diffusion tensor imaging findings. Alcohol Clin Exp Res 33:1825–1835PubMedPubMedCentralGoogle Scholar
  60. 60.
    Opris I, Santos L, Gerhardt GA et al (2013) Prefrontal cortical microcircuits bind perception to executive control. Sci Rep 3:2285. doi: 10.1038/srep02285 PubMedPubMedCentralGoogle Scholar
  61. 61.
    Clark CM, Li D, Conry J et al (2000) Structural and functional brain integrity of fetal alcohol syndrome in non-retarded cases. Pediatrics 105:1096–1099PubMedGoogle Scholar
  62. 62.
    Roussotte FF, Sulik KK, Mattson SN et al (2012) Regional brain volume reductions relate to facial dysmorphology and neurocognitive function in fetal alcohol spectrum disorders. Hum Brain Mapp 33:920–937PubMedGoogle Scholar
  63. 63.
    Nardelli A, Lebel C, Rasmussen C et al (2011) Extensive deep gray matter volume reductions in children and adolescents with fetal alcohol spectrum disorders. Alcohol Clin Exp Res 35:1404–1417PubMedGoogle Scholar
  64. 64.
    Coles CD, Goldstein FC, Lynch ME et al (2011) Memory and brain volume in adults prenatally exposed to alcohol. Brain Cogn 75:67–77PubMedPubMedCentralGoogle Scholar
  65. 65.
    Willoughby KA, Sheard ED, Nash K, Rovet J (2008) Effects of prenatal alcohol exposure on hippocampal volume, verbal learning, and verbal and spatial recall in late childhood. J Int Neuropsychol Soc 14:1022–1033PubMedGoogle Scholar
  66. 66.
    Spadoni AD, Bazinet AD, Fryer SL et al (2009) BOLD response during spatial working memory in youth with heavy prenatal alcohol exposure. Alcohol Clin Exp Res 33:2067–2076PubMedPubMedCentralGoogle Scholar
  67. 67.
    Malisza KL, Buss JL, Bolster RB et al (2012) Comparison of spatial working memory in children with prenatal alcohol exposure and those diagnosed with ADHD: a functional magnetic resonance imaging study. J Neurodev Disord 4:12. doi: 10.1186/1866-1955-4-12 PubMedPubMedCentralGoogle Scholar
  68. 68.
    Mattson SN, Roesch SC, Fagerlund A et al (2010) Toward a neurobehavioral profile of fetal alcohol spectrum disorders. Alcohol Clin Exp Res 34:1640–1650PubMedPubMedCentralGoogle Scholar
  69. 69.
    Mattson SN, Roesch SC, Glass L et al (2013) Further development of a neurobehavioral profile of fetal alcohol spectrum disorders. Alcohol Clin Exp Res 37:517–528PubMedPubMedCentralGoogle Scholar
  70. 70.
    Aragón AS, Kalberg WO, Buckley D et al (2008) Neuropsychological study of FASD in a sample of American Indian children: processing simple versus complex information. Alcohol Clin Exp Res 32:2136–2148PubMedPubMedCentralGoogle Scholar
  71. 71.
    Coles CD, Platzman KA, Raskind-Hood CL et al (1997) A comparison of children affected by prenatal alcohol exposure and attention deficit, hyperactivity disorder. Alcohol Clin Exp Res 21:150–161PubMedGoogle Scholar
  72. 72.
    Brown RT, Coles CD, Smith IE et al (1991) Effects of prenatal alcohol exposure at school age. II. Attention and behavior. Neurotoxicol Teratol 13:369–376PubMedGoogle Scholar
  73. 73.
    Bhatara V, Loudenberg R, Ellis R (2006) Association of attention deficit hyperactivity disorder and gestational alcohol exposure: an exploratory study. J Atten Disord 9:515–522PubMedGoogle Scholar
  74. 74.
    Fryer SL, McGee CL, Matt GE et al (2007) Evaluation of psychopathological conditions in children with heavy prenatal alcohol exposure. Pediatrics 119:e733–e741PubMedGoogle Scholar
  75. 75.
    Glass L, Ware AL, Crocker N et al (2013) Neuropsychological deficits associated with heavy prenatal alcohol exposure are not exacerbated by ADHD. Neuropsychology 27(6):713–724PubMedGoogle Scholar
  76. 76.
    Coles CD, Lynch ME, Kable JA et al (2010) Verbal and nonverbal memory in adults prenatally exposed to alcohol. Alcohol Clin Exp Res 34:897–906PubMedGoogle Scholar
  77. 77.
    Jacobson JL, Dodge NC, Burden MJ et al (2011) Number processing in adolescents with prenatal alcohol exposure and ADHD: differences in the neurobehavioral phenotype. Alcohol Clin Exp Res 35:431–442PubMedPubMedCentralGoogle Scholar
  78. 78.
    Crocker N, Vaurio L, Riley EP, Mattson SN (2009) Comparison of adaptive behavior in children with heavy prenatal alcohol exposure or attention-deficit/hyperactivity disorder. Alcohol Clin Exp Res 33:2015–2023PubMedPubMedCentralGoogle Scholar
  79. 79.
    Kodituwakku PW, Kalberg W, May PA (2001) The effects of prenatal alcohol exposure on executive functioning. Alcohol Res Health 25:192–198PubMedGoogle Scholar
  80. 80.
    Grant T, Huggins J, Connor P et al (2004) A pilot community intervention for young women with fetal alcohol spectrum disorders. Community Ment Health J 40:499–511PubMedGoogle Scholar
  81. 81.
    Löser H (2000) Alkohol und Schwangerschaft: Embryopathie und Alkoholeffekte. Ther Umschau 57:1–7Google Scholar
  82. 82.
    Greenbaum RL, Stevens SA, Nash K et al (2009) Social cognitive and emotion processing abilities of children with fetal alcohol spectrum disorders: a comparison with attention deficit hyperactivity disorder. Alcohol Clin Exp Res 33:1656–1670PubMedGoogle Scholar
  83. 83.
    Freunscht I (2007) Ab 18 fällt man durch das Raster Emotionale , soziale und berufliche Entwicklung junger Erwachsener mit Fetalem Alkoholsyndrom (FAS). Westfälische Wilhelms-Universität MünsterGoogle Scholar
  84. 84.
    O’Connor MJ, Paley B (2009) Psychiatric conditions associated with prenatal alcohol exposure. Dev Disabil Res Rev 15:225–234PubMedGoogle Scholar
  85. 85.
    Coggins TE, Timler GR, Olswang LB (2007) A state of double jeopardy: impact of prenatal alcohol exposure and adverse environments on the social communicative abilities of school-age children with fetal alcohol spectrum disorder. Lang Speech Hear Serv Sch 38:117–127PubMedGoogle Scholar
  86. 86.
    Willford JA, Richardson GA, Leech SL, Day NL (2004) Verbal and visuospatial learning and memory function in children with moderate prenatal alcohol exposure. Alcohol Clin Exp Res 28:497–507PubMedGoogle Scholar
  87. 87.
    Autti-Rämö I, Fagerlund A, Ervalahti N et al (2006) Fetal alcohol spectrum disorders in Finland: clinical delineation of 77 older children and adolescents. Am J Med Genet A 140:137–143PubMedGoogle Scholar
  88. 88.
    McGee CL, Bjorkquist OA, Riley EP, Mattson SN (2010) Impaired language performance in young children with heavy prenatal alcohol exposure. Neurotoxicol Teratol 31(2):71–75Google Scholar
  89. 89.
    Mattson SN, Crocker N, Nguyen TT (2011) Fetal alcohol spectrum disorders: neuropsychological and behavioral features. Neuropsychol Rev 21:81–101PubMedPubMedCentralGoogle Scholar
  90. 90.
    Domellöf E, Fagard J, Jacquet A-Y, Rönnqvist L (2011) Goal-directed arm movements in children with fetal alcohol syndrome: a kinematic approach. Eur J Neurol 18:312–320PubMedGoogle Scholar
  91. 91.
    Connor PD, Sampson PD, Streissguth AP et al (2006) Effects of prenatal alcohol exposure on fine motor coordination and balance: a study of two adult samples. Neuropsychologia 44:744–751PubMedGoogle Scholar
  92. 92.
    O’Hare ED, Lu LH, Houston SM et al (2009) Altered frontal-parietal functioning during verbal working memory in children and adolescents with heavy prenatal alcohol exposure. Hum Brain Mapp 30:3200–3208PubMedPubMedCentralGoogle Scholar
  93. 93.
    Hamilton DA, Kodituwakku P, Sutherland RJ, Savage DD (2003) Children with fetal alcohol syndrome are impaired at place learning but not cued-navigation in a virtual Morris water task. Behav Brain Res 143:85–94PubMedGoogle Scholar
  94. 94.
    Mattson SN, Roebuck TM (2002) Acquisition and retention of verbal and nonverbal information in children with heavy prenatal alcohol exposure. Alcohol Clin Exp Res 26:875–882PubMedGoogle Scholar
  95. 95.
    Kaemingk KL, Mulvaney S, Halverson PT (2003) Learning following prenatal alcohol exposure: performance on verbal and visual multitrial tasks. Arch Clin Neuropsychol 18:33–47PubMedGoogle Scholar
  96. 96.
    O’Leary CM, Nassar N, Kurinczuk JJ et al (2010) Prenatal alcohol exposure and risk of birth defects. Pediatrics 126:e843–e850PubMedGoogle Scholar
  97. 97.
    Chen ML, Olson HC, Picciano JF et al (2012) Sleep problems in children with fetal alcohol spectrum disorders. J Clin Sleep Med 8:421–429PubMedPubMedCentralGoogle Scholar
  98. 98.
    Åse F, Ilona A-R, Mirjam K et al (2012) Adaptive behaviour in children and adolescents with foetal alcohol spectrum disorders: a comparison with specific learning disability and typical development. Eur Child Adolesc Psychiatry 21:221–231PubMedGoogle Scholar
  99. 99.
    Larkby CA, Goldschmidt L, Hanusa BH, Day NL (2011) Prenatal alcohol exposure is associated with conduct disorder in adolescence: findings from a birth cohort. J Am Acad Child Adolesc Psychiatry 50:262–271PubMedPubMedCentralGoogle Scholar
  100. 100.
    Disney ER, Iacono W, McGue M et al (2008) Strengthening the case: prenatal alcohol exposure is associated with increased risk for conduct disorder. Pediatrics 122:e1225–e1230PubMedPubMedCentralGoogle Scholar
  101. 101.
    Alex K, Feldmann R (2012) Children and adolescents with fetal alcohol syndrome (FAS): better social and emotional integration after early diagnosis. Klin Padiatr 224:66–71PubMedGoogle Scholar
  102. 102.
    Streissguth AP, Bookstein FL, Barr HM et al (2004) Risk factors for adverse life outcomes in fetal alcohol syndrome and fetal alcohol effects. J Dev Behav Pediatr 25:228–238PubMedGoogle Scholar
  103. 103.
    Clark E, Lutke J, Minnes P, Ouellette-Kuntz H (2004) Secondary disabilities among adults with fetal alcohol spectrum disorder in British Columbia. J FAS Int 2:1–12Google Scholar
  104. 104.
    Olson HC, Feldman JJ, Streissguth AP et al (1998) Neuropsychological deficits in adolescents with fetal alcohol syndrome: clinical findings. Alcohol Clin Exp Res 22:1998–2012PubMedGoogle Scholar
  105. 105.
    Freunscht I, Feldmann R (2010) Young adults with fetal alcohol syndrome (FAS): social, emotional and occupational development. Klin Padiatr 223(1):33–37PubMedGoogle Scholar
  106. 106.
    Spohr H-L, Steinhausen H-C (2008) Fetal alcohol spectrum disorders and their persisting sequelae in adult life. Dtsch Arztebl Int 105:693–698PubMedPubMedCentralGoogle Scholar
  107. 107.
    Fast DK, Conry J (2009) Fetal alcohol spectrum disorders and the criminal justice system. Dev Disabil Res Rev 15:250–257PubMedGoogle Scholar
  108. 108.
    Walloch JE, Burger PH, Kornhuber J (2011) What is known about the outcome as adults for children with fetal alcohol syndrome (FAS)/fetal alcohol spectrum disorders (FASD)? Fortschr Neurol Psychiatr 80(6):320–326PubMedGoogle Scholar
  109. 109.
    Alati R, Al Mamun A, Williams GM et al (2006) In utero alcohol exposure and prediction of alcohol disorders in early adulthood: a birth cohort study. Arch Gen Psychiatry 63:1009–1016PubMedGoogle Scholar
  110. 110.
    Youngentob SL, Glendinning JI (2009) Fetal ethanol exposure increases ethanol intake by making it smell and taste better. Proc Natl Acad Sci USA 106:5359–5364PubMedPubMedCentralGoogle Scholar
  111. 111.
    Foltran F, Gregori D, Franchin L et al (2011) Effect of alcohol consumption in prenatal life, childhood, and adolescence on child development. Nutr Rev 69:642–659PubMedGoogle Scholar
  112. 112.
    Room R, Babor T, Rehm J (2005) Alcohol and public health. Lancet 365:519–530PubMedGoogle Scholar
  113. 113.
    Arnold K, Burke M, Decker A, Herzberg E, Maher M, Motz K, Nandu H, O´Donnel L, Pirmohamed A, Ybarra M (2013) Fetal alcohol spectrum disorders: knowledge and screening practices of university hospital medical students and residents. J Popul Ther Clin Pharmacol 20(1):e18–25Google Scholar
  114. 114.
    Hutton HE, Chander G, Green PP et al (2014) A novel integration effort to reduce the risk for alcohol-exposed pregnancy among women attending urban STD clinics. Public Health Rep 129:56–62PubMedGoogle Scholar
  115. 115.
    Burns E, Gray R, Smith LA (2010) Brief screening questionnaires to identify problem drinking during pregnancy: a systematic review. Addiction 105:601–614PubMedGoogle Scholar
  116. 116.
    O’Connor MJ, Whaley SE (2007) Brief intervention for alcohol use by pregnant women. Am J Public Health 97:252–258PubMedPubMedCentralGoogle Scholar
  117. 117.
    Morini L, Marchei E, Tarani L et al (2013) Testing ethylglucuronide in maternal hair and nails for the assessment of fetal exposure to alcohol: comparison with meconium testing. Ther Drug Monit 35:402–407PubMedGoogle Scholar
  118. 118.
    Gifford AE, Farkas KJ, Jackson LW et al (2010) Assessment of benefits of a universal screen for maternal alcohol use during pregnancy. Birth Defects Res A Clin Mol Teratol 88:838–846PubMedPubMedCentralGoogle Scholar
  119. 119.
    Abel EL, Hannigan JH (1995) Maternal risk factors in fetal alcohol syndrome: provocative and permissive influences. Neurotoxicol Teratol 17:445–462PubMedGoogle Scholar
  120. 120.
    Wozniak JR, Fuglestad AJ, Eckerle JK et al (2013) Choline supplementation in children with fetal alcohol spectrum disorders has high feasibility and tolerability. Nutr Res 33:897–904PubMedGoogle Scholar
  121. 121.
    Oesterheld JR, Kofoed L, Tervo R et al (1998) Effectiveness of methylphenidate in Native American children with fetal alcohol syndrome and attention deficit/hyperactivity disorder: a controlled pilot study. J Child Adolesc Psychopharmacol 8:39–48PubMedGoogle Scholar
  122. 122.
    Snyder J, Nanson J, Snyder R, Block G (1997) A study of stimulant medication in children with FAS. In: Streissguth A, Kanter J (eds) Overcoming and preventing secondary disabilities in fetal alcohol syndrome and fetal alcohol effects. University of Washington Press, SeattleGoogle Scholar
  123. 123.
    Coe J, Sidders J, Riley K et al (2001) A survey of medication responses in children and adolescents with fetal alcohol syndrome. Ment Heal Asp Dev Disabil 4:148–155Google Scholar
  124. 124.
    Doig J, McLennan JD, Gibbard W, Ben (2008) Medication effects on symptoms of attention-deficit/hyperactivity disorder in children with fetal alcohol spectrum disorder. J Child Adolesc Psychopharmacol 18:365–71Google Scholar
  125. 125.
    O’Malley KD, Koplin B, Dohner VA (2000) Psychostimulant clinical response in fetal alcohol syndrome. Can J Psychiatry 45:90–91PubMedGoogle Scholar
  126. 126.
    Lock TM (2012) A study of the efficacy of atomoxetine in treating the inattention, impulsivity and hyperactivity in children with fetal alcohol syndrome or effects. http://clinicaltrials.gov/show/NCT00417794
  127. 127.
    Kodituwakku PW, Kodituwakku EL (2011) From research to practice: an integrative framework for the development of interventions for children with fetal alcohol spectrum disorders. Neuropsychol Rev 21:204–223PubMedGoogle Scholar
  128. 128.
    Kable J, Coles CD, Taddeo E (2007) Socio-cognitive habilitation using the math interactive learning experience program for alcohol-affected children. Alcohol Clin Exp Res 31:1425–1434PubMedGoogle Scholar
  129. 129.
    Adnams CM, Sorour P, Kalberg WO et al (2007) Language and literacy outcomes from a pilot intervention study for children with fetal alcohol spectrum disorders in South Africa. Alcohol 41:403–414PubMedPubMedCentralGoogle Scholar
  130. 130.
    Wells AM, Chasnoff IJ, Schmidt CA et al (2012) Neurocognitive habilitation therapy for children with fetal alcohol spectrum disorders: an adaptation of the Alert Program®. Am J Occup Ther 66:24–34PubMedGoogle Scholar
  131. 131.
    Loomes C, Rasmussen C, Pei J et al (2008) The effect of rehearsal training on working memory span of children with fetal alcohol spectrum disorder. Res Dev Disabil 29:113–124PubMedGoogle Scholar
  132. 132.
    Coles CD, Strickland DC, Padgett L, Bellmoff L (2007) Games that “work”: using computer games to teach alcohol-affected children about fire and street safety. Res Dev Disabil 28:518–530PubMedGoogle Scholar
  133. 133.
    O’Connor MJ, Frankel F, Paley B et al (2006) A controlled social skills training for children with fetal alcohol spectrum disorders. J Consult Clin Psychol 74:639–648PubMedGoogle Scholar
  134. 134.
    Bertrand J (2009) Interventions for children with fetal alcohol spectrum disorders (FASDs): overview of findings for five innovative research projects. Res Dev Disabil 30:986–1006PubMedGoogle Scholar
  135. 135.
    Schonfeld AM, Paley B, Frankel F, O’Connor MJ (2009) Behavioral regulation as a predictor of response to children’s friendship training in children with fetal alcohol spectrum disorders. Clin Neuropsychol 23:428–445PubMedGoogle Scholar
  136. 136.
    Lemoine P, Harousseau H, Borteyru JP, Menuet JC (1968) Les enfants des parents alcooliques: anomalies observees apropos de 127 cas. Ouest Med 21:476–482Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Nora Dörrie
    • 1
  • Manuel Föcker
    • 1
    Email author
  • Inga Freunscht
    • 1
  • Johannes Hebebrand
    • 1
  1. 1.Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Universitätsklinikum EssenUniversity of Duisburg-EssenEssenGermany

Personalised recommendations