title: Fetal alcohol spectrum disorder: Canadian guidelines for diagnosis.
abstract: The diagnosis of fetal alcohol spectrum disorder (FASD) is complex and guidelines are warranted. A subcommittee of the Public Health Agency of Canada's National Advisory Committee on Fetal Alcohol Spectrum Disorder reviewed, analysed and integrated current approaches to diagnosis to reach agreement on a standard in Canada. The purpose of this paper is to review and clarify the use of current diagnostic systems and make recommendations on their application for diagnosis of FASD-related disabilities in people of all ages. The guidelines are based on widespread consultation of expert practitioners and partners in the field. The guidelines have been organized into 7 categories: screening and referral; the physical examination and differential diagnosis; the neurobehavioural assessment; and treatment and follow-up; maternal alcohol history in pregnancy; diagnostic criteria for fetal alcohol syndrome (FAS), partial FAS and alcohol-related neurodevelopmental disorder; and harmonization of Institute of Medicine and 4-Digit Diagnostic Code approaches. The diagnosis requires a comprehensive history and physical and neurobehavioural assessments; a multidisciplinary approach is necessary. These are the first Canadian guidelines for the diagnosis of FAS and its related disabilities, developed by broad-based consultation among experts in diagnosis.
authors.affiliation: Children's Hospital, Health Sciences Centre, Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Man.
authors.forename: Albert E
authors.initials: AE
authors.lastname: Chudley
authors.forename: Julianne
authors.initials: J
authors.lastname: Conry
authors.forename: Jocelynn L
authors.initials: JL
authors.lastname: Cook
authors.forename: Christine
authors.initials: C
authors.lastname: Loock
authors.forename: Ted
authors.initials: T
authors.lastname: Rosales
authors.forename: Nicole
authors.initials: N
authors.lastname: LeBlanc
mesh_terms: D000015:Abnormalities, Multiple / Q000175:diagnosis; D000328:Adult; D000428:Alcohol Drinking / Q000517:prevention & control; D000437:Alcoholism / Q000175:diagnosis / Q000517:prevention & control; D002170:Canada / Q000453:epidemiology; D002648:Child; D003937:Diagnosis, Differential; D000431:Ethanol; D005260:Female; D063647:Fetal Alcohol Spectrum Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control; D006801:Humans; D007231:Infant, Newborn; D008403:Mass Screening / Q000592:standards*; D008487:Medical History Taking / Q000592:standards; D009422:Nervous System Diseases / Q000175:diagnosis; D010808:Physical Examination / Q000592:standards*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000517:prevention & control; D011297:Prenatal Exposure Delayed Effects; D012017:Referral and Consultation / Q000592:standards*; D012307:Risk Factors
chemical_list: D000431:Ethanol
references.citation: Clin Chem. 2003 Jan;49(1):133-6
references.pmid: 12507969
references.citation: Alcohol Health Res World. 1994;18(1):30-36
references.pmid: 31798162
references.citation: Lancet. 1973 Jun 9;1(7815):1267-71
references.pmid: 4126070
references.citation: CMAJ. 1987 Aug 1;137(3):203-7
references.pmid: 3607663
references.citation: J Pediatr. 1987 Aug;111(2):267-8
references.pmid: 3612403
references.citation: J Craniofac Surg. 2003 Jul;14(4):449-56
references.pmid: 12867855
references.citation: Teratology. 1997 Nov;56(5):317-26
references.pmid: 9451756
references.citation: Can J Public Health. 1999 May-Jun;90(3):192-4
references.pmid: 10401171
references.citation: Teratology. 1975 Aug;12(1):1-10
references.pmid: 1162620
references.citation: Alcohol Alcohol. 2001 Mar-Apr;36(2):147-59
references.pmid: 11259212
references.citation: Alcohol Clin Exp Res. 1989 Aug;13(4):597-8
references.pmid: 2679217
references.citation: Lamp. 1978 Oct;35(10):4-7
references.pmid: 251812
references.citation: Alcohol Alcohol. 2000 Jul-Aug;35(4):400-10
references.pmid: 10906009
references.citation: J Pediatr. 1998 Sep;133(3):346-52
references.pmid: 9738714
references.citation: Alcohol Alcohol. 2000 Sep-Oct;35(5):509-19
references.pmid: 11022026
references.citation: J Pediatr. 1996 Jul;129(1):33-41
references.pmid: 8757560
references.citation: JAMA. 1998 Jul 8;280(2):166-71
references.pmid: 9669791
references.citation: Adv Alcohol Subst Abuse. 1987 Summer;6(4):105-18
references.pmid: 3425475
references.citation: Ambul Pediatr. 2003 Jan-Feb;3(1):40-3
references.pmid: 12540253
references.citation: Alcohol Alcohol. 2000 Sep-Oct;35(5):499-508
references.pmid: 11022025
references.citation: Lancet. 1973 Nov 3;302(7836):999-1001
references.pmid: 4127281
references.citation: Biol Psychiatry. 2002 Mar 15;51(6):507-14
references.pmid: 11922887
references.citation: Alcohol Clin Exp Res. 1994 Oct;18(5):1156-61
references.pmid: 7847599
references.citation: Alcohol Res Health. 1999;23(1):25-30
references.pmid: 10890795
references.citation: JAMA. 2003 Dec 10;290(22):2996-9
references.pmid: 14665662
references.citation: Am J Public Health. 1994 Sep;84(9):1421-8
references.pmid: 8092365
references.citation: Am J Med Genet. 2002 May 15;109(4):249-60
references.pmid: 11992478
references.citation: CMAJ. 1997 Jul 1;157(1):59-60
references.pmid: 9220946
references.citation: J Pediatr. 1997 Nov;131(5):718-21
references.pmid: 9403652
references.citation: Ther Drug Monit. 2003 Jun;25(3):271-8
references.pmid: 12766552
references.citation: Pediatrics. 2001 Aug;108(2):E34
references.pmid: 11483844
references.citation: Can J Public Health. 1996 May-Jun;87(3):204-7
references.pmid: 8771927
references.citation: Paediatr Child Health. 2002 Mar;7(3):147-51
references.pmid: 20046287
references.citation: J Pediatr. 2002 Nov;141(5):712-7
references.pmid: 12410204
references.citation: MMWR CDC Surveill Summ. 1988 Jul;37(3):17-24
references.pmid: 3137448
references.citation: Am J Orthopsychiatry. 1977 Jul;47(3):422-31
references.pmid: 888918