Day 52 of 99 Days to FASDay: FASD Diagnostic History

Day 52 of 99 days to FASDay

Continuing the history of FAS/FASD today we highlight a few significant dates in the medical and diagnostic arena. As with my posts, every attempt is made to obtain information from reliable sources. I encourage anyone to conduct their own research, consult professionals and feel free to contact OSB with any errors or omissions.

From the FASD Handbook :

In 1973, Dr. C Ulleland a resident at Harborview Hospital in Seattle, Washington (USA) noted that six infants in his care with failure to thrive were born to mothers who were alcoholics.

Dr. Ulleland brought these six cases, along with others he identified, to Drs. Ken Jones and David Smith who at the time were practicing pediatric dysmorphology at Harborview Hospital. Drs. Jones and Smith recognized in these children a characteristic pattern of facial features that were unlike those of any other condition.

At this point, Dr. Ann Streissguth, a child psychologist, was asked to examine the children and found that each had some degree of developmental delay or disability. Drs. Jones, Smith, Streissguth and Ulleland published “Pattern of Malformation in Offspring of Chronic Alcoholic Mothers” in the journal Lancet. It was in this article that the term Fetal Alcohol Syndrome (FAS) was first used.

In the years since the 1973 publication of this article, it has been recognized that FAS is only one part of a spectrum of disorders related to prenatal alcohol exposure due to maternal alcohol consumption.

In 1986, the United States Institutes of Medicine, Division of Biobehavioral Sciences and Mental Disorders created a Committee to Study Fetal Alcohol Syndrome. The culmination of the Committee’s work was the publication in 1996 of Fetal Alcohol Syndrome: Diagnosis, Epidemiology, Prevention and Treatment.

In 2004, a group of national experts representing the Centers for Disease Control (CDC), the National Institute on Alcohol Abuse and Alcoholism (NIAAA), the Substance Abuse and Mental Health Service Administration (SAMHSA), Health Canada and professionals in the fields of research, psychiatry and justice attended a meeting facilitated by the National Organization on Fetal Alcohol Syndrome (NOFAS). At this meeting, the term Fetal Alcohol Spectrum Disorders (FASD) was coined.

As a side-note, The FASD Handbook is a great information resource. It includes:
〉 A Historical Overview of FASD,
〉 Characteristics of FASD,
〉 Diagnostic Criteria for FASD,
〉 A Discussion of Executive Skills – their function and signs of their dysfunction,
〉 Secondary Concerns for Individuals with an FASD,
〉 FASD Prevention Information,
〉 Strategies for Individuals with FASD at Home,
〉 Educational Strategies for Individuals with FASD,
and much more.

Not from the FASD Handbook, but pertaining to the updated/new Canadian diagnostic guidelines, FASD is now the recommended diagnostic term, with two forms of FASD:

  1. FASD with sentinel facial findings (i.e. short palpebral fissures, smooth philtrum and thin upper lip).
  2. FASD with no sentinel facial findings.

More information on the new Canadian Guidelines can be found at the Journal for the Canadian Medical Association.


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