196387 Clinical and Genetic Factors and the Diagnosis of FASD

Tuesday, November 10, 2009

Helga Valdmanis Toriello, PhD , Genetics, Spectrum Health, Grand Rapids, MI
Vivian Grace Valdmanis, PhD , Health Policy Program, University of the Sciences in Philadelphia, Philadelphia, PA
Steven Pasternak, PhD , Neurobehavioral Science Clinic, DeVos Childrens Hospital, Grand Rapids, MI
Anthony Richtsmeier, MD , DVCH - Behavioral Peds, Spectrum Health, Grand Rapids, MI
Barbara Wybrecht, RN , Genetics, Spectrum Health, Grand Rapids, MI
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. .

Learning Objectives:
Define the symptoms of children presented to the clinic Discuss its relation to the diagnosis of FAS Identify independent factors related to FAS disability Evaluate the partnership between clinicians and referral agencies

Keywords: Alcohol Problems, Child Health Promotion

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I oversee the clinic and review the genetic markers and syndromes that are appropriate
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.