Assessing for Fetal Alcohol Spectrum Disorder.

Background The recommended "gold standard" for Fetal Alcohol Spectrum Disorder (FASD) assessment involves a multidisciplinary diagnostic team and comprehensive battery of neuropsychological tests to evaluate functioning across 10 brain domains. The current Canadian Guideline for diagnosis of FASD outlines a list of test measures for assessment; however, very little research exists to explore which specific tools are being used in clinical practice. Objectives The purpose of the current study was to gain a better understanding of the testing measures used by FASD clinicians in Alberta, Canada.   Methods A survey was sent to coordinators of 23 Alberta FASD clinics requesting them to distribute the survey to their diagnostic team members, including physicians, psychologists, speech-language pathologists (SLPs), and occupational therapists (OTs).   Results A wide range of measures (both direct and indirect; n = 173) to assess brain domains were reported by clinics. Many tests were used to assess function across multiple brain domains. Most of the commonly used tests aligned with those suggested in the Canadian Guideline; however, there were many additional measures being used that were that were not listed in the Guideline.   Conclusions This study revealed important information about the use of testing measures in FASD assessment and sheds light on the commonalities in practice across clinics in Alberta. Results demonstrate strong convergence of direct and indirect measures to assess brain function. Ultimately, identifying a comprehensive, reliable, and usable testing battery of measures for FASD assessment will improve the clarity and accuracy of the diagnostic process and facilitate advancements in the field, as well as enable comparisons across clinics.

Rural FASD diagnostic services model: Lakeland Centre for fetal alcohol spectrum disorder.

There are few FASD multi-disciplinary diagnostic teams in rural regions of Canada. Families often have difficulty accessing their services because of the lack of clinics available in Canada and the distance rural residents must travel to access one. Since its grass-roots beginning in 1995, the Lakeland Centre for FASD in north eastern Alberta has developed a community-based FASD diagnostic services model that utilizes the resources available in local communities and enhances the support to individuals and families living far away from urban centers. The article describes the history of the Lakeland Centre for FASD relative to the development of the model and diagnostic process used to diagnose children and adults. Rural adaptations to similar urban models are discussed. Critical elements to rural, in-kind services are also discussed along with ongoing challenges. Acknowledging the change in terminology over the years covered by this article, the term FASD (Fetal Alcohol Spectrum Disorder) is used throughout.