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Foetal alcohol spectrum disorder: identifying the neurobehavioural phenotype and effective interventions

Koren, Gideona; Zelner, Irenea; Nash, Kellyb; Koren, Gala

Current Opinion in Psychiatry: March 2014 - Volume 27 - Issue 2 - p 98–104
doi: 10.1097/YCO.0000000000000038

Purpose of review Since the first description of the foetal damage of alcohol in 1967, numerous studies have outlined different aspects of neurodevelopmental dysfunction, adversely affecting the lives of children worldwide. Although the cause of the syndrome is sorted out, the pathogenesis of brain damage is far from being clear. In contrast to children exhibiting the full facial dysmorphology, who are relatively easy to diagnose, in those presenting only with alcohol-related neurodevelopmental damage diagnosis is much more challenging due to poor specificity of the brain dysfunction. Hence, identifying the neurodevelopmental phenotype of foetal alcohol spectrum disorder (FASD) is a major challenge.

Recent findings Recently, a behavioural phenotype of FASD has been described and validated using items from the Child Behaviour Checklist. This tool has high sensitivity and specificity in separating children with FASD from those with ADHD and from healthy controls. In parallel, a number of intervention studies show promise in improving the abilities of children and adolescents with the syndrome to cope with daily tasks and improve their quality of life.

Summary The neurobehavioural screening test can facilitate screening for FASD and is an official screening tool in the FASD toolkit of the Public Health Agency of Canada. Promising new interventions may attenuate the long-term outcome of these children.

aMotherisk Program, Division of Clinical Pharmacology-Toxicology, Department of Pediatrics

bDepartment of Psychiatry, The Hospital for Sick Children, Toronto, Ontario, Canada

Correspondence to Gideon Koren, MD, FRCPC, Motherisk Program, Hospital for Sick Children, 555 University Ave, Toronto, ON M5G 1X8, Canada. Tel: +1 416 813 5781; e-mail:

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins