Screening for fetal alcohol syndrome in primary schools: A feasibility study

Abstract

Background This project was undertaken as a feasibility study to determine the possibility of screening for fetal alcohol syndrome (FAS) in early school‐age children for epidemiological and interventional purposes. Methods All elementary schools in two counties in Washington State were asked to screen first graders for possible FAS. A child was screen positive if found to be growth deficient, to have certain specific facial abnormalities, or have a known history of substantial alcohol exposure in gestation. All screen‐positive children were invited to “special diagnostic clinics” for final diagnosis and treatment planning. Results In County A, virtually all students were screened. In County B only about 25% of children were screened. This difference was related to the number of schools that agreed to participate in the project and the methods employed by each county to obtain parental permission. In each county, only about one‐half of the screen‐positive children were seen in the special clinics for diagnostic considerations. Only one of the seven children found to have FAS had been diagnosed previously. The minimal prevalence of FAS in County A was 3.1 in 1,000 students. The minimal prevalence of FAS in County B could not be calculated. The most efficient component in the screening process leading to a diagnosis of FAS was finding the specific facial features of the disorder. The diagnosis of FAS was generally helpful in improving educational planning. Conclusions This study demonstrated that population‐based FAS screening within a school system may be possible, but participation is dependent on local trust and understanding of the project before its inception within the schools and the community at large. Teratology 63:3–10, 2001. © 2001 Wiley‐Liss, Inc.

Identification of Children With Prenatal Alcohol Exposure

“…The active case ascertainment method has been employed in epidemiological studies of FASD conducted in the USA [11] and a number of other countries, including South Africa [32], Italy [38], and Croatia [39]. Unlike the surveillance method described above, the active case ascertainment approach has targeted all potential participants in a given population.…”

“…It has been estimated that the proportion of children on the spectrum without dysmorphia may be three times as high as that of FAS [18]. This method may also underestimate the rates of FAS because FAS and other genetic disorders are not often diagnosed at birth [11,25]. Furthermore, most health centers may not have clinicians to diagnose fetal alcohol syndrome.…”

Fuerza muscular máxima en atletas con discapacidad intelectual

“…El alcohol o sus derivados acetilaldehídos interfieren en los procesos metabólicos necesarios para el desarrollo del encéfalo durante la embriogénesis. Ocurre entre el 30 y el 50 de las madres que consumen alcohol durante el embarazo 6 . Condiciones perinatales como las distocias del parto, el parto pretérmino, fetos menores de 32 semanas y peso menor de 1.500 g, y la hipoxia neonatal pueden producir daño cerebral y provocar DI.…”

Building alliances to understanding and working with students affected by fetal alcohol spectrum disorder.

“…Clarren, Randels, Sanderson, and Fineman (2001) studied the feasibility of screening for FASD in primary schools for epidemiological and interventional purposes.…”

“…Most families noted improvements in terms of access to services or accommodations. Clarren et al (2001) identified several distinct advantages to screening at this point in a child's school career: his or her age allows for an accurate diagnosis; school entry was the first time after the newborn period that students come into contact with a single system; early academic interventions are possible, and are believed to reduce secondary disabilities; and children with another previously unrecognized syndrome might also be identified and offered appropriate services. Watson et al (2007) later observed that many problems related to FASD are not apparent in infancy, but can appear at an older age.…”