Updated clinical guidelines for diagnosing fetal alcohol spectrum disorders

H. Eugene Hoyme, Wendy O. Kalberg, Amy J. Elliott, Jason Blankenship, David Buckley, Anna Susan Marais, Melanie A. Manning, Luther K. Robinson, Margaret P. Adam, Omar Abdul-Rahman, Tamison Jewett, Claire D. Coles, Christina Chambers, Kenneth L. Jones, Colleen M. Adnams, Prachi E. Shah, Edward P. Riley, Michael E. Charness, Kenneth R. Warren, Philip A. May

Research output: Contribution to journalArticle

181 Scopus citations

Abstract

The adverse effects of prenatal alcohol exposure constitute a continuum of disabilities (fetal alcohol spectrum disorders [FASD]). In 1996, the Institute of Medicine established diagnostic categories delineating the spectrum but not specifying clinical criteria by which diagnoses could be assigned. In 2005, the authors published practical guidelines operationalizing the Institute of Medicine categories, allowing for standardization of FASD diagnoses in clinical settings. The purpose of the current report is to present updated diagnostic guidelines based on a thorough review of the literature and the authors' combined expertise based on the evaluation of >10 000 children for potential FASD in clinical settings and in epidemiologic studies in conjunction with National Institute on Alcohol Abuse and Alcoholism-funded studies, the Collaborative Initiative on Fetal Alcohol Spectrum Disorders, and the Collaboration on FASD Prevalence. The guidelines were formulated through conference calls and meetings held at National Institute on Alcohol Abuse and Alcoholism offices in Rockville, MD. Specific areas addressed include the following: precise definition of documented prenatal alcohol exposure; neurobehavioral criteria for diagnosis of fetal alcohol syndrome, partial fetal alcohol syndrome, and alcohol-related neurodevelopmental disorder; revised diagnostic criteria for alcoholrelated birth defects; an updated comprehensive research dysmorphology scoring system; and a new lip/philtrum guide for the white population, incorporating a 45-degree view. The guidelines reflect consensus among a large and experienced cadre of FASD investigators in the fields of dysmorphology, epidemiology, neurology, psychology, developmental/ behavioral pediatrics, and educational diagnostics. Their improved clarity and specificity will guide clinicians in accurate diagnosis of infants and children prenatally exposed to alcohol.

Original languageEnglish (US)
Article numbere20154256
JournalPediatrics
Volume138
Issue number2
DOIs
StatePublished - Aug 2016
Externally publishedYes

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Fingerprint Dive into the research topics of 'Updated clinical guidelines for diagnosing fetal alcohol spectrum disorders'. Together they form a unique fingerprint.

  • Cite this

    Hoyme, H. E., Kalberg, W. O., Elliott, A. J., Blankenship, J., Buckley, D., Marais, A. S., Manning, M. A., Robinson, L. K., Adam, M. P., Abdul-Rahman, O., Jewett, T., Coles, C. D., Chambers, C., Jones, K. L., Adnams, C. M., Shah, P. E., Riley, E. P., Charness, M. E., Warren, K. R., & May, P. A. (2016). Updated clinical guidelines for diagnosing fetal alcohol spectrum disorders. Pediatrics, 138(2), [e20154256]. https://doi.org/10.1542/peds.2015-4256