Fetal alcohol spectrum disorder

Topic Editor: Mary J. O'Connor, PhD, University of California at Los Angeles, USA

Screening in communities is an important first step to diagnosis, appropriate, timely intervention and prevention. Early identification of alcohol-abusing women is the key to successful intervention. This can be conceptualized in four stages: (1) pre-conception, (2) prenatal, (3) birth/infancy, and (4) toddlers/young children.

Once an FASD child is born, early identification and intervention become critical and should incorporate the following services:

• family-focused interventions that provide support to both the parent and child;
• school-based interventions; and
• residential programs that include individual psychotherapy, parenting education, child care and vocational training.

Several problems have been identified regarding the provision of services for FASD children:

• identification of guidelines for standards of care;
• services/programs specific to FASD children and their families;
• effectiveness of existing programs;
• identification of post-natal environmental variables or stressors such as instability of caregiving environment that interfere with child development.

Several policy and services implications can be gleaned from the accumulated body of FASD research:

• the need to develop screening programs that are low-cost, require only a modest time commitment and facilitate early identification;
• comprehensive needs assessment and comparing FASD individuals with others who have different disabilities in order to identify the similarities and differences between the two groups and learn from them;
• developing programs for young  (0-5) children;
• more coordinated system of care for alcohol-abusing women, such as coordination of obstetric, psychiatric and developmental services;
• Education of health-care providers.

Reviewing the current status of programs and services for individuals with FASD suggests that there is probably a high need for services to individuals and families with infants/young children with FASD. However, research is necessary to characterize these needs, as information available to guide planning for services remains fragmentary and anecdotal. While suggestive, this type of research can do little to convince policy-makers of the need for increased funding for program development or third-party support. Such a review further suggests that evaluation of program/service effectiveness should be a component of all programs for prevention, intervention and treatment.

See also...

• How important is it?
• What do we know?
• According to experts
• Key messages