title: Do pediatricians recognize fetal alcohol spectrum disorders in children with developmental and behavioral problems?
abstract: OBJECTIVE
  Limited studies have examined pediatricians' knowledge, attitudes, and practice about fetal alcohol spectrum disorders (FASDs), and none have examined alcohol-related neurodevelopmental disabilities (ARND). This study examined whether pediatricians consider FASDs in children with developmental and behavioral problems.
  
  
  METHODS
  All 149 pediatricians, 55 males and 94 females, in New Haven County, CT, were contacted to complete a web-based survey. They were given cases of preschool boys with (1) fetal alcohol syndrome (FAS), (2) ARND, and (3) Williams Syndrome (WS) and asked to provide a diagnosis and rate their confidence in this. They could access up to 7 additional pieces of information.
  
  
  RESULTS
  Sixty-six pediatricians responded (44.3%), and 46 had complete data (30.9%). Eight (17.4%) correctly identified FAS and 29 (63.1%) ARND. Significantly fewer pediatricians diagnosed FAS versus ARND and WS (p < .001), and they were less confident in identifying FAS and ARND than WS (10.9 % and 45.7% vs. 73.9%, p < .01). After viewing the photographs with sentinel dysmorphology and case description, respondents were more likely to diagnose WS (37%) versus FAS (19.6%) (p = .064), less confident in their diagnosis (p = .009), and required more information to make an FAS diagnosis (p = .002).
  
  
  CONCLUSIONS
  Pediatricians underrecognize FASDs, lack confidence in making this diagnosis, and are unfamiliar with the diagnostic criteria. They need more training to consider the possibility of an FASD when seeing children with developmental and behavioral problems.
authors.affiliation: *Developmental and Behavioral Pediatrics, Department of Pediatrics Yale School of Medicine, New Haven, CT; †Developmental and Behavioral Pediatrics, Department of Pediatrics, Mahidol University, Bangkok, Thailand; ‡Developmental and Behavioral Pediatrics, Department of Pediatrics, Rhode Island Hospital, Providence, RI.
authors.forename: Pat
authors.initials: P
authors.lastname: Rojmahamongkol
authors.forename: Ayesha
authors.initials: A
authors.lastname: Cheema-Hasan
authors.forename: Carol
authors.initials: C
authors.lastname: Weitzman
mesh_terms: D000328:Adult; D002648:Child; D002653:Child Behavior Disorders / Q000175:diagnosis* / Q000209:etiology; D002658:Developmental Disabilities / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D063647:Fetal Alcohol Spectrum Disorders / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010372:Pediatrics / Q000592:standards / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D018980:Williams Syndrome / Q000175:diagnosis / Q000209:etiology