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More than 86% of foster and adopted youth with fetal alcohol spectrum disorder were either not diagnosed or had been misdiagnosed, as the disorder is often mistaken for behavioral issues such as attention-deficit/hyperactivity disorder, a study showed.
According to Dr. Ira J. Chasnoff and his associates, 125 of 156 (80.1%) children and adolescents who met the criteria for a diagnosis within the fetal alcohol spectrum had never been diagnosed as affected by prenatal alcohol exposure. And of the 31 children who had been recognized before referral as affected by prenatal alcohol exposure, 10 had their fetal alcohol spectrum disorder (FASD) diagnoses changed within the spectrum, representing a misdiagnosis rate of 6.4% (Pediatrics 2014 [doi:10.1542/peds.2014-2171]).
Dr. Chasnoff and his colleagues at Children’s Research Triangle (CRT), Chicago, collected data from a sample of 547 children aged 4-18 years who were referred to a Chicago children’s mental health center for behavioral issues. All of the children in the sample were in foster or adoptive homes at the time of referral and evaluation, and the most common reason for referral of the 547 children to the CRT clinic was “behavioral problems.”
Neurodevelopmental deficits among children who have confirmed prenatal exposure to alcohol but who do not meet diagnostic criteria for FASD (growth retardation, central nervous system impairment, and facial dysmorphology) are common. The most common mental health diagnoses for the children at the time of referral were attention-deficit/hyperactivity disorder (ADHD), post-traumatic stress disorder, and conduct disorder.
The researchers cautioned that FASD can have far-reaching consequences for development and that properly diagnosing the disorder should happen as early as possible. Looking beyond the physical criteria (facial dysmorphology) and adhering to modern diagnostic criteria should help more doctors recognize the disorder, as well as increase public awareness of the signs and symptoms of FASD.
“The role of the pediatrician and other children’s health care providers is clear: early recognition of the child or adolescent with FASD, referral to a provider who can 1conduct a full evaluation, and participation in the development of a targeted treatment plan that incorporates mental health treatment, behavioral management strategies, and special education services,” the investigators wrote. “Learning disorders, communication disorders, and intellectual disability, objective signs of significant neurocognitive damage, had not been recognized in a large majority of the children with these disabilities.”
The study was supported in part by a grant from the Administration for Children and Families, Department of Health & Human Services. The investigators had no relevant financial disclosures.
More than 86% of foster and adopted youth with fetal alcohol spectrum disorder were either not diagnosed or had been misdiagnosed, as the disorder is often mistaken for behavioral issues such as attention-deficit/hyperactivity disorder, a study showed.
According to Dr. Ira J. Chasnoff and his associates, 125 of 156 (80.1%) children and adolescents who met the criteria for a diagnosis within the fetal alcohol spectrum had never been diagnosed as affected by prenatal alcohol exposure. And of the 31 children who had been recognized before referral as affected by prenatal alcohol exposure, 10 had their fetal alcohol spectrum disorder (FASD) diagnoses changed within the spectrum, representing a misdiagnosis rate of 6.4% (Pediatrics 2014 [doi:10.1542/peds.2014-2171]).
Dr. Chasnoff and his colleagues at Children’s Research Triangle (CRT), Chicago, collected data from a sample of 547 children aged 4-18 years who were referred to a Chicago children’s mental health center for behavioral issues. All of the children in the sample were in foster or adoptive homes at the time of referral and evaluation, and the most common reason for referral of the 547 children to the CRT clinic was “behavioral problems.”
Neurodevelopmental deficits among children who have confirmed prenatal exposure to alcohol but who do not meet diagnostic criteria for FASD (growth retardation, central nervous system impairment, and facial dysmorphology) are common. The most common mental health diagnoses for the children at the time of referral were attention-deficit/hyperactivity disorder (ADHD), post-traumatic stress disorder, and conduct disorder.
The researchers cautioned that FASD can have far-reaching consequences for development and that properly diagnosing the disorder should happen as early as possible. Looking beyond the physical criteria (facial dysmorphology) and adhering to modern diagnostic criteria should help more doctors recognize the disorder, as well as increase public awareness of the signs and symptoms of FASD.
“The role of the pediatrician and other children’s health care providers is clear: early recognition of the child or adolescent with FASD, referral to a provider who can 1conduct a full evaluation, and participation in the development of a targeted treatment plan that incorporates mental health treatment, behavioral management strategies, and special education services,” the investigators wrote. “Learning disorders, communication disorders, and intellectual disability, objective signs of significant neurocognitive damage, had not been recognized in a large majority of the children with these disabilities.”
The study was supported in part by a grant from the Administration for Children and Families, Department of Health & Human Services. The investigators had no relevant financial disclosures.
More than 86% of foster and adopted youth with fetal alcohol spectrum disorder were either not diagnosed or had been misdiagnosed, as the disorder is often mistaken for behavioral issues such as attention-deficit/hyperactivity disorder, a study showed.
According to Dr. Ira J. Chasnoff and his associates, 125 of 156 (80.1%) children and adolescents who met the criteria for a diagnosis within the fetal alcohol spectrum had never been diagnosed as affected by prenatal alcohol exposure. And of the 31 children who had been recognized before referral as affected by prenatal alcohol exposure, 10 had their fetal alcohol spectrum disorder (FASD) diagnoses changed within the spectrum, representing a misdiagnosis rate of 6.4% (Pediatrics 2014 [doi:10.1542/peds.2014-2171]).
Dr. Chasnoff and his colleagues at Children’s Research Triangle (CRT), Chicago, collected data from a sample of 547 children aged 4-18 years who were referred to a Chicago children’s mental health center for behavioral issues. All of the children in the sample were in foster or adoptive homes at the time of referral and evaluation, and the most common reason for referral of the 547 children to the CRT clinic was “behavioral problems.”
Neurodevelopmental deficits among children who have confirmed prenatal exposure to alcohol but who do not meet diagnostic criteria for FASD (growth retardation, central nervous system impairment, and facial dysmorphology) are common. The most common mental health diagnoses for the children at the time of referral were attention-deficit/hyperactivity disorder (ADHD), post-traumatic stress disorder, and conduct disorder.
The researchers cautioned that FASD can have far-reaching consequences for development and that properly diagnosing the disorder should happen as early as possible. Looking beyond the physical criteria (facial dysmorphology) and adhering to modern diagnostic criteria should help more doctors recognize the disorder, as well as increase public awareness of the signs and symptoms of FASD.
“The role of the pediatrician and other children’s health care providers is clear: early recognition of the child or adolescent with FASD, referral to a provider who can 1conduct a full evaluation, and participation in the development of a targeted treatment plan that incorporates mental health treatment, behavioral management strategies, and special education services,” the investigators wrote. “Learning disorders, communication disorders, and intellectual disability, objective signs of significant neurocognitive damage, had not been recognized in a large majority of the children with these disabilities.”
The study was supported in part by a grant from the Administration for Children and Families, Department of Health & Human Services. The investigators had no relevant financial disclosures.
FROM PEDIATRICS
Key clinical point: Children’s health care providers should screen children and youth in their practices for FASD more often.
Major finding: More than 80% of children sampled with fetal alcohol spectrum disorder had never been diagnosed.
Data source: A sample of 547 foster and adopted children 4-18 years of age.
Disclosures:The study was supported in part by a grant from the Administration for Children and Families, Department of Health & Human Services. The investigators had no relevant financial disclosures.