Fetal Alcohol Spectrum Disorder
Literature Review
Nancy Shipkey, MS, RN, doctoral student University at Buffalo, State University of
New York, School of Nursing
Linda M. Caley PhD RN, Assistant Professor, University at Buffalo, State
University of New York School of Nursing
Mary Ann Jezewski, PhD RN, Associate Director for Research, Associate Professor,
University at Buffalo, State University of New York School of Nursing
Sally Speed, Unit Director
Medicaid Training Institute – HLTC03
Meg Brin, Administrative Director
CC02 Child Welfare/Child Protective Services Common Core Training for
Caseworkers
Vivian Figliotti, Child Welfare/CPS Trainer
Jeannette Climenti, Child Welfare Trainer
Will Rea, Child Welfare Trainer
Maria Rivera, Child Welfare Trainer
Funding for this research project was provided by NYS Office of Children and Family
Services, Contract year 2003: Project 1029345, Award: 27379; Project: 1029071, Award:
27229 Contract year 2004: Project 1037112, Award 31177; Project: 1037122, Award:
31183, Contract year: 2005: Project: 1044887, Award: 34963; Project: 1044698, Award:
34851 through the Center for Development of Human Services, College Relations Group,
Research Foundation of SUNY, Buffalo State College.
© 2005 CDHS/Research Foundation of SUNY/BSC College Relations Group
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FETAL ALCOHOL SPECTRUM DISORDER LITERATURE
Fetal Alcohol Syndrome and Pregnancy
Citation
Significance
Allard-Hendren, R. (2000). Alcohol use and
pregnancy. MCN, American Journal of
Maternal Child Nursing, 25(3), 159-162.
Reports indicate that 33/4% of adolescents engage in heavy episodic alcohol
consumption, and that 34.8% of adolescents are sexually active by the age of 15
without using any form of contraception. Combined, these activities can lead to
adolescent pregnancy complicated by fetal alcohol syndrome (FAS), a disorder that is
totally preventable by abstinence from alcohol during pregnancy. This article offers
some primary strategies in working with adolescents and communities to help prevent
FAS.
Curet, L. B. & Hsi, A. C. (2002). Drug
abuse during pregnancy. Clinical
Obstetrics & Gynecology, 45 (1), 73-88.
Substance abuse remains a major health problem in the United States. The health
consequences of substance abuse have been extensively researched and documented
among men. However, the impact of substance abuse on the health of women and
pregnancy has only recently received adequate attention. Nationwide, the use of
alcohol and other drugs has increased dramatically in recent years. A major effect of
this trend has been an increase in the awareness of the need to target special
populations, especially women and more recently pregnant women and their children.
This article concludes that substance abuse programs for pregnant women should
provide comprehensive care with as much “one-stop” shopping as possible. Goals
should be to promote safe and healthy pregnancies, improve perinatal outcome, and
enhance development of children exposed to alcohol, nicotine, and other drugs.
Golden, J. (2000). A tempest in a cocktail
This article examines the portrayal of pregnancy and alcohol in thirty-six national
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glass”: mothers, alcohol, and television.
1977-1996. Journal of Health Politics,
Policy & Law, 25 (3), 473-498.
network evening news broadcasts (ABC, CBS, NBC). Early coverage focused on
white, middle-class women, as scientific authorities and government officials warned
against drinking during pregnancy. After 1987, however, women who drank during
pregnancy were depicted as members of minority groups and as a danger to society.
The thematic transition began before warning labels appeared on alcoholic beverages
and gained strength from official government efforts to prevent fetal alcohol
syndrome. The greatest impetus for the revised discourse, however, was the eruption
of a “moral panic” over crack cocaine use. By linking fetal harm to substance abuse,
the panic suggested it was in the public’s interest to control the behavior of pregnant
women.
Hawke, M. (2202). FAS: an ounce of
prevention. Nursing Spectrum (Greater
Philadelphia/Tri-State Edition), 11(24), 1011.
In the case of fetal alcohol syndrome (FAS), prevention is the cure. “FAS is 100%
preventable if the mother doesn’t drink alcohol during pregnancy. While we know the
cause and effects, what we don’t know is the minimum amounts of alcohol required to
produce FAS and other alcohol-related disorders. FAS is often misdiagnosed and the
treatment is delayed because the diagnosis so greatly depends on the disclosure of the
mother’s alcohol use during pregnancy. The importance of early diagnosis is
discussed.
Hicks, M., Sauve, R., Lyon, A., Clarke, M.,
& Tough, S. (2003). Alcohol use and abuse
in pregnancy: an evaluation of the merits
of screening. The Canadian Child and
Adolescent Psychiatry Review, 12(3), 77-80.
This article briefly reviews the evidence for screening for alcohol use and abuse in the
perinatal period using the WHO criteria. There is some evidence of the benefits of
such a program but limited evidence of the effectiveness of screening tools,
interventions, and the current capacity of the health care and mental health systems to
deal with individuals identified at risk. This review highlights the importance of using
standardized screening methods for alcohol use and abuse during pregnancy and with
women of childbearing age.
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Fetal Alcohol Syndrome Diagnosis, Management and Prevention
Citation
Significance
Applebaum, N. G. (1995). Fetal alcohol
syndrome: diagnosis, management and
prevention. Nurse Practitioner, 20 (10), 2433.
Fetal alcohol syndrome (FAS) and fetal alcohol effects (FAE) encompass a pattern of
birth defects in persons whose mother ingested alcohol during pregnancy. Persons
with FAE display fewer of the FAS traits. The hallmarks of FAS are pre- and postnatal
growth retardation, central nervous system dysfunction, and characteristic facial
dysmorphology. However, its effects can be multi-systemic -- encompassing the
cardiac, skeletal, and muscular systems, as well as presenting as lack of coordination,
hyperactivity, diminished or distorted sense of danger, and lack of ability to function
as an independent adult. The frequent incidence of this constellation of symptoms has
a far-reaching impact (familial, medical, educational, and societal) because a myriad
of professionals and large amounts of funding are used to help manage FAS/FAE
children and adults. This article identifies, for a primary care provider, the essential
characteristics of FAS/FAE and discusses available management options. Early
diagnosis and continued education are advantageous at all levels, benefiting the
individual and all of society.
Astley, S. J. & Clarren, K. (2000).
Diagnosing the full spectrum of fetal
alcohol exposed individuals introducing
the 4-digit diagnostic code. Alcohol and
Alcoholism, 35(4), 400-410.
The medical/research records of 1,014 patients diagnosed at the Washington State
FAS Diagnostic and Prevention Network of clinics were used to develop a new,
comprehensive reproducible method for diagnosing the full spectrum of outcomes
among patients with prenatal alcohol exposure. This new diagnostic method, called the
4-Digit Diagnostic Code, was compared to the standard method of diagnosis. The 4Digit Diagnostic Code more accurately and comprehensively documented the
outcomes of the patients. The four digits in the code reflect the magnitude of
expression of the four key diagnostic features of FAS in the following order: (1)
growth deficiency, (2) the FAS facial phenotype, (3) central nervous system
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damage/dysfunction, and (4) gestational alcohol exposure. The 4-Digit Diagnostic
Code is being used effectively for diagnosis, screening, and surveillance efforts n all
Washington State FAS DPN clinics
Astley, S. J. Stachowiak, et al. (2002).
Application of the Fetal alcohol syndrome
facial screening tool in a foster care
population. Journal of Pediatrics, 141(5),
712-717.
The researchers determined the prevalence of fetal alcohol syndrome (FAS) in a foster
care population and evaluated the performance of the FAS Facial Photographic
Screening Tool. All children enrolled in a Washington State Foster Care Program were
screened for three conditions.
The prevalence of FAS in this foster care population was 10 to 15/1000, or 10 to 15
times greater than in the general population. They conclude that the foster car
population is a high-risk population for FAS. The screening tool performed with very
high accuracy and could be used to track FAS prevalence over time in foster care to
accurately assess the effectiveness of primary prevention efforts.
Effects of Fetal Alcohol Syndrome
Citation
Significance
Adams, J., Bittner, P., Buttar, H., Chambers,
C., Collins, T. Daston, G., et al. (2002).
Statement of the Public Affairs Committee
of the Teratology Society on the fetal
alcohol syndrome. Teratology, 66(6), 344347.
This statement acknowledges that although there are numerous gaps in knowledge
when considering the full spectrum of effects of prenatal exposure to alcohol, several
unresolved problems relating to the diagnosis and prevention of the most severe end of
the spectrum, fetal alcohol syndrome are of particular importance. The following five
points are of particular importance. (1) Improved recognition of FAS, (2) Identifying
neurobehavioral effects associated with prenatal exposure to alcohol, (3) Determining
risks of heavy alcohol consumption during early pregnancy, (4) Risk factors for and
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prevention of FAS, (5) Social and economic factors associated with prevalence and
prevention of FAS.
American Academy of Pediatrics (2000).
Fetal alcohol syndrome and alcoholrelated neurodevelopmental disorders.
Pediatrics, 106 (2 part 1), 358-361.
Prenatal exposure to alcohol is one of the leading preventable causes of birth defects,
mental retardation, and neurodevelopmental disorders. In 1973, a cluster of birth
defects resulting from prenatal alcohol exposure was recognized as a clinical entity
called fetal alcohol syndrome. More recently, alcohol exposure in utero has been
linked to a variety of other neurodevelopmental problems, and the terms alcoholrelated neurodevelopmental disorder and alcohol-related birth defects have been
proposed to identify infants so affected. This statement is an update of a previous
statement by the American Academy of Pediatrics and reflects the current thinking
about alcohol exposure in utero and the revised effects.
Chambers, C., & Jones, K. (2002). Is
genotype important in predicting the fetal
alcohol syndrome? Journal of Pediatrics,
141 (6), 751-753.
A number of factors have been identified during the last few years that appear to be
important predictors of whether a woman who drinks alcohol during pregnancy will
have a baby with the fetal alcohol syndrome. None of these appear to be more
complex, more difficult to understand, and potentially more important, than the
alcohol metabolizing genes. African American race/ethnicity was previously
suggested to be a risk factor for FAS, because of a certain gene. Non African
American women with the same gene were found to have significantly higher chance
of having infants with growth retardation and/or facial features of FAS.
Clark, C., Li, D., Conry, J., Conry, R., &
Loock, C. (2000). Structural and functional
brain integrity of fetal alcohol syndrome
in non-retarded case. Pediatrics, 105 (5),
1096-1099.
The purpose of this research study was to determine the structural and functional
integrity of the brain in a sample of non-retarded individuals with fetal alcohol
syndrome. The results of this study when coupled with previous findings suggest a
continuum of neuropathology in fetal alcohol syndrome. For cases with relatively mild
intellectual deficits, the cause of the deficit is at a micro-level rather than a macrolevel. For these individuals, the effects of maternal alcohol consumption, behaviorally
and neuropathologically, may be subtler but still disabling.
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Kenner, C., & D’Apolito, K. (1997).
Outcomes for children exposed to drugs in
utero. JOGNN -Journal of Obstetric,
Gynecologic, & Neonatal Nursing, 26 (5),
595-603.
Substance abuse among pregnant women remains a national health issue. The
incidence of infants born addicted to licit and illicit substances is increasing. The longterm outcomes have not been consistently documented. These appear to include mild
to severe developmental and cognitive problems, depending upon the substance used.
Central nervous system problems, behavioral dysfunction, and safety issues are major
parental concerns for these children as they grow. Interventions must be aimed at
thorough assessments, including an accurate maternal history, use of supports for
positive neurodevelopment, parent education about infant/child cues, and
encouragement of educational environments that are highly structured and safe.
Consistent, long-term follow-up is essential to optimize long-term outcomes
Prevalence of Fetal Alcohol Syndrome
Citation
Significance
Centers for Disease Control. (2002). Fetal
alcohol syndrome – Alaska, Arizona,
Colorado, and New York, 1995-1997.
MMWR – Morbidity & Mortality Weekly
Report, 51 (20). 433-435.
This report demonstrates that maternal alcohol use during pregnancy continues to
affect children. Recent data indicate that the prevalence of binge (i.e., >5 drinks on
any one occasion) and frequent drinking (i.e., > 7 drinks per week or >5 drinks on any
one occasion) during pregnancy reached a high point in 1995 and has not declined.
Ongoing, consistent, population-based surveillance systems are necessary to measure
the occurrence of FAS and the impact of FAS prevention activities. One of the
national health objectives for 2010 is to reduce the occurrence of FAS; however, no
national surveillance program exists to evaluate progress in achieving this objective.
May, P., & Gossage, J. (2001). Estimating
the prevalence of fetal alcohol syndrome:
Discusses methods of estimating the prevalence of fetal alcohol syndrome (FAS).
Three main types of research methods used to study FAS are passive surveillance,
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A summary . Alcohol Health & Research
World, 25 (3), 159-167.
clinic-based studies, and active case ascertainment. Researchers using passive systems
use existing records, including birth certificates, special registries for children with
developmental disabilities or birth defects, and medical charts of hospitals and
physicians. Clinic-based studies are generally conducted in prenatal clinics of large
hospitals where researchers can collect data from mothers during their pregnancies.
Active case ascertainment studies are unique in that they actively seek, find, and
recruit children who may have FAS within the population under study. The maternal
risk factors associated with FAS and other alcohol-related anomalies include advanced
maternal age, low SES, frequent binge drinking, family and friends with drinking
problems, and poor social and psychological indicators. Literature indicates a FAS
prevalence rate of 0.5-2 cases per 1,000 births in the US during the 1980s and 1990s.
Fetal Alcohol Syndrome and Families
Citation
Significance
Hess, D., & Kenner, C. (1998). Families
caring for children with fetal alcohol
syndrome: the nurse’s role in early
identification and intervention. Holistic
Nursing Practice, 12 (3), 47-54.
Alcohol is a teratogenic substance that, when ingested during pregnancy, may cause
the fetus to be born with a condition known as fetal alcohol syndrome (FAS). FAS is a
life-long condition that leads to serious primary and secondary disabilities. Holistic
early identification and intervention for children with FAS and their families may
ameliorate the secondary disabilities associated with FAS. Nurses working with
families and young children could play a key role in early identification and
intervention for children with FAS.
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Fetal Alcohol Syndrome and Native Americans
Citation
Significance
Indian and Inuit Health Committee &
Society. (2002). Fetal alcohol syndrome.
Paediatrics & Child Health, 7(3), 161-174.
Although FAS is found in all socioeconomic groups in Canada, it has been observed at
high prevalence in select First nations and Inuit communities in Canada. Although all
races are susceptible, FAS is disproportionately higher among American Indian
offspring. This statement addresses FAS prevention, diagnosis, early identification and
management. Interventions focus on optimizing development, managing behavioral
difficulties and providing appropriate school programming. Of prime importance is
earliest possible childhood intervention to prevent secondary disabilities that may
result from delay while awaiting a definitive diagnosis of FAS.
Robinson, G., Armstrong, R. Moczuk, I. &
Loock. (1992). Knowlede of fetal alcohol
syndrome among native Indians. Canadian
Journal of Public Health, 83 (5), 337-338.
This report on a survey of native Indians revealed limited teaching about alcohol.
Nevertheless, virtually all were aware of the danger of maternal drinking during
pregnancy. The majority said they had heard of FAS but major gaps existed in
knowledge about causation, characteristics and implications of FAS.
Fetal Alcohol Syndrome Surveys
Citation
Significance
Diekman, S. Floyd, R., Decoufle, P.
Schulkin, J., Ebrahim, S., & Sokol, R.
(2000). A survey of obstetricians-
This survey was conducted to examine knowledge, attitudes, current clinical practices,
and educational needs of obstetrician-gynecologists regarding patients' alcohol use
during pregnancy. METHODS: A 20-item, self-administered questionnaire on
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gynecologists on their patient’s alcohol use
during pregnancy. Obstetrics &
Gynecology, 95(5), 756-763.
patients' prenatal alcohol use was sent to 1000 active ACOG fellows. Responses were
analyzed using univariate and multivariate statistical techniques. RESULTS: Of the
60% of the obstetrician-gynecologists who responded to the survey, 97% reported
asking their pregnant patients about alcohol use. When a patient reports alcohol use,
most respondents reported that they always discuss adverse effects and always advise
abstinence. One fifth of the respondents (20%) reported abstinence to be the safest
way to avoid all four of the adverse pregnancy outcomes cited (i.e., spontaneous
abortion, central nervous system impairment, birth defects, and fetal alcohol
syndrome); 13% were unsure about levels associated with all of the adverse outcomes;
and 4% reported that consumption of eight or more drinks per week did not pose a risk
for any of the four adverse outcomes. The two resources that respondents said they
needed most to improve alcohol-use assessment were information on thresholds for
adverse reproductive outcomes (83%) and referral resources for patients with alcohol
problems (63%). CONCLUSION: Efforts should be made to provide practicing
obstetrician-gynecologists with updates on the adverse effects of alcohol use by
pregnant women and with effective methods for screening and counseling women who
report alcohol use during pregnancy.
Tough, S., Clarke, M & Hicks, M. (2003).
Knowledge and attitudes of Canadian
Psychiatrists regarding fetal alcohol
spectrum disorder. The Canadian Child and
Adolescent Psychiatry Review, 12 (3), 64-71.
This study represents the first survey of psychiatrists in the area of knowledge,
attitudes and practices related to FASD in Canada. The results revealed that there is a
great need to help psychiatrists recognize the primary and secondary disabilities of
FASD especially in affected individuals who do not have mental retardation or
dysmorphic features as part of their diagnosis. There will be a great need in the future
for psychiatrists to work closely with colleagues in the fields of addictions, pediatrics
and neuropsychology to develop a comprehensive multidisciplinary approach to this
significant and ultimately preventable condition.
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Historical Perspective of Fetal Alcohol Syndrome
Citation
Significance
Golden, J. (1999). An argument that goes
back to the womb: The demedicalization
of fetal alcohol syndrome. Journal of Social
History, 33 (2), 269-298.
This article provides a cultural history of fetal alcohol syndrome (FAS) from its
naming in 1973 until the 1990s, when it began to be cited in appeals from death-row
inmates. It argued that FAS was demedicalized as physicians gradually lost the
cultural authority to frame its public meaning. Under the leadership of government
officials & legal professionals, & in response to growing public mistrust of the
medicalization of deviance, FAS came to be understood not as a cluster of precisely
delineated symptoms, but as a social deformity that expressed the moral failings of
mothers & marked their children as politically marginal & potentially dangerous.
Critical to this reframing of FAS was its identification with a racial minority - Native
Americans - its interpretation as an expression of maternal/fetal conflict, & its
economic & social costs. In charting the demedicalization of FAS, popular portrayals
of the syndrome as well as professional literatures are examined
Wekselman, K., Spiering, K., et. al., (1995).
Fetal alcohol syndrome from infancy
through childhood: a review of the
literature. Journal of Pediatric Nursing,
10(5), 296-303.
This review discusses how because fetal alcohol syndrome (FAS), or fetal alcohol
effects (FAE), is being diagnosed in growing numbers of children, there is more
interest in their common characteristics and how they change throughout childhood.
Few longitudinal studies that describe the common childhood course of FAS address
appropriate interventions. Some literature exists that describes follow-up and support
services needed by these children and their families. This article examines the
common childhood course of FAS/FAE and the interventions and services needed to
promote positive child and family health
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State Fetal Alcohol Syndrome Programs
Citation
Significance
Baumeister, A., & Hamlett, C. (1996). A
national survey of state – sponsored
programs to prevent fetal alcohol
syndrome. Mental Retardation. 24(3), 169173.
This is a report of a survey that was conducted to ascertain the extent to which
programs have been undertaken to prevent fetal alcohol syndrome and/or fetal alcohol
related birth defects. A questionnaire was sent to the public health departments in each
state and the District of Columbia. Telephone follow-up interviews were conducted.
Data were combined with respect to the nature and costs of fetal alcohol syndrome
(and fetal alcohol effects) prevention programs. Other information was elicited
concerning perception of fetal alcohol effects as a health problem. The major
conclusion was that, as a whole, state governments have not made a sustained
commitment to the prevention of fetal alcohol syndrome. There are some instructive
exceptions, however. Several states have initiated programs that could serve as a
model for a national effort. These data, scant as they are, suggest that a properly
focused and balanced prevention program can reduce maternal alcohol consumption.
Centers for Disease Control, (2002). Fetal
alcohol syndrome – Alaska, Arizona,
Colorado, and New York, 1995-1997.
MMWR – Morbidity & Mortality Weekly
Report (1998). 47(40), 861-864.
This report documents one program’s efforts to identify a population likely to have
undiagnosed effects of in utero alcohol exposure. The birth mothers of these persons
are a high-risk target population (women who have already given birth to an alcohol
affected child) for primary prevention, although neither the mothers not their health
care providers may realize their potential for producing subsequent affected children.
The University of Washington is implementing a primary prevention intervention for
these women that will rely on identification through early diagnosis of FAS in their
children. For most patients in this study, an alcohol related diagnosis had never been
considered in any other medical or mental setting, and only 22% were referred by a
health care provider for further diagnostic services. This may be because the syndrome
manifests itself in ways that may not be recognized in the traditional medical setting.
As a result, multidisciplinary diagnostic clinics staffed by a physician, psychologist,
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language pathologist, occupational therapist, a social worker may facilitate the proper
diagnosis of conditions in patients who have not been appropriately identified in other
clinical settings.
National Fetal Alcohol Syndrome Task Force Reports
Citation
Significance
U S Public Health Service, (2000). Records
of the Meeting of the National Task Force
on Fetal Alcohol Syndrome and Fetal
Alcohol Effect. Atlanta
This was the first meeting of the National Task Force on Fetal Alcohol Syndrome
(FAS) and Fetal Alcohol Effect (FAE), held on December 14-15, 2000. In addition to
the Task Force members and the CDC staff, representatives of Federal agencies,
partner organizations and interested members of the public attended the meeting. They
reviewed the committee’s mandate to advise and provide information and
recommendations on FAS and FAE to educate professional and paraprofessionals, the
lay public, and individuals at potential risk, and to prevent FAS and FAE. CDC
support was pledged. It was announced that the Division of Birth Defects and
Developmental Disabilities, now siting the FAS/FAE activity, will soon become a
separate CDC Center for Birth Defects and Developmental Disabilities.
U S Public Health Service, (2001). Records
of the Meeting of the National Task Force
on Fetal Alcohol Syndrome and Fetal
Alcohol Effect. Atlanta
At this second meeting The Task Force discussed the lack of review to ensure the
consistency of the agencies’ FAS/E message. The Visibility Public Awareness
Campaign Workgroup suggested that three basic principles guide the work to raise the
visibility of FAS/E issues. Specific recommendations were to: 1) develop a broadbased national communication plan to convey that FAS/E is a preventable disability,
2) seek and secure national spokespersons, 3) produce a document based on parents’
and other caregivers’ experience, 4) activate an FAS/E Public Awareness Training
Team to present at major conferences /meetings around the country, and 5) work
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closely with other ICCFAS members and Task Force Workgroups.
U S Public Health Service, (2002). Records
of the Meeting of the National Task Force
on Fetal Alcohol Syndrome and Fetal
Alcohol Effect. Atlanta
At this meeting of the National Task Force on Fetal Alcohol Syndrome and Fetal
Alcohol Effect, the Task Force was joined by liaisons from state health departments,
academia, and other organizations such as the National Organization of Fetal Alcohol
Syndrome (NOFAS), the Center for Science in the public interest, the American
College of Obstetrics and Gynecology (ACOG), the American Academy of Family
Practitioners (AAFP) and the American Academy of Pediatrics (AAP). Reports from
the Scientific Working Group subgroups were made to the Task Force. These included
reports form the Screening and Diagnosis of FAS subgroup, the Essential Services for
Children with FAS and ARND Subgroup, the Screening and Diagnosis of ARND
Subgroup, ant the Screening and Intervening in Prenatal Alcohol Use Subgroup. Other
presentations included a report on the SAMSA/CSAP stakeholders meetings and town
hall meetings, agency updates by NIAA and CDC, a report on key concerns of
biological mothers of children with FAS, and a presentation on Health Canada’s FAS
activities. An overview of the newly created Scientific Working Group on Diagnostic
Guidelines for FAS and ARND was provided. The Subgroup recommended a presence
in every state to ensure that the systems serving children and families receive materials
and education on FAS.
Weber, M., Floyd, R, et al. (2002). National
Task Force on Fetal Alcohol Syndrome
and Fetal Alcohol Effect: defining the
national agenda for fetal alcohol syndrome
and other prenatal alcohol-related effects.
MMWR –Morbidity & Mortality Weekly
Report, 51(RR-14), 9-12.
Prenatal alcohol exposure can lead to serious birth defects and developmental
disabilities. A need exists to develop effective strategies for both children with fetal
alcohol syndrome (FAS) or other prenatal alcohol-related effects and for women at
high risk for having an alcohol-exposed pregnancy. Since the syndrome was identified
approximately 30 years ago, advancements have been made in FAS diagnostics,
surveillance, prevention, and intervention, but a substantial amount of work remains.
Collaborations among partners in federal, state, and local agencies, academia, clinical
professions, school systems, and families are critical to developing and implementing
successful efforts related to FAS and fetal alcohol effect (FAE). In 1999, Congress
directed the Secretary of the U.S. Department of Health and Human Services to
convene the National Task Force on FAS and FAE (the Task Force). CDC's National
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Center on Birth Defects and Developmental Disabilities, Fetal Alcohol Syndrome
Prevention Team, coordinates the Task Force and manages its operation. Since the
Task Force was chartered in 2000, Task Force members, with input from multiple
partners, have convened to deliberate and determine the Task Force mission, goals,
and priority concerns to be addressed. This report describes the structure, function,
mission, and goals of the Task Force and provides their first recommendations. An
explanation of how the Task Force recommendations were generated and the Task
Force's next steps are also reported.
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