Testing the Feasibility of Screening for FASD Risk in EI Settings

Early identification of Fetal Alcohol Spectrum Disorders (FASD) by the age of six, subsequent interventions, and living in a stable environment are protective factors for increased positive outcomes for children and their families. Early identification of an FASD helps to focus targeted treatments, reduce redundancy in medical care, may assist in identifying other at-risk children in the family, and prevent further alcohol-exposed pregnancies. To increase the identification of children at risk for FASD, an initiative was undertaken to: design a simple FASD Risk screening tool; screen children (birth-3) with developmental delays receiving Early Intervention (EI); assess feasibility of screening in EI settings; and improve FASD knowledge among provider organizations in the target delivery systems to facilitate referrals and diagnosis. This innovative tool and screening outcomes will be presented. Of 1,161 children screened in EI, 19 (2%) displayed at least one of the physical and one of the behavioral risk factors. Sixty-eight percent of the positive screens were identified in the site which served families with the highest risk factors for FASD (i.e., poverty, transience, trauma histories, mental health disorders, stress, and tobacco use); used a single staff member for the screening; and had the most time for project training and technical assistance. Obtaining maternal alcohol histories requires sensitivity to stigma and cultural awareness, and linkages to substance disorder treatment resources. These protocols are transferable to other programs such as homeless shelters; WIC; child care and pre-school centers; community health centers; and substance use disorder family treatment programs.