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Fetal Alcohol Spectrum Disorders: a Case Study

Abstract

This grand rounds manuscript reviews important considerations in developing case conceptualizations for individuals with a history of prenatal alcohol exposure. This case study provides an introduction to fetal alcohol spectrum disorders, diagnostic issues, a detailed description of the individual’s history, presenting symptoms, neuropsychological test results, and an integrated summary. We describe a 9-year-old girl diagnosed with a fetal alcohol spectrum disorder (FASD): Neurobehavioral Disorder Associated with Prenatal Alcohol Exposure (ND-PAE). This patient is a composite of a prototypical child who participated as part of a research project at the Center for Behavioral Teratology who was subsequently seen at an outpatient child psychiatry facility.

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References

  1. Achenbach, T.M., & Rescorla, L.A. (2001). Manual for the ASEBA school-age forms & profiles. Burlington, VT: University of Vermont, Research Center for Children, Youth, & Families.

  2. Adnams, C. M., Sorour, P., Kalberg, W. O., Kodituwakku, P., Perold, M. D., Kotze, A., & May, P. A. (2007). Language and literacy outcomes from a pilot intervention study for children with fetal alcohol spectrum disorders in South Africa. Alcohol, 41(6), 403–414. doi:10.1016/j.alcohol.2007.07.005.

  3. American Academy of Pediatrics. (2000). Committee on substance abuse and committee on children with disabilities. Fetal alcohol syndrome and alcohol-related neurodevelopmental disorders. Pediatrics, 106, 358–361.

  4. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders, DSM-5 (5th ed.). Arlington, VA: American Psychiatric Publishing, Inc.

  5. Astley, S. J., Clarren, S. K. (2000). Diagnosing the full spectrum of fetal alcohol-exposed individuals: Introducing the 4-digit diagnostic code. Alcohol and Alcoholism 35(4), 400–410, PMID: 10906009.

  6. Autti-Ramo, I. (2000). Twelve-year follow-up of children exposed to alcohol in utero. Developmental Medicine and Child Neurology, 42(6), 406–411.

  7. Bell, S. H., Stade, B., Reynolds, J. N., Rasmussen, C., Andrew, G., Hwang, P. A., & Carlen, P. L. (2010). The remarkably high prevalence of epilepsy and seizure history in fetal alcohol spectrum disorders. Alcoholism, Clinical and Experimental Research, 34(6), 1084–1089. doi:10.1111/j.1530-0277.2010.01184.x.

  8. Bertrand, J., Floyd, R. L., Weber, M. K., et al. (2004). National task force on fetal alcohol syndrome and fetal alcohol effect. Fetal alcohol syndrome: Guidelines for referral and diagnosis. Atlanta, GA: Centers for Disease Control and Prevention (CDC).

  9. Bertrand, J., Floyd, L. L., & Weber, M. K. (2005). Fetal alcohol syndrome prevention team, division of birth defects, developmental disabilities, national center on birth defects, developmental disabilities, centers for disease control, & prevention. Guidelines for identifying and referring persons with fetal alcohol syndrome. MMWR - Recommendations and Reports, 54(RR-11), 1–14.

  10. Bhatara, V., Loudenberg, R., & Ellis, R. (2006). Association of attention deficit hyperactivity disorder and gestational alcohol exposure: an exploratory study. Journal of Attention Disorders, 9(3), 515–522. doi:10.1177/1087054705283880.

  11. Boys, C. J., Bjorke, J., Dole, K. D., Dalnes, C., Terwey, S., & Chang, P.-N. (2016). Improving educational outcomes in fetal alcohol spectrum disorder through interagency collaboration. Journal of Pediatric Neuropsychology, 2(1), 50–57.

  12. Burd, L., Klug, M. G., Martsolf, J. T., & Kerbeshian, J. (2003). Fetal alcohol syndrome: neuropsychiatric phenomics. Neurotoxicology and Teratology, 25(6), 697–705. doi:10.1016/j.ntt.2003.07.014.

  13. Carr, J. L., Agnihotri, S., & Keightley, M. (2010). Sensory processing and adaptive behavior deficits of children across the fetal alcohol spectrum disorder continuum. Alcoholism, Clinical and Experimental Research, 34(6), 1022–1032. doi:10.1111/j.1530-0277.2010.01177.x.

  14. Chasnoff, I. J., Wells, A. M., & King, L. (2015). Misdiagnosis and missed diagnoses in foster and adopted children with prenatal alcohol exposure. Pediatrics. doi:10.1542/peds.2014-2171.

  15. Church, M. W., & Kaltenbach, J. A. (1997). Hearing, speech, language, and vestibular disorders in the fetal alcohol syndrome: a literature review. Alcoholism, Clinical and Experimental Research, 21(3), 495–512.

  16. Coffman, B. A., Kodituwakku, P., Kodituwakku, E. L., Romero, L., Sharadamma, N. M., Stone, D., & Stephen, J. M. (2012). Primary visual response (M100) delays in adolescents with FASD as measured with MEG. Human Brain Mapping. doi:10.1002/hbm.22110.

  17. Conners, C. K. (2014). Conners continuous performance test, third edition (CPT-III). Toronto: Multi-Health Systems Inc.

  18. Cook, J. L., Green, C. R., Lilley, C. M., Anderson, S. M., Baldwin, M. E., Chudley, A. E., Conry, J. L., LeBlanc, N., Loock, C. A., Lutke, J. & Mallon, B. F. (2016). Fetal alcohol spectrum disorder: a guideline for diagnosis across the lifespan. Canadian Medical Association Journal, 188(3), pp.191-197.

  19. Crocker, N., Riley, E. P., & Mattson, S. N. (2015). Visual-spatial abilities relate to mathematics achievement in children with heavy prenatal alcohol exposure. Neuropsychology, 29(1), 108–116. doi:10.1037/neu0000094.

  20. Crocker, N., Vaurio, L., Riley, E. P., & Mattson, S. N. (2009). Comparison of adaptive behavior in children with heavy prenatal alcohol exposure or attention-deficit/hyperactivity disorder. Alcoholism, Clinical and Experimental Research, 33(11), 2015–2023. doi:10.1111/j.1530-0277.2009.01040.x.

  21. Delis, D. C., Kaplan, E., & Kramer, J. H. (2001). The Delis-Kaplan Executive Function System: examiner’s manual. San Antonio: The Psychological Corporation.

  22. Delis, D. C., Kramer, J. H., Kaplan, E., & Ober, B. A. (1994). Manual for the California Verbal Learning Test Children’s Version. San Antonio: The Psychological Corporation.

  23. Doig, J., McLennan, J. D., & Gibbard, W. B. (2008). Medication effects on symptoms of attention-deficit/hyperactivity disorder in children with fetal alcohol spectrum disorder. Journal of Child and Adolescent Psychopharmacology, 18(4), 365–371.

  24. Doyle, L. R., & Mattson, S. N. (2015). Neurobehavioral disorder associated with prenatal alcohol exposure (ND-PAE): review of evidence and guidelines for assessment. Current Developmental Disorders Reports, 2(3), 175–186. doi:10.1007/s40474-015-0054-6.

  25. Drabble, L., Thomas, S., O’Connor, L., & Roberts, S. C. (2014). State responses to alcohol use and pregnancy: findings from the alcohol policy information system (APIS). Journal of Social Work Practice in the Addictions, 14(2), 191–206. doi:10.1080/1533256X.2014.900409.

  26. Duquette, C., Stodel, E., Fullarton, S., & Hagglund, K. (2006). Persistence in high school: experiences of adolescents and young adults with fetal alcohol spectrum disorder. Journal of Intellectual and Developmental Disability, 31(4), 219–231.

  27. Finer, L. B., & Zolna, M. R. (2011). Unintended pregnancy in the United States: incidence and disparities, 2006. Contraception, 84(5), 478–485. doi:10.1016/j.contraception.2011.07.013.

  28. Fryer, S. L., McGee, C. L., Matt, G. E., Riley, E. P., & Mattson, S. N. (2007). Evaluation of psychopathological conditions in children with heavy prenatal alcohol exposure. Pediatrics, 119(3), e733–e741. doi:10.1542/peds.2006-1606.

  29. Gahagan, S., Sharpe, T. T., Brimacombe, M., Fry-Johnson, Y., Levine, R., Mengel, M., & Brenneman, G. (2006). Pediatricians’ knowledge, training, and experience in the care of children with fetal alcohol syndrome. Pediatrics, 118(3), e657–e668. doi:10.1542/peds.2005-0516.

  30. Glass, L., Graham, D. M., Akshoomoff, N., & Mattson, S. N. (2015). Cognitive factors contributing to spelling performance in children with prenatal alcohol exposure. Neuropsychology. doi:10.1037/neu0000185.

  31. Glass, L., Ware, A. L., Crocker, N., Deweese, B. N., Coles, C. D., Kable, J. A., & CIFASD. (2013). Neuropsychological deficits associated with heavy prenatal alcohol exposure are not exacerbated by ADHD. Neuropsychology, 27(6), 713–724. doi:10.1037/a0033994.

  32. Glass, L., Ware, A. L., & Mattson, S. N. (2014). Neurobehavioral, neurologic, and neuroimaging characteristics of fetal alcohol spectrum disorders. Handbook of Clinical Neurology, 125, 435–462. doi:10.1016/B978-0-444-62619-6.00025-2.

  33. Goh, P.K., Doyle, L.R., Glass, L., Jones, K.L., Riley, E.P., Coles, C.D., Hoyme, H.E., Kable, J.A., May, P.A., Kalberg, W.O., Sowell, E.R., Wozniak, J.R., Mattson, S.N., & CIFASD. (2016). Decision tree to identify children affected by prenatal alcohol exposure. Journal of Pediatrics, in press. doi:10.1016/j.jpeds.2016.06.047.

  34. Goldschmidt, L., Richardson, G. A., Stoffer, D. S., Geva, D., & Day, N. L. (1996). Prenatal alcohol exposure and academic achievement at age six: a nonlinear fit. Alcoholism, Clinical and Experimental Research, 20(4), 763–770.

  35. Grant, T., Huggins, J., Connor, P., Pedersen, J. Y., Whitney, N., & Streissguth, A. (2004). A pilot community intervention for young women with fetal alcohol spectrum disorders. Community Mental Health Journal, 40(6), 499–511.

  36. Green, J. H. (2007). Fetal alcohol spectrum disorders: understanding the effects of prenatal alcohol exposure and supporting students. Journal of School Health, 77(3), 103–108. doi:10.1111/j.1746-1561.2007.00178.x.

  37. Green, P. P., McKnight-Eily, L. R., Tan, C. H., Mejia, R., & Denny, C. H. (2016). Vital signs: alcohol-exposed pregnancies—United States, 2011–2013. MMWR. Morbidity and Mortality Weekly Report, 65(4), 91–97. doi:10.15585/mmwr.mm6504a6.

  38. Greenbaum, R. L., Stevens, S. A., Nash, K., Koren, G., & Rovet, J. (2009). Social cognitive and emotion processing abilities of children with fetal alcohol spectrum disorders: a comparison with attention deficit hyperactivity disorder. Alcoholism, Clinical and Experimental Research, 33(10), 1656–1670. doi:10.1111/j.1530-0277.2009.01003.x.

  39. Helder, E.J., Brooker, B., Kapitula, L.R., Goalen, B., & Gunnoe, M.J. (2016). Predictors and correlates of inattentive/overactive behaviors in internationally adopted children. Applied Neuropsychology Child, 1–15. doi:10.1080/21622965.2015.1038207.

  40. Howell, K. K., Lynch, M. E., Platzman, K. A., Smith, G. H., & Coles, C. D. (2006). Prenatal alcohol exposure and ability, academic achievement, and school functioning in adolescence: a longitudinal follow-up. Journal of Pediatric Psychology, 31(1), 116–126. doi:10.1093/jpepsy/jsj029.

  41. Hoyme, H. E., May, P. A., Kalberg, W. O., Kodituwakku, P., Gossage, J. P., & Trujillo, P. M. (2005). A practical clinical approach to diagnosis of fetal alcohol spectrum disorders: clarification of the 1996 Institute of Medicine criteria. Pediatrics, 115(1), 39–47.

  42. Hoyme, H. E., Kalberg, W. O., Elliott, A. J., Blankenship, J., Buckley, D., Marais, A. S., Manning, M. A., Robinson, L. K., Adam, M. P., Abdul-Rahman, O., & Jewett, T. (2016). Updated clinical guidelines for diagnosing fetal alcohol spectrum disorders. Pediatrics, 138, e20154256.

  43. Jan, J. E., Asante, K. O., Conry, J. L., Fast, D. K., Bax, M. C., Ipsiroglu, O. S., & Wasdell, M. B. (2010). Sleep health issues for children with FASD: clinical considerations. International Journal of Pediatrics, 2010. doi:10.1155/2010/639048.

  44. Jirikowic, T., Carmichael Olson, H., & Kartin, D. (2008). Sensory processing, school performance, and adaptive behavior of young school-age children with fetal alcohol spectrum disorders. Physical & Occupational Therapy in Pediatrics, 28(2), 117–136.

  45. Jones, K. L., Robinson, L. K., Bakhireva, L. N., Marintcheva, G., Storojev, V., Strahova, A., & Chambers, C. D. (2006). Accuracy of the diagnosis of physical features of fetal alcohol syndrome by pediatricians after specialized training. Pediatrics, 118(6), e1734–e1738. doi:10.1542/peds.2006-1037.

  46. Jones, K. L., & Smith, D. W. (1973). Recognition of the fetal alcohol syndrome in early infancy. Lancet, 302(7836), 999–1001.

  47. Kable, J. A., Taddeo, E., Strickland, D., & Coles, C. D. (2015). Community translation of the math interactive learning experience program for children with FASD. Research in Developmental Disabilities, 39, 1–11. doi:10.1016/j.ridd.2014.12.031.

  48. Kable, J. A., Coles, C. D., & Taddeo, E. (2007). Socio-cognitive habilitation using the math interactive learning experience program for alcohol-affected children. Alcoholism, Clinical and Experimental Research, 31(8), 1425–1434. doi:10.1111/j.1530-0277.2007.00431.x.

  49. Kable, J. A., O’Connor, M. J., Olson, H. C., Paley, B., Mattson, S. N., Anderson, S. M., & Riley, E. P. (2016). Neurobehavioral disorder associated with prenatal alcohol exposure (ND-PAE): proposed DSM-5 diagnosis. Child Psychiatry and Human Development, 47(2), 335–346. doi:10.1007/s10578-015-0566-7.

  50. Kaemingk, K. L., Mulvaney, S., & Halverson, P. T. (2003). Learning following prenatal alcohol exposure: performance on verbal and visual multitrial tasks. Archives of Clinical Neuropsychology, 18(1), 33–47.

  51. Kalberg, W. O., & Buckley, D. (2006). Educational planning for children with fetal alcohol syndrome. Annali dell’Istituto Superiore de Sanitá, 42(1), 58–66.

  52. Kalberg, W. O., & Buckley, D. (2007). FASD: what types of intervention and rehabilitation are useful? Neuroscience and Biobehavioral Reviews, 31(2), 278–285. doi:10.1016/j.neubiorev.2006.06.014.

  53. Kalberg, W. O., Provost, B., Tollison, S. J., Tabachnick, B. G., Robinson, L. K., Eugene Hoyme, H., & May, P. A. (2006). Comparison of motor delays in young children with fetal alcohol syndrome to those with prenatal alcohol exposure and with no prenatal alcohol exposure. Alcoholism, Clinical and Experimental Research, 30(12), 2037–2045. doi:10.1111/j.1530-0277.2006.00250.x.

  54. Kerns, K.A., Macoun, S., MacSween, J., Pei, J., & Hutchison, M. (2016). Attention and working memory training: a feasibility study in children with neurodevelopmental disorders. Applied Neuropsychology Child, 1–18. doi:10.1080/21622965.2015.1109513.

  55. Kerns, K. A., Macsween, J., Vander Wekken, S., & Gruppuso, V. (2010). Investigating the efficacy of an attention training programme in children with foetal alcohol spectrum disorder. Developmental Neurorehabilitation, 13(6), 413–422. doi:10.3109/17518423.2010.511421.

  56. Kodituwakku, P. W., & Kodituwakku, E. L. (2011). From research to practice: an integrative framework for the development of interventions for children with fetal alcohol spectrum disorders. Neuropsychology Review, 21(2), 204–223. doi:10.1007/s11065-011-9170-1.

  57. Koren, G., Chudley, A., Loock, C., MacLeod, S. M., Orrbine, E., Rosales, T., & Sarkar, M. (2014). Screening and referral to identify children at risk for FASD: search for new methods 2006–2013. Journal of Population Therapeutics and Clinical Pharmacology, 21(2), e260–e265.

  58. Korkman, M., Kirk, U., & Kemp, S. (2007). NEPSY-II 2nd ed. Administration manual. San Antonio: Harcourt Assessment.

  59. Loomes, C., Rasmussen, C., Pei, J., Manji, S., & Andrew, G. (2008). The effect of rehearsal training on working memory span of children with fetal alcohol spectrum disorder. Research in Developmental Disabilities, 29(2), 113–124. doi:10.1016/j.ridd.2007.01.001.

  60. Mattson, S. N., Crocker, N., & Nguyen, T. T. (2011). Fetal alcohol spectrum disorders: neuropsychological and behavioral features. Neuropsychology Review, 21(2), 81–101. doi:10.1007/s11065-011-9167-9.

  61. Mattson, S. N., Gramling, L., Delis, D., Jones, K. L., & Riley, E. P. (1996). Global–local processing in children prenatally exposed to alcohol. Child Neuropsychology, 2(3), 165–175.

  62. Mattson, S. N., & Riley, E. P. (2011). The quest for a neurobehavioral profile of heavy prenatal alcohol exposure. Alcohol Research and Health, 34(1), 51–55.

  63. Mattson, S. N., Roesch, S. C., Glass, L., Deweese, B. N., Coles, C. D., Kable, J. A., & Cifasd. (2013). Further development of a neurobehavioral profile of fetal alcohol spectrum disorders. Alcoholism, Clinical and Experimental Research, 37(3), 517–528. doi:10.1111/j.1530-0277.2012.01952.x.

  64. May, P. A., Baete, A., Russo, J., Elliott, A. J., Blankenship, J., Kalberg, W. O., & Hoyme, H. E. (2014). Prevalence and characteristics of fetal alcohol spectrum disorders. Pediatrics, 134(5), 855–866. doi:10.1542/peds.2013-3319.

  65. May, P. A., Keaster, C., Bozeman, R., Goodover, J., Blankenship, J., Kalberg, W. O., & Hoyme, H. E. (2015). Prevalence and characteristics of fetal alcohol syndrome and partial fetal alcohol syndrome in a Rocky Mountain Region City. Drug and Alcohol Dependence, 155, 118–127. doi:10.1016/j.drugalcdep.2015.08.006.

  66. McFarlane, A., & Rajani, H. (2007). Rural FASD diagnostic services model: Lakeland centre for fetal alcohol spectrum disorder. Canadian Journal of Clinical Pharmacology: Journal Canadien de Pharmacologie Clinique, 14(3), e301–e306.

  67. McGee, C. L., Fryer, S. L., Bjorkquist, O. A., Mattson, S. N., & Riley, E. P. (2008). Deficits in social problem solving in adolescents with prenatal exposure to alcohol. American Journal of Drug and Alcohol Abuse, 34(4), 423–431. doi:10.1080/00952990802122630.

  68. Moore, E. M., & Riley, E. P. (2015). What happens when children with fetal alcohol spectrum disorders become adults? Current Developmental Disorders Reports, 2(3), 219–227. doi:10.1007/s40474-015-0053-7.

  69. Nash, K., Stevens, S., Greenbaum, R., Weiner, J., Koren, G., & Rovet, J. (2015). Improving executive functioning in children with fetal alcohol spectrum disorders. Child Neuropsychology, 21(2), 191–209. doi:10.1080/09297049.2014.889110.

  70. Nguyen, T. T., Glass, L., Coles, C. D., Kable, J. A., May, P. A., Kalberg, W. O., & Cifasd. (2014). The clinical utility and specificity of parent report of executive function among children with prenatal alcohol exposure. Journal of the International Neuropsychological Society, 20(7), 704–716. doi:10.1017/S1355617714000599.

  71. O’Connor, M. J., Frankel, F., Paley, B., Schonfeld, A. M., Carpenter, E., Laugeson, E. A., & Marquardt, R. (2006). A controlled social skills training for children with fetal alcohol spectrum disorders. Journal of Consulting and Clinical Psychology, 74(4), 639–648.

  72. Paolozza, A., Rasmussen, C., Pei, J., Hanlon-Dearman, A., Nikkel, S. M., Andrew, G., & Reynolds, J. N. (2014). Working memory and visuospatial deficits correlate with oculomotor control in children with fetal alcohol spectrum disorder. Behavioural Brain Research, 263, 70–79. doi:10.1016/j.bbr.2014.01.024.

  73. Peadon, E., Rhys-Jones, B., Bower, C., & Elliott, E.J. (2009). Systematic review of interventions for children with fetal alcohol spectrum disorders. BMC Pediatrics, 9(35). doi:10.1186/1471-2431-9-35.

  74. Pei, J., Flannigan, K., Walls, L., & Rasmussen, C. (2016). Interventions for fetal alcohol spectrum disorder: meeting needs across the lifespan. International Journal of Neurorehabilitation, 3(1).

  75. Pei, J. R., Rinaldi, C. M., Rasmussen, C., Massey, V., & Massey, D. (2008). Memory patterns of acquisition and retention of verbal and nonverbal information in children with fetal alcohol spectrum disorders. The Canadian Journal of Clinical Pharmacology, 15(1), e44–e56.

  76. Premji, S., Benzies, K., Serrett, K., & Hayden, K. A. (2007). Research-based interventions for children and youth with a fetal alcohol spectrum disorder: revealing the gap. Child: Care, Health and Development, 33(4), 389–397. doi:10.1111/j.1365-2214.2006.00692.x. discussion 398–400.

  77. Rogers-Adkinson, D. L., & Stuart, S. K. (2007). Collaborative services: children experiencing neglect and the side effects of prenatal alcohol exposure. Language, Speech, and Hearing Services in Schools, 38(2), 149–156. doi:10.1044/0161-1461(2007/015).

  78. Rojmahamongkol, P., Cheema-Hasan, A., & Weitzman, C. (2015). Do pediatricians recognize fetal alcohol spectrum disorders in children with developmental and behavioral problems? Journal of Developmental and Behavioral Pediatrics, 36(3), 197–202. doi:10.1097/DBP.0000000000000146.

  79. Senturias, Y. S. (2014). Fetal alcohol spectrum disorders: an overview for pediatric and adolescent care providers. Current Problems in Pediatric and Adolescent Health Care, 44(4), 74–81. doi:10.1016/j.cppeds.2013.12.012.

  80. Shaffer, D., Fisher, P., Lucas, C. P., Dulcan, M. K., & Schwab-Stone, M. E. (2000). NIMH diagnostic interview schedule for children version IV (NIMH DISC-IV): description, differences from previous versions, and reliability of some common diagnoses. The Journal of American Academy of Child Psychiatry, 39, 28–38.

  81. Simmons, R. W., Madra, N. J., Levy, S. S., Riley, E. P., & Mattson, S. N. (2011). Co-regulation of movement speed and accuracy by children with heavy prenatal alcohol exposure. Perceptual and Motor Skills, 112(1), 172–182.

  82. Simmons, R. W., Thomas, J. D., Levy, S. S., & Riley, E. P. (2006). Motor response selection in children with fetal alcohol spectrum disorders. Neurotoxicology and Teratology, 28(2), 278–285.

  83. Simmons, R. W., Thomas, J. D., Levy, S. S., & Riley, E. P. (2010). Motor response programming and movement time in children with heavy prenatal alcohol exposure. Alcohol, 44(4), 371–378. doi:10.1016/j.alcohol.2010.02.013.

  84. Sood, B., Delaney-Black, V., Covington, C., Nordstrom-Klee, B., Ager, J., Templin, T., & Sokol, R. J. (2001). Prenatal alcohol exposure and childhood behavior at age 6 to 7 years: I. dose–response effect. Pediatrics, 108(2), E34.

  85. Sparrow S.S., Cicchetti D.V., & Balla D.A. (2005). Vineland adaptive behavior scales—2nd edn. Pearson Assessments: Bloomington, MN. Pines, MN: American Guidance Service.

  86. Strauss, E., Sherman, E. S., & Spreen, S. (2006). A compendium of neuropsychological tests: administration, norms, and commentary. Oxford, New York: Oxford University Press.

  87. Steinhausen, H.-C., & Spohr, H.-L. (1998). Long-term outcome of children with fetal alcohol syndrome: psychopathology, behavior and intelligence. Alcoholism, Clinical and Experimental Research, 22(2), 334–338.

  88. Streissguth, A. P., Aase, J. M., Clarren, S. K., Randels, S. P., LaDue, R. A., & Smith, D. F. (1991). Fetal alcohol syndrome in adolescents and adults. JAMA, 265(15), 1961–1967.

  89. Streissguth, A. P., Barr, H. M., Carmichael Olson, H., Sampson, P. D., Bookstein, F. L., & Burgess, D. M. (1994). Drinking during pregnancy decreases word attack and arithmetic scores on standardized tests: adolescent data from a population-based prospective study. Alcoholism, Clinical and Experimental Research, 18(2), 248–254.

  90. Streissguth, A. P., Barr, H. M., Kogan, J., & Bookstein, F. L. (1996). Final report: understanding the occurrence of secondary disabilities in clients with fetal alcohol syndrome (FAS) and fetal alcohol effects (FAE). Seattle: University of Washington Publication Services.

  91. Streissguth, A. P., Barr, H. M., Kogan, J., & Bookstein, F. L. (1997). Primary and secondary disabilities in fetal alcohol syndrome. In A. P. Streissguth, J. Kanter, et al. (Eds.), The challenge of fetal alcohol syndrome: overcoming secondary disabilities (pp. 25–39). Seattle: University of Washington Press.

  92. Streissguth, A. P., Bookstein, F. L., Barr, H. M., Sampson, P. D., O’Malley, K., & Young, J. K. (2004). Risk factors for adverse life outcomes in fetal alcohol syndrome and fetal alcohol effects. Journal of Developmental and Behavioral Pediatrics, 25(4), 228–238.

  93. Thomas, G., Gonneau, G., Poole, N., & Cook, J. (2014). The effectiveness of alcohol warning labels in the prevention of fetal alcohol spectrum disorder: a brief review. International Journal of Alcohol and Drug Research, 3(1), 91–103. doi:10.7895/ijadr.vXiY.126.

  94. Wechsler, D. (2015). Wechsler Intelligence Scale for Children-Fifth Edition (WISC-V). Bloomington: Pearson.

  95. Wechsler, D. (2009). Wechsler Individual Achievement Test, Third Edition (WIAT-III). San Antonio: Psychological Corporation.

  96. Wells, A. M., Chasnoff, I. J., Schmidt, C. A., Telford, E., & Schwartz, L. D. (2012). Neurocognitive habilitation therapy for children with fetal alcohol spectrum disorders: an adaptation of the Alert Program(R). American Journal of Occupational Therapy, 66(1), 24–34. doi:10.5014/ajot.2012.002691.

  97. Wengel, T., Hanlon-Dearman, A. C., & Fjeldsted, B. (2011). Sleep and sensory characteristics in young children with fetal alcohol spectrum disorder. Journal of Developmental and Behavioral Pediatrics, 32(5), 384–392. doi:10.1097/DBP.0b013e3182199694.

  98. Willford, J. A., Richardson, G. A., Leech, S. L., & Day, N. L. (2004). Verbal and visuospatial learning and memory function in children with moderate prenatal alcohol exposure. Alcoholism, Clinical and Experimental Research, 28(3), 497–507.

  99. Willoughby, K. A., Sheard, E. D., Nash, K., & Rovet, J. (2008). Effects of prenatal alcohol exposure on hippocampal volume, verbal learning, and verbal and spatial recall in late childhood. Journal of the International Neuropsychological Society, 14(6), 1022–1033. doi:10.1017/S1355617708081368.

  100. Yan, A., Bell, E., & Racine, E. (2014). Ethical and social challenges in newborn screening for prenatal alcohol exposure. The Canadian Journal of Neurological Sciences, 41(1), 115–118.

  101. Zelner, I., Shor, S., Gareri, J., Lynn, H., Roukema, H., Lum, L., & Koren, G. (2010). Universal screening for prenatal alcohol exposure: a progress report of a pilot study in the region of Grey Bruce, Ontario. Therapeutic Drug Monitoring, 32(3), 305–310. doi:10.1097/FTD.0b013e3181dca381.

  102. Zelner, I., Shor, S., Lynn, H., Roukema, H., Lum, L., Eisinga, K., & Koren, G. (2012). Neonatal screening for prenatal alcohol exposure: assessment of voluntary maternal participation in an open meconium screening program. Alcohol, 46(3), 269–276. doi:10.1016/j.alcohol.2011.09.029.

  103. Zizzo, N., Di Pietro, N., Green, C., Reynolds, J., Bell, E., & Racine, E. (2013). Comments and reflections on ethics in screening for biomarkers of prenatal alcohol exposure. Alcoholism, Clinical and Experimental Research, 37(9), 1451–1455. doi:10.1111/acer.12115.

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Acknowledgements

Preparation of this paper was supported by the National Institute on Alcohol Abuse and Alcoholism grants U01 AA014834 (Mattson) and F31 AA022261 (Glass). We thank the families and children affected by prenatal alcohol exposure for graciously participating in studies at the Center for Behavioral Teratology at San Diego State University.

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Correspondence to Sarah N. Mattson.

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This article does not contain any studies with human participants or animals performed by the author. The case study is a composite of cases seen by the first author.

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The authors declare that they have no conflict of interest.

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Glass, L., Mattson, S.N. Fetal Alcohol Spectrum Disorders: a Case Study. J Pediatr Neuropsychol 3, 114–135 (2017) doi:10.1007/s40817-016-0027-7

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Keywords

  • Prenatal alcohol exposure
  • Neurobehavioral Disorder Associated with Prenatal Alcohol Exposure (ND-PAE)
  • Fetal alcohol spectrum disorder (FASD)
  • Fetal alcohol syndrome (FAS)
  • Neuropsychological assessment