Clinical and Genetic Factors and the Diagnosis of FASD

In 2000, a fetal alcohol spectrum disorders (FASD) diagnostic center was established at Spectrum Health, using the diagnostic model established by the FASD Diagnostic and Prevention Network in Seattle, WA. Over 300 children ages 3-18 have been evaluated at the Spectrum Clinic. We found that in general our patient population consisted of children with learning deficits, behavior problems, or both; and whose mothers may have drunk alcohol during pregnancy. Most of these children did not have FASD, yet all of their difficulties were attributed to prenatal alcohol exposure.

There is a wealth of literature indicating that other prenatal exposures can adversely affect the fetal central nervous system; genetic factors can be crucial determinants of a child's phenotype; and postnatal environment (e.g., abuse, neglect, etc.) can have huge impact on a child's outcome. However, very few studies control for these potential co-morbidities, and in most cases, FASD is the wrong diagnosis. In this study, we control for adverse childhood environments and genetic factors to better understand the specific effects of prenatal alcohol exposure. Since the children seen in the clinic have multiple problems, we applied multivariate analysis in order to better appreciate the multifactorial nature of this syndrome. .