Monday, October 27, 2014

Why You Should be Thinking About Fetal Alcohol Spectrum Disorders in Your Practice

By: Lewis First, MD, MS; Editor-in-Chief 

Diagnosing someone with a fetal alcohol spectrum disorder (FASD) is easier said than done. The findings can be subtle and might be easily missed unless you uncover clues in the family history or are aware of the constellation of dysmorphology findings that can be associated with this disorder.

Sometimes there is a sense that a fetal alcohol spectrum disorder is a rarer entity than it actually is—and thus you need not worry about missing something unlikely to occur. Alternatively, you may figure it will eventually declare itself anyway if a child develops progressive development delay or another less subtle finding prompting a more careful diagnostic approach.

Yet the prevalence of fetal alcohol spectrum disorders appears to be more common than we might hope—at least according to a representative sample of children examined at ages 6 to 7 in the Midwest US as studied by May et al. (doi:10.1542/peds.2013-3319).

Figure showing final estimate of FASD prevalence in a Midwestern US city.
Copyright 2014 © American Academy of Pediatrics. Used with permission.

The researchers selected their sample simply on the basis of their being below the 25th percentile for height, weight, and head circumference. This interesting study also includes a discussion of the risk factors that might point you towards diagnosing this disorder sooner.

If you need a refresher on ways to identify fetal alcohol syndrome so you can diagnose and implement early intervention services sooner rather than later, this is the study for you.

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