An Interdisciplinary Approach to Increasing Access to Care for Individuals with Fetal Alcohol Spectrum Disorders
Main Article Content
Keywords
fetal alcohol spectrum disorders, FASD, interdisciplinary care, access to care
Abstract
Fetal alcohol spectrum disorders (FASD) have a prevalence of roughly 1 in 20, making it one of the most prevalent disorders in the United States (May et al., 2018). However, FASD has a diagnostic rate of less than 1%, resulting in late diagnosis, identification, and intervention (May, Baete, & Russo, 2014; May, Chambers, Kalberg, et al, 2018; Cleveland, Deere, Kyzer, & Smith, 2020). Only a handful of physicians regularly diagnose FASDs, even further decreasing access to care (Manning & Hoyme, 2007). In response, the Specialty Diagnostic Resource Center (SDRC) in Arkansas developed the following interdisciplinary approach to FASD diagnosis. Seventy-seven individuals ages four months to 37 years were evaluated for Other Specified Neurodevelopmental Disability: Neurodevelopmental Disability Associated with Prenatal Alcohol Exposure (ND-PAE) between April 2020 and February 2022; 54 individuals were diagnosed. Trends were identified for individuals given a ND-PAE diagnosis and analyzed, with Spearman-rho analysis conducted. As FASDs are widely underdiagnosed, an approach similar to SDRC may assist other interdisciplinary teams in efforts to increase access both to diagnosis and intervention.
References
American Psychiatric Association (APA). (2013). Diagnostic and statistical manual of mental disorders, fifth edition (DSM-5®). American Psychiatric Pub.
Astley, S. J., Aylward, E. H., Olson, H. C., Kerns, K., Brooks, A., Coggins, T. E., Davies, J., Dorn, S., Gendler, B., Jirikowic, T., & Kraegel, P. (2009). Magnetic resonance imaging outcomes from a comprehensive magnetic resonance study of children with fetal alcohol spectrum disorders. Alcoholism: Clinical and Experimental Research, 33(10), 1671-1689.
Carmichael-Olson, H. Ohlemiller, M., O’Connor, M., Brown, C., Morris, C., & Damus, K. (2009). A Call to Action; Advancing Essential Services and Research on Fetal Alcohol Spectrum Disorders. A Report of the National Task Force on Fetal Alcohol Syndrome and Fetal Alcohol Effect.
Cleveland, E., Deere, D., Kyzer, A., & Smith, S. (2020). Fetal alcohol spectrum disorders advocacy in Arkansas. Journal of Arkansas Medical Society. May 2020 Issue.
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), 191-197.
Craig, F., Margari, F., Legrottaglie, A. R., Palumbi, R., De Giambattista, C., & Margari, L. (2016). A review of executive function deficits in autism spectrum disorder and attention-deficit/hyperactivity disorder. Neuropsychiatric disease and treatment, 12, 1191.
Feldman, H.S., Jones, K.L., Lindsay, S., Slymen, K., Klonoff-Cohen, H., Kao, K., Rao, S., Chambers, C. (2012). Prenatal alcohol exposure patterns and alcohol-related birth defects and growth deficiencies: A prospective study. Alcoholism, Clinical and Experimental Research, 36(4), 670-676.
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., Abdule-Rahman, O., Jewett, T., Coles, C.D., Chambers, C., Jones, K.L., Adnams, C.M., Shah, P.E., Riley, E.P., Charness, M.E., Warren, K.R., May, P.A. (2016) Updated clinical guidelines for diagnosing fetal alcohol spectrum disorders. Pediatrics, 138(2).
Kable, J. A., & Mukherjee, R. A. (2017). Neurodevelopmental disorder associated with prenatal exposure to alcohol (ND-PAE): A proposed diagnostic method of capturing the neurocognitive phenotype of FASD. European Journal of Medical Genetics, 60(1), 49-54.
Lange, S., Shield, K., Rehm, J., & Popova, S. (2013). Prevalence of fetal alcohol spectrum disorders in child care settings: a meta-analysis. Pediatrics, 132(4), e980-e995.
Malbin, D. (2002). Fetal Alcohol Syndrome and Alcohol-related Neurodevelopmental Disorders: Trying Differently Rather Than Harder. Tectrice, Incorporated.
Manning, M. A., & Hoyme, H. E. (2007). Fetal alcohol spectrum disorders: a practical clinical approach to diagnosis. Neuroscience & Biobehavioral Reviews, 31(2), 230-238.
Mattson, S.N., Crocker, N., Nguyen, T.T. (2011) Fetal alcohol spectrum disorders: Neuropsychological and behavioral features. Neuropsychology Review, 21, 81-101.
May, P., Chambers, C., Kalberg, W., Zellner, J., Feldman, H., Buckley, D., Kopald, D., Hasken, J.M., Xu, R., Honerkamp-Smith, G., & Taras, H. (2018). Prevalence of fetal alcohol spectrum disorders in 4 US communities. Journal of the American Medical Association, 319(5), 474-482.
McLaughlin, S. A., Thorne, J. C., Jirikowic, T., Waddington, T., Lee, A. K., & Astley Hemingway, S. J. (2019). Listening difficulties in children with fetal alcohol spectrum disorders: More than a problem of audibility. Journal of Speech, Language, and Hearing Research, 62(5), 1532-1548.
Moore, E.S. Ward, R.W., Wetherill, L.F., Rogers, J.L., Autti-Rämö, I., Fagerlund, A, Jacobson, S.W., Robinson, L.K., Hoyme, H.E., Mattson, S.N., & Foroud, T. (2007). Unique facial features distinguish fetal alcohol syndrome patients and controls in diverse ethnic populations. Alcoholism, Clinical and Experimental Research, 31(10), 1707-1713.
Paolozza, A., Rasmussen, C., Pei, J., Hanlon-Dearman, A., Nikkel, S., Andrew, G., McFarlane, A., Samdup, D., & A., Samdup, D., & Reynolds, J. (2014). Working memory and visuospatial deficits correlate with oculomotor control in children with fetal alcohol spectrum disorder. Behavioural Brain Research, 263, 70-79.
Petrenko, C. L., & Alto, M. E. (2017). Interventions in fetal alcohol spectrum disorders: An international perspective. European journal of medical genetics, 60(1), 79-91.
Popova, S., Lange, S., Bekmuradov, D., Mihic, A., & Rehm, J. (2011). Fetal alcohol spectrum disorder prevalence estimates in correctional systems: a systematic literature review. Canadian Journal of Public Health, 102(5), 336-340.
Popova, S., Lange, S., Burd, L., & Rehm, J. (2014). Canadian children and youth in care: The cost of fetal alcohol spectrum disorder. In Child & Youth Care Forum 43(1), 83-96.
Popova, S., Lange, S., Shield, K., Mihic, A., Chudley, A. E., Mukherjee, R. A., Bekmuradov, D., & Rehm, J. (2016). Comorbidity of fetal alcohol spectrum disorder: A systematic review and meta-analysis. The Lancet, 387(10022), 978-987.
Rasmussen, C., Benz, J., Pei, J., Andrew, G., Schuller, G., Abele-Webster, L., Alton, C., & Lord, L. (2010). The impact of an ADHD co-morbidity on the diagnosis of FASD. Journal of Population Therapeutics and Clinical Pharmacology, 17(1), e165-e176.
Riley, E. P., Infante, M. A., & Warren, K. R. (2011). Fetal alcohol spectrum disorders: An overview. Neuropsychology review, 21(2), 73-84.
Riley, E.P., McGee, C.L. (2005). Fetal alcohol spectrum disorders: An overview with emphasis on changes in brain and behavior. Experimental Biology and Medicine, 230, 357-365.
Terband, H., Spruit, M., & Maassen, B. (2018). Speech impairment in boys with fetal alcohol spectrum disorders. American Journal of Speech-Language Pathology, 27(4), 1405-1425.
Thorne, J. C. (2017). Accentuate the negative: Grammatical errors during narrative production as a clinical marker of central nervous system abnormality in school-aged children with fetal alcohol spectrum disorders. Journal of Speech, Language, and Hearing Research, 60(12), 3523-3537.
Thorne, J. C., & Coggins, T. E. (2016). Cohesive referencing errors during narrative production as clinical evidence of central nervous system abnormality in school-aged children with fetal alcohol spectrum disorders. American Journal of Speech-Language Pathology, 25(4), 532-546.
Vaurio, L., Riley, E. P., & Mattson, S. N. (2008). Differences in executive functioning in children with heavy prenatal alcohol exposure or attention-deficit/hyperactivity disorder. Journal of the International Neuropsychological Society, 14(1), 119-129.
Wilhoit, L.F., Scott, D.A., Simecka, B.A. (2017) Fetal alcohol spectrum disorders: Characteristics, complications, and treatment. Community Mental Health Journal, 53, 711-718.
Astley, S. J., Aylward, E. H., Olson, H. C., Kerns, K., Brooks, A., Coggins, T. E., Davies, J., Dorn, S., Gendler, B., Jirikowic, T., & Kraegel, P. (2009). Magnetic resonance imaging outcomes from a comprehensive magnetic resonance study of children with fetal alcohol spectrum disorders. Alcoholism: Clinical and Experimental Research, 33(10), 1671-1689.
Carmichael-Olson, H. Ohlemiller, M., O’Connor, M., Brown, C., Morris, C., & Damus, K. (2009). A Call to Action; Advancing Essential Services and Research on Fetal Alcohol Spectrum Disorders. A Report of the National Task Force on Fetal Alcohol Syndrome and Fetal Alcohol Effect.
Cleveland, E., Deere, D., Kyzer, A., & Smith, S. (2020). Fetal alcohol spectrum disorders advocacy in Arkansas. Journal of Arkansas Medical Society. May 2020 Issue.
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), 191-197.
Craig, F., Margari, F., Legrottaglie, A. R., Palumbi, R., De Giambattista, C., & Margari, L. (2016). A review of executive function deficits in autism spectrum disorder and attention-deficit/hyperactivity disorder. Neuropsychiatric disease and treatment, 12, 1191.
Feldman, H.S., Jones, K.L., Lindsay, S., Slymen, K., Klonoff-Cohen, H., Kao, K., Rao, S., Chambers, C. (2012). Prenatal alcohol exposure patterns and alcohol-related birth defects and growth deficiencies: A prospective study. Alcoholism, Clinical and Experimental Research, 36(4), 670-676.
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., Abdule-Rahman, O., Jewett, T., Coles, C.D., Chambers, C., Jones, K.L., Adnams, C.M., Shah, P.E., Riley, E.P., Charness, M.E., Warren, K.R., May, P.A. (2016) Updated clinical guidelines for diagnosing fetal alcohol spectrum disorders. Pediatrics, 138(2).
Kable, J. A., & Mukherjee, R. A. (2017). Neurodevelopmental disorder associated with prenatal exposure to alcohol (ND-PAE): A proposed diagnostic method of capturing the neurocognitive phenotype of FASD. European Journal of Medical Genetics, 60(1), 49-54.
Lange, S., Shield, K., Rehm, J., & Popova, S. (2013). Prevalence of fetal alcohol spectrum disorders in child care settings: a meta-analysis. Pediatrics, 132(4), e980-e995.
Malbin, D. (2002). Fetal Alcohol Syndrome and Alcohol-related Neurodevelopmental Disorders: Trying Differently Rather Than Harder. Tectrice, Incorporated.
Manning, M. A., & Hoyme, H. E. (2007). Fetal alcohol spectrum disorders: a practical clinical approach to diagnosis. Neuroscience & Biobehavioral Reviews, 31(2), 230-238.
Mattson, S.N., Crocker, N., Nguyen, T.T. (2011) Fetal alcohol spectrum disorders: Neuropsychological and behavioral features. Neuropsychology Review, 21, 81-101.
May, P., Chambers, C., Kalberg, W., Zellner, J., Feldman, H., Buckley, D., Kopald, D., Hasken, J.M., Xu, R., Honerkamp-Smith, G., & Taras, H. (2018). Prevalence of fetal alcohol spectrum disorders in 4 US communities. Journal of the American Medical Association, 319(5), 474-482.
McLaughlin, S. A., Thorne, J. C., Jirikowic, T., Waddington, T., Lee, A. K., & Astley Hemingway, S. J. (2019). Listening difficulties in children with fetal alcohol spectrum disorders: More than a problem of audibility. Journal of Speech, Language, and Hearing Research, 62(5), 1532-1548.
Moore, E.S. Ward, R.W., Wetherill, L.F., Rogers, J.L., Autti-Rämö, I., Fagerlund, A, Jacobson, S.W., Robinson, L.K., Hoyme, H.E., Mattson, S.N., & Foroud, T. (2007). Unique facial features distinguish fetal alcohol syndrome patients and controls in diverse ethnic populations. Alcoholism, Clinical and Experimental Research, 31(10), 1707-1713.
Paolozza, A., Rasmussen, C., Pei, J., Hanlon-Dearman, A., Nikkel, S., Andrew, G., McFarlane, A., Samdup, D., & A., Samdup, D., & Reynolds, J. (2014). Working memory and visuospatial deficits correlate with oculomotor control in children with fetal alcohol spectrum disorder. Behavioural Brain Research, 263, 70-79.
Petrenko, C. L., & Alto, M. E. (2017). Interventions in fetal alcohol spectrum disorders: An international perspective. European journal of medical genetics, 60(1), 79-91.
Popova, S., Lange, S., Bekmuradov, D., Mihic, A., & Rehm, J. (2011). Fetal alcohol spectrum disorder prevalence estimates in correctional systems: a systematic literature review. Canadian Journal of Public Health, 102(5), 336-340.
Popova, S., Lange, S., Burd, L., & Rehm, J. (2014). Canadian children and youth in care: The cost of fetal alcohol spectrum disorder. In Child & Youth Care Forum 43(1), 83-96.
Popova, S., Lange, S., Shield, K., Mihic, A., Chudley, A. E., Mukherjee, R. A., Bekmuradov, D., & Rehm, J. (2016). Comorbidity of fetal alcohol spectrum disorder: A systematic review and meta-analysis. The Lancet, 387(10022), 978-987.
Rasmussen, C., Benz, J., Pei, J., Andrew, G., Schuller, G., Abele-Webster, L., Alton, C., & Lord, L. (2010). The impact of an ADHD co-morbidity on the diagnosis of FASD. Journal of Population Therapeutics and Clinical Pharmacology, 17(1), e165-e176.
Riley, E. P., Infante, M. A., & Warren, K. R. (2011). Fetal alcohol spectrum disorders: An overview. Neuropsychology review, 21(2), 73-84.
Riley, E.P., McGee, C.L. (2005). Fetal alcohol spectrum disorders: An overview with emphasis on changes in brain and behavior. Experimental Biology and Medicine, 230, 357-365.
Terband, H., Spruit, M., & Maassen, B. (2018). Speech impairment in boys with fetal alcohol spectrum disorders. American Journal of Speech-Language Pathology, 27(4), 1405-1425.
Thorne, J. C. (2017). Accentuate the negative: Grammatical errors during narrative production as a clinical marker of central nervous system abnormality in school-aged children with fetal alcohol spectrum disorders. Journal of Speech, Language, and Hearing Research, 60(12), 3523-3537.
Thorne, J. C., & Coggins, T. E. (2016). Cohesive referencing errors during narrative production as clinical evidence of central nervous system abnormality in school-aged children with fetal alcohol spectrum disorders. American Journal of Speech-Language Pathology, 25(4), 532-546.
Vaurio, L., Riley, E. P., & Mattson, S. N. (2008). Differences in executive functioning in children with heavy prenatal alcohol exposure or attention-deficit/hyperactivity disorder. Journal of the International Neuropsychological Society, 14(1), 119-129.
Wilhoit, L.F., Scott, D.A., Simecka, B.A. (2017) Fetal alcohol spectrum disorders: Characteristics, complications, and treatment. Community Mental Health Journal, 53, 711-718.
Article Sidebar
Published
Mar 20, 2023
Article Details
Section
Research Articles and Essays
This work is licensed under a Creative Commons Attribution 4.0 International License.
RDS Journal is an open-access journal, create a free account to read full articles and to submit a proposal. For visual arts and multimedia, submission will be considered evidence that you are offering RDS the right to display your work without penalty, compensation or royalties.