Estimating the community prevalence, child traits, and maternal risk factors of fetal alcohol spectrum disorders (FASD) from a random sample of school children
Utilize a random sample to estimate the prevalence, child traits, and maternal risk for fetal alcohol spectrum disorders (FASD) in a Southeastern United States county.
From all first-grade students (n = 1073) a simple random sample was drawn, and 32 % (n = 231) were consented. All 231 children were examined for dysmorphology and growth, 84 were tested and rated on neurobehavior, and 72 mothers were interviewed for maternal risk.
Significant differences between the physical traits of children diagnosed with FASD and the entire sample were height, weight, head circumference, body mass index, and total dysmorphology scores, and all three cardinal features of fetal alcohol syndrome: palpebral fissure length, smooth philtrum, and narrow vermilion.
Intellectual function and inhibition were not significantly different between FASD and typically-functioning children, but two executive function measures and one visual/spatial measure approached significance.
Six behavioral measures were significantly worse for the FASD group: teacher-rated aggressive behavior, oppositional defiant problems, and conduct problems, and parent-rated problems of communication, daily living, and socialization.
Significant maternal risk factors reported were postpartum depression, frequency of alcohol use, and recovery from alcohol use disorder.
The prevalence of FASD was 71.4 per 1,000 or 7.1 %. This rate falls clearly within the prevalence range identified in eight larger samples of other communities in the Collaboration on FASD Prevalence (CoFASP) study in four regions of the United States.
Careful and detailed clinical evaluation of children from small random samples can be useful for estimating the prevalence and traits of FASD in a community.
Utilizing proven clinical methods to diagnose children with FASD drawn from a relatively small random sample in a defined population of first grade school children, proved to be efficacious. Findings compared favorably to other studies on overall prevalence results, family characteristics, physical traits, and neurocognitive abilities, and indicate that previously undiagnosed children can still be identified as early as their entry into formal schooling. Such early identification, in turn, can enable and facilitate early interventions to assist the development of those affected by FASD.
- The prevalence of FASD in this random sample was 7.1 %.
- The prevalence estimates are consistent with current US estimates.
- Microcephaly and total dysmorphology score were typical of FASD.
- Impulse control and adaptive function were significant FASD traits.
- Random samples can be useful for estimating the prevalence of FASD.