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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
A practical clinical approach to diagnosis of fetal alcohol spectrum disorders: Clarification of the 1996 institute of medicine criteria
Pediatrics, Volume 115, No. 1, Year 2005
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Description
Background. The adverse effects of alcohol on the developing human represent a spectrum of structural anomalies and behavioral and neurocognitive disabilities, most accurately termed fetal alcohol spectrum disorders (FASD). The first descriptions in the modern medical literature of a distinctly recognizable pattern of malformations associated with maternal alcohol abuse were reported in 1968 and 1973. Since that time, substantial progress has been made in developing specific criteria for defining and diagnosing this condition. Two sets of diagnostic criteria are now used most widely for evaluation of children with potential diagnoses in the FASD continuum, ie, the 1996 Institute of Medicine (IOM) criteria and the Washington criteria. Although both approaches have improved the clinical delineation of FASD, both suffer from significant drawbacks in their practical application in pediatric practice. Objective. The purpose of this report is to present specific clarifications of the 1996 IOM criteria for the diagnosis of FASD, to facilitate their practical application in clinical pediatric practice. Methods. A large cohort of children who were prenatally exposed to alcohol were identified, through active case-ascertainment methods, in 6 Native American communities in the United States and 1 community in the Western Cape Province of South Africa. The children and their families underwent standardized multidisciplinary evaluations, including a dysmorphology examination, developmental and neuropsychologic testing, and a structured maternal interview, which gathered data about prenatal drinking practices and other demographic and family information. Data for these subjects were analyzed, and revisions and clarifications of the existing IOM FASD diagnostic categories were formulated on the basis of the results. Results. The revised IOM method defined accurately and completely the spectrum of disabilities among the children in our study. On the basis of this experience, we propose specific diagnostic criteria for fetal alcohol syndrome and partial fetal alcohol syndrome. We also define alcohol-related birth defects and alcohol-related neurodevelopmental disorder from a practical standpoint. Conclusions. The 1996 IOM criteria remain the most appropriate diagnostic approach for children prenatally exposed to alcohol. The proposed revisions presented here make these criteria applicable in clinical pediatricpractice. Copyright © 2005 by the American Academy of Pediatrics.
Authors & Co-Authors
Hoyme, H. Eugene
United States, Stanford
Stanford University School of Medicine
May, Philip A.
United States, Albuquerque
The University of new Mexico
Kalberg, Wendy O.
United States, Albuquerque
The University of new Mexico
Kodituwakku, Piyadasa W.
United States, Albuquerque
The University of new Mexico
Phillip Gossage, J.
United States, Albuquerque
The University of new Mexico
Trujillo, Phyllis M.
United States, Albuquerque
The University of new Mexico
Buckley, David G.
United States, Albuquerque
The University of new Mexico
Miller, Joseph H.
United States, Albuquerque
The University of new Mexico
Aragón, Alfredo S.
United States, Albuquerque
The University of new Mexico
Khaole, Nathaniel C.O.
South Africa, Cape Town
Foundation for Alcohol Related Research Farr
Viljoen, Dennis Lucy
South Africa, Cape Town
Foundation for Alcohol Related Research Farr
South Africa, Johannesburg
University of the Witwatersrand Faculty of Health Sciences
Jones, Kenneth Lyons
United States, La Jolla
Uc San Diego School of Medicine
Robinson, Luther K.
United States, Buffalo
Jacobs School of Medicine and Biomedical Sciences
Statistics
Citations: 872
Authors: 13
Affiliations: 6
Identifiers
Doi:
10.1542/peds.2004-0259
ISSN:
00314005
e-ISSN:
00314005
Research Areas
Health System And Policy
Maternal And Child Health
Mental Health
Substance Abuse
Study Design
Cohort Study
Study Locations
South Africa