BUILDING CLINICAL CAPACITY FOR FETAL ALCOHOL SPECTRUM DISORDER DIAGNOSES IN WESTERN AND NORTHERN CANADA
Main Article Content
Keywords
FASD, diagnosis, Canada, clinics
Abstract
Background
Fetal alcohol syndrome and fetal alcohol spectrum disorder are common problems. In response to this problem the Canada Northwest FASD Research Network was established in 2005 by the Canada Northwest FASD Ministerial Partnership. This study was conducted to determine the FASD clinical activity in Canada Northwest.
Methods
The Network identified all clinical programs via Internet sites, provincial postings and professional word of mouth references that purported to do FASD assessments regularly using a multidisciplinary assessment team. Each of these programs was sent a questionnaire asking about clinical capacity, aggregate diagnostic results, team composition, time of clinical assessment and cost of assessment.
Results
Of the 27 programs identified to receive the questionnaire 15 programs responded. These programs were determined to have evaluated about 85% of the patients evaluated by all the programs. The total 7 jurisdictional capacity for FASD diagnosis was 816 evaluations in 2005 and projected to be 975 in 2006. Selection methods for appointing patients for assessment seemed excellent as 23% of those assessed were found to have FAS or pFAS and another 44% had other forms of FASD. The most common professionals to participate in the team evaluations were Paediatricians, Clinical Psychologists, Speech and Language Pathologists and Occupational Therapists.
Interpretation
Clinics are developing in western and northern Canada to diagnose patients with FASD. Comparing the experiences of these clinics can help to determine the continued need to increase diagnostic capacity, standardize diagnostic approaches to assure consistency of approach and diagnosis across the sites and appropriately staff and fund the programs
References
2. Sokol RJ, Clarren SK. Guidelines for use of terminology describing the impact of prenatal alcohol on the offspring. Alcohol Clin Exp Res 1989;13(4):597-8.
3. Stratton K, Howe C, Battaglia FC. Fetal alcohol syndrome: diagnosis, epidemiology, prevention and treatment. Washington: Institute of Medicine and National Academy press; 1996.
4. Sampson PD, Streissguth AP, Bookstein FL, Little RE, Clarren SK, Dehaene P, et al. Incidence of fetal alcohol syndrome and prevalence of alcohol related neurodevelopmental disorder. Teratology 1997; 56(5):317-26.
5. Chudley AE, Conry J, Cook JL, Loock C, Rosales T, LeBlanc N, et al. Fetal alcohol spectrum disorder guidelines for diagnosis, Canadian Medical Association Journal 2005;172 (5 suppl):S1-S21.
6. Clarren SK, Carmichael Olson H, Clarren SGB, Astley SJ. Chapter 15: A child with fetal alcohol syndrome. In: Handbook of Clinical Assessment for Young Children with Developmental Disability. Guralnick M ed. Paul H. Brooks Publications, Baltimore pp 307-326. 2000.
7. Astley SJ, Clarren SK. Diagnostic Guide for Fetal Alcohol Syndrome and Related Conditions: the 4 Digit Diagnostic Code. University Press, Seattle, 1997.
8. Alberta Children's Services, personal communication.