Foetal alcohol spectrum disorder: identifying the neurobehavioural phenotype and effective interventions.

PURPOSE OF REVIEW: Since the first description of the foetal damage of alcohol in 1967, numerous studies have outlined different aspects of neurodevelopmental dysfunction, adversely affecting the lives of children worldwide. Although the cause of the syndrome is sorted out, the pathogenesis of brain damage is far from being clear. In contrast to children exhibiting the full facial dysmorphology, who are relatively easy to diagnose, in those presenting only with alcohol-related neurodevelopmental damage diagnosis is much more challenging due to poor specificity of the brain dysfunction. Hence, identifying the neurodevelopmental phenotype of foetal alcohol spectrum disorder (FASD) is a major challenge. RECENT FINDINGS: Recently, a behavioural phenotype of FASD has been described and validated using items from the Child Behaviour Checklist. This tool has high sensitivity and specificity in separating children with FASD from those with ADHD and from healthy controls. In parallel, a number of intervention studies show promise in improving the abilities of children and adolescents with the syndrome to cope with daily tasks and improve their quality of life. SUMMARY: The neurobehavioural screening test can facilitate screening for FASD and is an official screening tool in the FASD toolkit of the Public Health Agency of Canada. Promising new interventions may attenuate the long-term outcome of these children.

Managing fetal alcohol spectrum disorder in the public school system: a needs assessment pilot.

BACKGROUND: Published data and Canadian population reports suggest that approximately 1% of students in Toronto may have learning problems related to Fetal Alcohol Spectrum Disorders (FASDs). It is therefore imperative to understand how the needs of affected students are being met by various practitioners in their school environment. To date no comprehensive follow-up studies on FASD-affected children, families and educators in Toronto public schools are available. Documentation of school experiences associated with FASDs is needed to aid in developing appropriate and efficient intervention models for FASDs. OBJECTIVES: Identify and document needs as related to school capacities and education practitioner capabilities with respect to their abilities to support children diagnosed with FASDs. METHODS: A qualitative approach using semi-structured interviews was utilized for this exploratory pilot study. Twelve practitioners from various disciplines, all of whom work for Toronto public schools participated. RESULTS: Participants represented approximately 3500 students enrolled amongst their schools and classrooms. Only one respondent reported having worked with a child diagnosed with an FASD during their career. Education practitioners commonly report a lack of knowledge of FASDs and how to appropriately plan for affected children. CONCLUSIONS: Practitioners need additional supports in order to address FASDs in their schools. As this is the first pilot study on FASDs in the Ontario school system, further study is warranted.