Abstract
From the time the constellation of impairments associated with prenatal alcohol exposure was first described in the medical literature as fetal alcohol syndrome (FAS) in 1973, science has refined our understanding of the physical and behavioral signs and symptoms of this brain-based disorder and the consequences for affected individuals through the lifespan. Although phenotype variability remains in medical and behavioral health diagnostic guidelines, it generally is understood that the disability, now generally called fetal alcohol spectrum disorder (FASD), is a multisystem condition that involves the entire body, with the most common and significant impairments related to structural and functional brain damage. Despite its significance as the leading preventable nonhereditary cause of developmental disabilities, affecting as many as one in 20 school-age children in the United States, complex clinical and societal factors contribute to inadequate diagnostic capacity and limited awareness of FASD from the classroom to the courtroom. Systemic ignorance of FASD compounds the untreated progression of disabilities inherent in the disorder and underlies discriminatory treatment of individuals vulnerable to mental and substance use disorders and victimization, who lack accountability beyond their cognitive capacity. This chapter describes an evolution in our understanding of FASD and the models developed to clinically identify the disability. An increase in diagnostic accuracy is noted as well as a need for expanded research and scientific translation. Corresponding advances are essential in recognizing FASD across systems of care and non-medical settings to increase attention to and investment in the disorders, so affected children and adults achieve the outcomes and equitable treatment they deserve.
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Donaldson, T. (2021). Diagnostic History: Prenatal Exposure to Alcohol and Other Teratogens. In: Novick Brown, N. (eds) Evaluating Fetal Alcohol Spectrum Disorders in the Forensic Context. Springer, Cham. https://doi.org/10.1007/978-3-030-73628-6_1
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