ANTICIPATORY GUIDANCE FOR CHILDREN AND ADOLESCENTS WITH FETAL ALCOHOL SPECTRUM DISORDER (FASD): PRACTICE POINTS FOR PRIMARY HEALTH CARE PROVIDERS
Main Article Content
Keywords
Fetal Alcohol Spectrum Disorde r (FASD), children, adolescents, anticipatory guidance
Abstract
Background
Fetal Alcohol Spectrum Disorder (FASD) is an umbrella term that describes the range of effects that can occur in an individual who was prenatally exposed to alcohol and includes an array of complex neurodevelopmental and physical findings.
Objectives
To give primary healthcare providers (PHCP) evidence-based recommendations for supporting and managing the symptoms of FASD after patients have received a diagnosis.
Methods
Primary health recommendations for the management of children and adolescents with FASD were developed based on expert clinical judgment and supported by evidence-based research, where appropriate. The format was adapted from other health supervision practice guidelines as de veloped by the American Academy of Pediatrics. Clinical practice “ Point s” for the PHCP are highlighted. A reference table of anticipatory recommendations by age is presented.
Results
In most cases, the initial screening and referral for diagnosis will be made by the PHCP, and they will be responsible for ongoing management. It is anticipated that these recommendations will provide the PHCP with evidence to support the longitudinal health care of children and adolescents with FASD and their families as they transition throughout all developmental stages.
Conclusion
There is a pressing need for the involvement of PHCP in the active care of children and adolescents with FASD and their families over the lifespan. PHCP are trained in screening, prevention, and management of health needs, and are in the position to coordinate sub-specialty referrals as needed. Engaging PH CP will provide a truly integrated care system for individuals with FASD and their families
References
2. Clarren SK, Smith DW. The fetal alcohol syndrome. N Engl J Med May 11 1978;298(19):1063- 1067.
3. Mattson SN, Schoenfeld A M, Riley EP. Teratogenic effects of alcohol on brain and behavior. Alcohol research & health: The Journal of the National Institute on Alcohol Abuse and Alcoholism 2001;25(3):185.
4. Abel EL, Sokol RJ. Maternal and fetal characteristics affecting alcohol's teratogenicity. Neurobehav Toxicol Teratol Jul -Aug 1986;8(4):329- 334.
5. Uban KA, Bodnar T, Butts K, Sliwowska JH, Comeau W, Weinberg J. Direct and indirect mechanisms of alcohol teratogenicity: Implications for understanding alterations in brain and beha vior in FASD. Fetal Alcohol Spectrum Disorder: Management and policy perspectives of FASD, First Edition: Wiley; 2011.
6. Loock C, Conry J, Cook JL, Chudley AE, Rosales T. Identifying fetal alcohol spectrum disorder in primary care. CMAJ Mar 1 2005;172(5): 628 -630.
7. Chudley AE, Longstaffe SE. Fetal Alcohol Syndrome and Fetal Alcohol Spectrum Diosrder. In: Cassidy S, Allanson J, eds. Management of Genetic Syndromes. Third ed. New York, NY: John Wiley and Sons, Inc.; 2010:363- 380.
8. Riley EP, Clarren SK, We inberg J, Jonsson E. Fetal Alcohol Spectrum Disorder: Management and Policy Perspectives of FASD. Wiley -Blackwell; 2010.
9. Gahagan S, Sharpe TT, Brimacombe M, et al. Pediatricians' knowledge, training, and experience in the care of children with fetal alc ohol syndrome. Pediatrics Sep 2006;118(3):e657- 668.
10. Chavez GF, Cordero JF, Becerra JE. Leading major congenital malformations among minority groups in the United States, 1981- 1986. MMWR CDC Surveill Summ 1988;37(3):17- 24.
11. Sokol RJ, Clarren SK. Guid elines for use of terminology describing the impact of prenatal alcohol on the offspring. Alcohol Clin Exp Res 1989;13(4):597- 598.
12. Sampson PD, Streissguth AP, Bookstein FL, et al. Incidence of fetal alcohol syndrome and prevalence of alcohol-related neurodevelopmental disorder. Teratology 1997;56(5):317- 326.
13. Sampson PD, Bookstein FL, Barr HM, Streissguth AP. Prenatal alcohol exposure, birthweight, and measures of child size from birth to age 14 years. Am J Public Health 1994;84(9):1421- 1428.
14. May PA, Gossage JP, Kalberg WO, et al. Prevalence and epidemiologic characteristics of FASD from various research methods with an emphasis on recent in- school studies. Dev Disabil Res Rev 2009;15(3):176- 192.
15. Health CfAaM. Fetal alcohol spectrum disorders: How widespread are they in Canada? 2013; http:// www.camh.ca/en/hospital/about_camh/n ewsroom/news_releases_media_advisories_and_backgrounders/current_year/Pages/Fetal - Alcohol -Spectrum -Disorders -How - Widespread -Are -They- in-Canada.aspx . Accessed March 21, 2014.
16. de SL, Memo L, Pichini S, Tarani L, Vagna relli F. Fetal alcohol syndrome: new perspectives for an ancient and underestimated problem. J Matern Fetal Neonatal Med 2011;24 Suppl 1:34- 37.
17. Paintner A, Williams AD, Burd L. Fetal alcohol spectrum disorders --implications for child neurology, part 1: prenatal exposure and dosimetry. J Child Neurol 2012;27(2):258- 263.
18. Maier SE, West JR. Drinking patterns and alcohol -related birth defects. Alcohol research & health : The Journal of the National Institute on Alcohol Abuse and Alcoholism 2001;25(3):168- 174.
19. Stade BC, Ali A, Bennett D, et al. The burden of prenatal exposure to alcohol: revised measurement of cost. The C anadian Journal of Clinical Pharmacology 2009;16(1):e91- 102.
20. Popova S, Lange S, Burd L, Rehm J. Health care burden and cost assoc iated with fetal alcohol syndrome: based on official Canadian data. PLoS.One 2012;7(8):e43024.
21. CCSA CCoSA. Drinking Guidelines. 2013; http://www.ccsa.ca/Eng/to pics/alcohol/drinkin g-guidelines/Pages/default.aspx . Accessed April 3, 2014.
22. McKnight -Eily LR, Liu Y, Brewer RD, et al. Vital signs: communication between health professionals and their patients about alcohol use --44 states and the District of Columbi a, 2011. MMWR Morb Mortal Wkly Rep Jan 10 2014;63(1):16- 22.
23. McCormick KA, Cochran NE, Back AL, Merrill JO, Williams EC, Bradley KA. How primary care providers talk to patients about alcohol: a qualitative study. J Gen Intern Med Sep 2006;21(9):966- 972.
24. Shannon GD, Alberg C, Nacul L, Pashayan N. Preconception Healthcare and Congenital Disorders: Systematic Review of the Effectiveness of Preconception Care Programs in the Prevention of Congenital Disorders. Matern Child Health J Oct 4 2013.
25. Rendal l-Mkosi K, Morojele N, London L, Moodley S, Singh C, Girdler -Brown B. A randomized controlled trial of motivational interviewing to prevent risk for an alcohol - exposed pregnancy in the Western Cape, South Africa. Addiction Apr 2013;108(4):725- 732.
26. National Institute of Alcohol Abuse and Alcoholism N. Assessing alcohol problems: A guide for clinicians and researchers, Second edition. Washington, DC: Dept. of Health and Human Services, Public Health Service;2003.
27. Babor TF, Higgins -Biddle J, Saunders J B, Monteiro MG. AUDIT. The alcohol use disorders identification test: Guidelines for use in primary care. 2nd Edition. Geneva, Switzerland: Department of Mental Health and Substance Dependence, World Health Organization;2001.
28. CAPHC. National screening tool kit for children and youth identified and potentially affected by FASD. 2010; http://ken.caphc.org/xwiki/bin/view/FASDScr eeningToolkit/National+Screening+Tool+Kit +for+Children+and+Youth+Identified+and+P otentially+Affected+by+FASD . Accessed March 17, 2014.
29. Goh YI, Chudley AE, Clarren SK, et al. Development of Canadian screening tools for fetal alcohol spectrum disorder. Can J Clin Pharmacol Summer 2008;15(2):e344- 366.
30. LaFrance MA, McLachlan K, Nash K, et al. Evaluation of the Neurobehavioral Screening Tool in Children with Fetal Alcohol Spectrum Disorders (FASD). J Popul Ther Clin Pharmacol 2014;21(2):e197- 210.
31. Zizzo N, DiPietro N, Green CR, Reynolds JN, Bell E, Racine E. Review and reflections on ethics in screening for biomarkers of prenatal alcohol exposure. Alcohol Clin Exp Res 2013;(in press).
32. Yan A, Bell E, Racine E. Ethical and social challenges in newborn screening for prenatal alcohol exposure. Can J Neurol Sci Jan 2014;41(1):115- 118.
33. Poole N. Bringing a women's health perspective to FASD prevention. In: Riley EP, Clarren SK, Weinberg J, Jonsson E, eds. Fetal Alcohol Spectrum Disorder: Management and policy perspectives: Wiley -Blackwell; 2010:161- 174.
34. Grant TM. Maternal alcohol and drug abuse: Effective case management with high- risk mothers and their children. In: Rubin A, ed. Programs and interventions for maltreated children and families at risk. The clinician's guide to evidence -based practice series: Wiley Blackwell Publishers; 2011:207 -221.
35. Kobor MS, Weinberg J. Focus on: Epigenetics and fetal alcohol spectrum disorders. Alcohol Research & Health 20 11;34(1):29- 37.
36. Hellemans KG, Sliwowska JH, Verma P, Weinberg J. Prenatal alcohol exposure: fetal programming and later life vulnerability to stress, depression and anxiety disorders. Neurosci Biobehav Rev May 2010;34(6):791- 807.
37. Chudley AE. Geneti c factors in Fetal Alcohol Spectrum Disorder. In: Riley EP, Clarren SK, Weinberg J, Jonsson E, eds. Fetal Alcohol Spectrum Disorder. Management and Policy Perspectives of FASD. New York: Wiley/Blackwell; 2011:109 -126.
38. Zhang X, Sliwowska JH, Weinberg J . Prenatal alcohol exposure and fetal programming: effects on neuroendocrine and immune function. Exp Biol Med (Maywood.). 2005;230(6):376- 388.
39. Hall JG. Epigenetics: What does it mean for paediatric practice? Paediatr Child Health Jan 2014;19(1):27- 30.
40. Hellemans KG, Verma P, Yoon E, Yu WK, Young AH, Weinberg J. Prenatal alcohol exposure and chronic mild stress differentially alter depressive - and anxiety- like behaviors in male and female offspring. Alcohol Clin Exp Res Apr 2010;34(4):633- 645.
41. CD C CfDC. Adverse Childhood Experiences (ACE) Study. 2013; http://www.cdc.gov/ace/about.htm . Accessed March 28, 2014.
42. University CotDCaH. http://develo pingchild.harvard.edu/ .
43. O'Connor MJ, Kogan N, Findlay R. Prenatal alcohol exposure and attachment behavior in children. Alcohol Clin Exp Res Oct 2002;26(10):1592- 1602.
44. Garner AS, Shonkoff JP, Committee on Psychosocial Aspects of C, et al. Early childhood adversity, toxic stress, and the role of the pediatrician: translating developmental science into lifelong health. Pediatrics Jan 2012;129(1):e224- 231.
45. Shonkoff JP. Protecting brains, not simply stimulating minds. Science Aug 19 2011;333(6045): 982 -983.
46. Shonkoff JP, Boyce WT, McEwen BS. Neuroscience, molecular biology, and the childhood roots of health disparities: building a new framework for health promotion and disease prevention. JAMA Jun 3 2009;301(21):2252- 2259.
47. Shonkoff JP, Garner AS, Committee on Psychosocial Aspects of C, et al. The lifelong effects of early childhood adversity and toxic stress. Pediatrics Jan 2012;129(1):e232- 246.
48. Ahmed -Landeryou MJ. Fetal central nervous system development and alcohol --the evidence so far. F etal Pediatr Pathol Dec 2012;31(6):349- 359.
49. Fuchs D, Burnside L, Marchenski S, Mudry A. Children with FASD -related disabilities receiving services from child welfare agencies in Manitoba. Int J Ment Health Addiction 2010;8:232- 244.
50. Zeanah CH, Shauf fer C, Dozier M. Foster care for young children: why it must be developmentally informed. J Am Acad Child Adolesc Psychiatry Dec 2011;50(12):1199- 1201.
51. Streissguth AP, Barr HM, Kogan J, Bookstein FL. Understanding the occurrence of secondary disabilities in clients with fetal alcohol syndreome (FAS) and fetal alcohol effects (FAE). Final report to the Centers for Disease Control and Prevention. Seattle: University of Washington, Fetal Alcohol and Drug Unit;1996.
52. Streissguth AP, Bookstein FL, Barr H M, Sampson PD, O'Malley K, Young JK. Risk factors for adverse life outcomes in fetal alcohol syndrome and fetal alcohol effects. J Dev Behav Pediatr 2004;25(4):228- 238.
53. Macmillan HL. Protecting children from maltreatment: A Canadian call to action. Paediatr Child Health Oct 2013;18(8):409- 410.
54. Tonmyr L, Hovdestad WE, Draca J. Commentary on Canadian child maltreatment data. Journal of I nterpersonal Violence Jan 2014;29(1):186- 197.
55. Mattson SN, Crocker N, Nguyen TT. Fetal alcohol spectrum disorders : neuropsychological and behavioral features. Neuropsychol Rev 2011;21(2):81- 101.
56. Rasmussen C, Andrew G, Zwaigenbaum L, Tough S. Neurobehavioural outcomes of children with fetal alcohol spectrum disorders: A Canadian perspective. Paediatr Child Health 2008;13(3):185- 191.
57. Quattlebaum JL, O'Connor MJ. Higher functioning children with prenatal alcohol exposure: Is there a specific neurocognitive profile? Child Neuropsychol Aug 21 2012.
58. Paley B, O'Connor MJ. Neurocognitive and neurobehavioural impai rments in individuals with fetal alcohol spectrum disorders: Recognition and assessment. Int J Disabil Hum Dev 2007;6:127- 142.
59. Ware AL, Crocker N, O'Brien JW, et al. Executive function predicts adaptive behavior in children with histories of heavy prenatal alcohol exposure and attention - deficit/hyperactivity disorder. Alcohol Clin Exp Res 2012;36(8):1431- 1441.
60. Fagerlund A, Autti -Ramo I, Hoyme HE, Mattson SN, Korkman M. Risk factors for behavioural problems in foetal alcohol spectrum disorders. Acta Paediatr 2011;100(11):1481- 1488.
61. Fagerlund A, Autti -Ramo I, Kalland M, et al. Adaptive behaviour in children and adolescents with foetal alcohol spectrum disorders: a comparison with specific learning disability and typical development. Eur Child Adole sc Psychiatry Apr 2012;21(4):221- 231.
62. Astley SJ. Profile of the first 1,400 patients receiving diagnostic evaluations for fetal alcohol spectrum disorder at the Washington State Fetal Alcohol Syndrome Diagnostic & Prevention Network. Can J Clin Pharmacol 2010;17(1):e132- e164.
63. Rasmussen C. Executive functioning and working memory in fetal alcohol spectrum disorder. Alcohol Clin Exp Res 2005;29(8):1359- 1367.
64. Pei J, Job J, Kully -Martens K, Rasmussen C. Executive function and memory in children with Fetal Alcohol Spectrum Disorder. Child Neuropsychol 2011;17(3):290 -309.
65. Quattlebaum JL, O'Connor MJ. Higher functioning children with prenatal alcohol exposure: is there a specific neurocognitive profile? Child Neuropsychol 2013;19(6):561- 578.
66. Man ji S, Pei J, Loomes C, Rasmussen C. A review of the verbal and visual memory impairments in children with foetal alcohol spectrum disorders. Dev Neurorehabil Aug 2009;12(4):239- 247.
67. Pei J, Denys K, Hughes J, Rasmussen C. Mental health issues in fetal a lcohol spectrum disorder. J Ment Health 2011;20(5):438- 448.
68. Kooistra L, Crawford S, Gibbard B, Ramage B, Kaplan BJ. Differentiating attention deficits in children with fetal alcohol spectrum disorder or attention -deficit -hyperactivity disorder. Dev Med Child Neurol Feb 2010;52(2):205- 211.
69. Mattson SN, Calarco KE, Lang AR. Focused and shifting attention in children with heavy prenatal alcohol exposure. Neuropsychology May 2006;20(3):361- 369.
70. Rasmussen C, Wyper K, Talwar V. The relation between theory of mind and executive functions in children with fetal alcohol spectrum disorders. Can J Clin Pharmacol Summer 2009;16(2):e370- 380.
71. Coles CD, Kable JA, Taddeo E. Math performance and behavior problems in children affected by prenatal alcohol exposu re: intervention and follow -up. J Dev Behav Pediatr Feb 2009;30(1):7- 15.
72. Paley B, O'Connor MJ. Behavioral interventions for children and adolescents with fetal alcohol spectrum disorders. Alcohol research & health : The Journal of the National Institute on Alcohol Abuse and Alcoholism 2011;34(1):64- 75.
73. A 14 -month randomized clinical trial of treatment strategies for attention - deficit/hyperactivity disorder. The MTA Cooperative Group. Multimodal Treatment Study of Children with ADHD. Arch Gen Psychiat ry Dec 1999;56(12):1073- 1086.
74. Subcommittee on Attention - Deficit/Hyperactivity D, Steering Committee on Quality I, Management, et al. ADHD: clinical practice guideline for the diagnosis, evaluation, and treatment of attention - deficit/hyperactivity disor der in children and adolescents. Pediatrics Nov 2011;128(5):1007- 1022.
75. Sumner CR, Gathercole S, Greenbaum M, et al. Atomoxetine for the treatment of attention - deficit/hyperactivity disorder (ADHD) in children with ADHD and dyslexia. Child and Adolescen t P sychiatry and M ental Health 2009;3:40.
76. Michelson D, Allen AJ, Busner J, et al. Once - daily atomoxetine treatment for children and adolescents with attention deficit hyperactivity disorder: a randomized, placebo -controlled study. Am J Psychiatry Nov 2002;159(11):1896- 1901.
77. Cinnamon Bidwell L, Dew RE, Kollins SH. Alpha -2 adrenergic receptors and attention - deficit/hyperactivity disorder. Current Psychiatry Reports Oct 2010;12(5):366- 373.
78. Olatunji BO, Cisler JM, Deacon BJ. Efficacy of cognitive be havioral therapy for anxiety disorders: a review of meta -analytic findings. Psychiatr Clin North Am Sep 2010;33(3):557- 577.
79. Walkup JT, Albano AM, Piacentini J, et al. Cognitive behavioral therapy, sertraline, or a combination in childhood anxiety. N En gl J Med Dec 25 2008;359(26):2753- 2766.
80. Silverman WK, Ollendick TH. Evidence - based assessment of anxiety and its disorders in children and adolescents. J Clin Child Adolesc Psychol. Sep 2005;34(3):380- 411.
81. Alliance TCA -DHDR. http://www.caddra.ca .
82. Steiner NJ, Sheldrick RC, Gotthelf D, Perrin EC. Computer -based attention training in the schools for children with attention deficit/hyperactivity disorder: a preliminary trial. Clin Pediatr (Phila.) Jul 2011;50(7 ):615- 622.
83. Arns M, de Ridder S, Strehl U, Breteler M, Coenen A. Efficacy of neurofeedback treatment in ADHD: the effects on inattention, impulsivity and hyperactivity: a meta - analysis. Clin EEG Neurosci Jul 2009;40(3):180- 189.
84. Forehand R, Jones DJ, Parent J. Behavioral parenting interventions for child disruptive behaviors and anxiety: what's different and what's the same. Clin Psychol Rev Feb 2013;33(1):133- 145.
85. Haley DW, Handmaker NS, Lowe J. Infant stress reactivity and prenatal alcohol expos ure. Alcohol Clin Exp Res 2006;30(12):2055- 2064.
86. Motz M, Espinet SD, Jeong JJ, et al. The role of the mother -child relationship in developmental outcomes of infants and young children with and without prenatal alcohol exposure. J Popul Ther Clin Pharma col 2011;18(3):e544- 563.
87. Molteno CD, Jacobson JL, Carter RC, Dodge NC, Jacobson SW. Infant emotional withdrawal: a precursor of affective and cognitive disturbance in fetal alcohol spectrum disorders. Alcohol Clin Exp Res Feb 2014;38(2):479- 488.
88. Ja cobson SW, Jacobson JL, Stanton ME, Meintjes EM, Molteno CD. Biobehavioral markers of adverse effect in fetal alcohol spectrum disorders. Neuropsychol Rev Jun 2011;21(2):148- 166.
89. Lambert BL, Bann CM, Bauer CR, et al. Risk - taking behavior among adolesce nts with prenatal drug exposure and extrauterine environmental adversity. J Dev Behav Pediatr. Nov -Dec 2013;34(9):669- 679.
90. Dej E. What was once sick is now bad: the shift from victim to deviant identity for those diagnosed with FASD. Can J Sociol 2011; 36(2):137- 160.
91. Frankel F, Paley B, Marquardt R, O'Connor M. Stimulants, neuroleptics, and children's friendship training for children with fetal alcohol spectrum disorders. J Child Adolesc Psychopharmacol Dec 2006;16(6):777- 789.
92. O'Malley KD, Koplin B, Dohner VA. Psychostimulant clinical response in fetal alcohol syndrome. Can J Psychiatry Feb 2000;45(1):90- 91.
93. O'Leary C, Zubrick SR, Taylor CL, Dixon G, Bower C. Prenatal alcohol exposure and language delay in 2 -year -old children: the importance o f dose and timing on risk. Pediatrics Feb 2009;123(2):547- 554.
94. Coggins T, Friet T, Morgan T. Analysing narrative productions in older school age children and adolescents with fetal alcohol syndrome: An experimental toll for clinical applications. Clin Linguist Phon 1998;12(3):221- 236.
95. Rasmussen C, Becker M, McLennan J, Urichuk L, Andrew G. An evaluation of social skills in children with and without prenatal alcohol exposure. Child Care Health Dev Sep 2011;37(5):711- 718.
96. McGee CL, Bjorkquist OA, Price JM, Mattson SN, Riley EP. Social information processing skills in children with histories of heavy prenatal alcohol exposure. J Abnorm Child Psychol Aug 2009;37(6):817- 830.
97. McGee CL, Fryer SL, Bjorkquist OA, Mattson SN, Riley EP. Deficits in social problem solving in adolescents with prenatal exposure to alcohol. Am J Drug Alcohol Abuse 2008;34(4):423- 431.
98. Rasmussen C, Talwar V, Loomes C, Andrew G. Brief report: lie -telling in children with fetal alcohol spectrum disorder. J Pediatr Psychol Mar 2008;33(2):220- 225.
99. Bishop S, Gahagan S, Lord C. Re -examining the core features of autism: a comparison of autism spectrum disorder and fetal alcohol spectrum disorder. J Child Psychol Psychiatry Nov 2007;48(11):1111- 1121.
100. Petrenko CL, Tahir N, Mahoney EC, Chin NP. Prevention of secondary conditions in Fetal Alcohol Spectrum Disorders: Identification of s ystems -level barriers. Matern Child Health J Nov 1 2013.
101. Brown JD, Bednar LM. Challenges of parenting children with Fetal Alcohol Spectrum Disorder: A concept map. J Fam Soc Work 2004;8(3):1- 17.
102. Pelech W, Badry D, Daoust G. It takes a team: Improving placement stability among children and youth with FASD in care in Canada. Child Youth Serv Rev 2013;35:120- 127.
103. Olson HC, Oti R, Gelo J, Beck S. "Family matters:" fetal alcohol spectrum disorders and the family. Dev Disabil Res Rev 2009;15(3):235- 249.
104. Peadon E, Rhys -Jones B, Bower C, Elliott EJ. Systematic review of interventions for children with Fetal Alcohol Spectrum Disorders. BMC Pediatr 2009;9:35.
105. Green CR, Roane J, Hewitt A, et al. Frequent behavoural challenges in children with Fetal Alcohol Spectrum Disorder: A needs -based assessment reported by caregivers and clinicians. J Popul Ther Clin Pharmacol 2014;21(3):e405- e42 0.
106. Lawrence S, Cummings E, Chanoine JP, et al. Canadian Pediatric Endocrine Group extension to WHO growth charts: Why bother? Paediatr Child Health Jun 2013;18(6):295- 297.
107. Astley SJ, Clarren SK. Measuring the facial phenotype of individuals with prenatal alcohol exposure: correlations with brain dysfunction. Alcohol Alcohol Mar -Apr 2001;36(2):147- 159.
108. Andrew G. Diagnosis of FASD: An overview. In: Riley EP, Clarren SK, Weinberg J, Jonsson E, eds. Fetal Alcohol Spectrum Disorder: Management and policy perspectives: Wiley -Blackwell; 2011:127- 148.
109. Leibson T, Neuman G, Chudley AE, Koren G. The differential diagnosis of fetal alcohol spectrum disorder. J Popul Ther Clin Pharmacol 2014;21(1):e1- e30.
110. Bell SH, Stade B, Reynolds JN, et al. The remarkably high prevalence of epilepsy and seizure history in fetal alcohol spectrum disorders. Alcohol Clin Exp Res 2010;34(6):1084- 1089.
111. Treit S, Lebel C, Baugh L, Rasmussen C, Andrew G, Beaulieu C. Longitudinal MRI reveals altered trajectory of br ain development during childhood and adolescence in fetal alcohol spectrum disorders. J Neurosci Jun 12 2013;33(24):10098- 10109.
112. Anda RF, Centers for Disease C, Felitti VJ, Permanente K. The adverse childhood experiences study. 2008; http://acestudy.org/ . Accessed March 27, 2014.
113. Anda RF, Felitti VJ, Bremner JD, et al. The enduring effects of abuse and related adverse experiences in childhood. A convergence of evidence from neurobiology and epidemiology. Eur A rch Psychiatry Clin Neurosci. Apr 2006;256(3):174- 186.
114. Dube SR, Felitti VJ, Dong M, Giles WH, Anda RF. The impact of adverse childhood experiences on health problems: evidence from four birth cohorts dating back to 1900. Prev Med Sep 2003;37(3):268 -277.
115. Jan JE, Asante KO, Conry JL, et al. Sleep health issues for children with FASD: Clinical considerations. Int J Pediatr 2010;2010.
116. Ipsiroglu OS, McKellin WH, Carey N, Loock C. "They silently live in terror..." why sleep problems and night -time related quality -of-life are missed in children with a fetal alcohol spectrum disorder. Soc Sci Med Feb 2013;79:76- 83.
117. Chen ML, Olson HC, Picciano JF, Starr JR, Owens J. Sleep problems in children with fetal alcohol spectrum disorders. J Clin Sleep Med 2012;8(4):421- 429.
118. Wengel T, Hanlon -Dearman AC, Fjeldsted B. Sleep and sensory characteristics in young children with fetal alcohol spectrum disorder. J Dev Behav Pediatr Jun 2011;32(5):384- 392.
119. Mindell JA, Owens JA. A clinical guide to pediatric sleep: Diagnosis and management of sleep problems, volume 2. Lippincott Williams & Wilkins; 2003.
120. Ho J, Panagiotopoulos C, McCrindle B, et al. Management recommendations for metabolic complications associated with second - generation antipsychotic use in children and youth. Paediatr Child Health Nov 2011;16(9):575- 580.
121. Ho J, Panagiotopoulos C, McCrindle B, Grisaru S, Pringsheim T, group Cg. Management recommendations for metabolic complications associated with second generation antipsychotic use i n children and youth. J Can Acad Child Adolesc Psychiatry Aug 2011;20(3):234- 241.
122. Streissguth AP, Barr HM, Bookstein FL, Sampson PD, Olson HC. The long- term neurocognitive consequences of prenatal alcohol exposure: A 14- year study. Psychological Sicen ce 1999;10:186- 190.
123. O'Leary CM, Slack -Smith LM. Dental hospital admissions in the children of mothers with an alcohol -related diagnosis: a population -based, data- linkage study. J Pediatr Aug 2013;163(2):515- 520 e511.
124. Paley B, O'Connor MJ. Interve ntion for individuals with fetal alcohol spectrum disorders: treatment approaches and case management. Dev Disabil Res Rev 2009;15(3):258- 267.
125. Carson G, Cox LV, Crane J, et al. Alcohol use and pregnancy consensus clinical guidelines. J Obstet Gynaecol Can Aug 2010;32(8 Suppl 3):S1 -31.
126. Thanh NX, Jonsson E, Moffatt J, Dennett L. Fetal alcohol spectrum disorder --poverty trap? J Popul Ther Clin Pharmacol 2013;20(1):e63- 66.
127. Fuglestad AJ, Fink BA, Eckerle JK, et al. Inadequate intake of nutrients essential for neurodevelopment in children with fetal alcohol spectrum disorders (FASD). Neurotoxicol Teratol Sep -Oct 2013;39:128- 132.
128. Keen CL, Uriu -Adams JY, Skalny A, et al. The plausibility of maternal nutritional status being a contributing factor to the risk for fetal alcohol spectrum disorders: the potential influence of zinc status as an example. Biofactors Mar -Apr 2010;36(2):125- 135.
129. Patten AR, Sickmann HM, Dyer RA, Innis SM, Christie BR. Omega -3 fatty acids can reverse the long -term deficits in hippocampal synaptic plasticity caused by prenatal ethanol exposure. Neurosci Lett Sep 13 2013;551:7- 11.
130. Thomas JD, Abou EJ, Dominguez HD. Prenatal choline supplementation mitigates the adverse effects of prenatal alcohol exposure on development in rats. Neurotoxicol Teratol Sep -Oct 2009;31(5):303- 311.
131. Thomas JD, Idrus NM, Monk BR, Dominguez HD. Prenatal choline supplementation mitigates behavioral alterations associated with prenatal alcohol exposure in rats. Birth Defects Res A Clin Mol Teratol Oct 2010;88(10):827- 837.
132. Carter RC, Jacobson SW, Molteno CD, Jacobson JL. Fetal alcohol exposure, iron - deficiency anemia, and infant growth. Pediatrics 2007;120(3):559- 567.
133. Carter RC, Jacobson JL, Burden MJ, et al. Iron deficiency anemia an d cognitive function in infancy. Pediatrics Aug 2010;126(2):e427- 434.
134. Wozniak JR, Fuglestad AJ, Eckerle JK, et al. Choline supplementation in children with fetal alcohol spectrum disorders has high feasibility and tolerability. Nutrition R esearch Nov 2013;33(11):897- 904.
135. American Academy of Pediatrics. Committee on G. American Academy of Pediatrics: Health supervision for children with Down syndrome. Pediatrics Feb 2001;107(2):442- 449.
136. Peadon E, O'Leary C, Bower C, Elliott E. Impacts of alcoh ol use in pregnancy-- the role of the GP. Aust Fam Physician Nov 2007;36(11):935- 939.
137. Brennan D, Giles S. Ocular Involvement in Fetal Alcohol Spectrum Disorder: a r eview. Curr Pharm Des Feb 5 2014.
138. Davies L, Dunn M, Chersich M, et al. Developmenta l delay of infants and young children with and without fetal alcohol spectrum disorder in the Northern Cape Province, South Africa. Afr J Psychiatry (Johannesbg) Sep 2011;14(4):298- 305.
139. Stephen JM, Kodituwakku PW, Kodituwakku EL, et al. Delays in audi tory processing identified in preschool children with FASD. Alcohol Clin Exp Res Oct 2012;36(10):1720- 1727.
140. de Beer M, Kritzinger A, Zsilavecz U. Young children with fetal alcohol spectrum disorder -- communication profiles. S Afr J Commun Disord Dec 2010;57:33- 42.
141. Kalberg WO, Provost B, Tollison SJ, et al. Comparison of motor delays in young children with fetal alcohol syndrome to those with prenatal alcohol exposure and with no prenatal alcohol exposure. Alcohol Clin Exp Res Dec 2006;30(12):2037- 2045.
142. Whaley SE, O'Connor, Mj, Gunderson B. Comparison of the adaptive functioning of children prenatally exposed to alcohol to a nonexposed clinical sample. Alcohol Clin Exp Res Jul 2001;25(7):1018- 1024.
143. Sood B, Delaney -Black V, Covington C, et a l. Prenatal alcohol exposure and childhood behavior at age 6 to 7 years: I. dose -response effect. Pediatrics Aug 2001;108(2):E34.
144. Jirikowic T, Olson HC, Kartin D. Sensory processing, school performance, and adaptive behavior of young school -age childr en with fetal alcohol spectrum disorders. Phys Occup Ther Pediatr May 2008;28(2):117- 136.
145. Alex K, Feldmann R. Children and adolescents with fetal alcohol syndrome (FAS): better social and emotional integration after early diagnosis. Klin Padiatr Mar 2012;224(2):66- 71.
146. Stevens SA, Nash K, Fantus E, Nulman I, Rovet J, Koren G. Towards identifying a characteristic neuropsychological profile for fetal alcohol spectrum disorders. 2. Specific caregiver -and teacher -rating. J Popul Ther Clin. Pharmacol 20 13;20(1):e53- 62.
147. Pruett D, Waterman EH, Caughey AB. Fetal alcohol exposure: consequences, diagnosis, and treatment. Obstet Gynecol Surv Jan 2013;68(1):62- 69.
148. Mattson SN, Roesch SC, Glass L, et al. Further development of a neurobehavioral profile of fetal alcohol spectrum disorders. Alcohol Clin Exp Res Mar 2013;37(3):517- 528.