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Fetal alcohol spectrum disorder: a guideline for diagnosis across the lifespan

Canadian Medical Association journal (CMAJ), 2016-02, Vol.188 (3), p.191-197 [Peer Reviewed Journal]

COPYRIGHT 2016 Joule Inc. ;Copyright 8872147 Canada Inc. Feb 16, 2016 ;2016 8872147 Canada Inc. or its licensors 2016 ;ISSN: 0820-3946 ;EISSN: 1488-2329 ;DOI: 10.1503/cmaj.141593 ;PMID: 26668194 ;CODEN: CMAJAX

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  • Title:
    Fetal alcohol spectrum disorder: a guideline for diagnosis across the lifespan
  • Author: Cook, Jocelynn L ; Green, Courtney R ; Lilley, Christine M ; Anderson, Sally M ; Baldwin, Mary Ellen ; Chudley, Albert E ; Conry, Julianne L ; LeBlanc, Nicole ; Loock, Christine A ; Lutke, Jan ; Mallon, Bernadene F ; McFarlane, Audrey A ; Temple, Valerie K ; Rosales, Ted
  • Subjects: Advisory Committees ; Alcohol Drinking ; Alcoholism ; Algorithms ; Canada ; Child ; Child, Preschool ; Diagnosis ; Effect of alcohol on ; Evaluation ; Female ; Fetal Alcohol Spectrum Disorders - diagnosis ; Fetal alcohol syndrome ; Fetus ; Focus Groups ; Forecasts and trends ; Guidelines ; Humans ; Infant ; Infant, Newborn ; Male ; Mass Screening ; Medical diagnosis ; Medical research ; Medical statistics ; Medicine, Experimental ; Patient Care Team ; Practice guidelines (Medicine) ; Practice Guidelines as Topic ; Pregnancy ; Referral and Consultation
  • Is Part Of: Canadian Medical Association journal (CMAJ), 2016-02, Vol.188 (3), p.191-197
  • Description: The consequences of prenatal alcohol exposure were first described more than 40 years ago.1,2 The term "fetal alcohol syndrome" (FAS) was first used to describe the cluster of birth defects due to prenatal alcohol exposure (including growth restriction, craniofacial abnormalities and intellectual disabilities) with lifetime consequences.2 The term "fetal alcohol spectrum disorder" (FASD) has since been adopted to describe a broader spectrum of presentations and disabilities resulting from alcohol exposure in utero. The prevalence has been estimated at 1 in 100 people, which translates to more than 330 000 affected individuals in Canada.3 The development of clinical capacity for FASD diagnosis remains difficult,4 because the diagnosis requires a medical evaluation and neurodevelopmental assessment conducted by a multidisciplinary team. In 2005, an international, collaborative, evidence-based guideline for diagnoses related to prenatal alcohol exposure was published.5 Since then, the field has evolved, and additional evidence, expertise and experience have emerged to suggest that a revision was required to improve both diagnoses and outcomes. The literature has also shown that impairments in behaviour and function associated with FASD have been detected from exposure to binge drinking, even infrequently or early in pregnancy, which underscores the importance of pre-pregnancy counselling. Specific research involving infants, young children and adults with FASD, as well as further insight into the neurodevelopmental dysfunction and nomenclature, prompted the update and revision process. A literature review and broad consultation process was undertaken to revise the 2005 guideline for diagnosing FASD.5 The guideline was developed according to the Appraisal of Guidelines, Research and Evaluation (AGREE II) framework,6 which provides a rigorous, evidence-based approach. The steering committee identified the scope of the guidelines and developed the key questions. These tasks were accomplished during the first meetings, after which the scope and questions were further refined and approved by consensus. The literature review was then conducted by two committee members (J.L.C. and C.R.G.) using the following combinations of MeSH (medical subject heading) search terms to address the key questions: "fetal alcohol," "diagnosis*," "infant*," "prenatal alcohol" and "adult." Relevant reports published from 2005 to September 2014 were identified from the following databases: PubMed, PsychLIT, Medscape, MEDLINE, the Canadian Institutes of Health Research funding database and the Cochrane Library.
  • Publisher: Canada: Joule Inc
  • Language: English
  • Identifier: ISSN: 0820-3946
    EISSN: 1488-2329
    DOI: 10.1503/cmaj.141593
    PMID: 26668194
    CODEN: CMAJAX
  • Source: ProQuest One Psychology
    GFMER Free Medical Journals
    MEDLINE
    PubMed Central
    Alma/SFX Local Collection
    ProQuest Central
    DOAJ Directory of Open Access Journals
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