Two Recent Approaches to FASD Diagnosis

Overview

Over the last 50 years, a significant amount of research and clinical expertise has been devoted to characterizing the effects of prenatal alcohol exposure on the developing fetus. Simultaneously, a variety of systems and approaches have also emerged to provide diagnostic guidance for the related diagnoses.

Fetal Alcohol Spectrum Disorder (FASD) is now widely used to describe the resultant sequelae associated with prenatal alcohol exposure. Despite ongoing pressure to develop a consensus around diagnostic approaches for FASD, different multidisciplinary diagnostic systems continue to emerge.

Recently, significant differences in diagnostic sensitivity and specificity were revealed after comparing the 2005 Canadian diagnostic guidelines and the Diagnostic and Statistical Manual of Mental Disorders, 5th edition diagnosis Neurobehavioural disorder
associated with prenatal alcohol exposure (ND-PAE).

Although considerable overlap was identified between both sets of criteria, the neurobehavioural domains assessed for a ND-PAE diagnosis limited the identification of patients with FASD.

Similarly, two recent publications that describe revised diagnostic approaches for outcomes resulting from prenatal alcohol exposure are now available: the revised Canadian guidelines and an updated IOM approach.

The Canadian publication documents a national process, which included representation from multidisciplinary experts in the field, while the other was developed by a group of leading specialists and researchers from the United States.

Though the two publications share some commonalities, several significant differences are noted and described further in this issue paper. Both publications arose in response to emergent data in the field that supported improvements and changes to the diagnostic
process. Although, both approaches continue to underscore the need for a multidisciplinary team approach, comprised of individuals with specific expertise and experience in the field of FASD, three specific differences were apparent:

1) the craniofacial criteria;

2) the clinical cut-off for neuropsychological impairment; and

3) the diagnostic nomenclature.

Just click to read the full issue paper written by Courtney R. Green, PhD: Two-Approaches-to-FASD-diagnosis