Although the brain is the developing structure most sensitive to alcohol, the diagnosis of Fetal Alcohol syndrome (FAS), which represents the most severe end of the spectrum of Fetal Alcohol Spectrum Disorders (FASD), is presently dependent, not upon alterations of brain structure or behavior, but upon features identified on a careful physical examination. Over the previous funding periods the Dysmorphology Core has evaluated 345 subjects with FAS, 771 who have been Deferred and 502 with NO FAS at consortium sites throughout the world.
The specific aims of this proposal are to continue to support these activities throughout the renewal period at all consortium sites, to develop a training DVD that could be used to teach physicians and other health care professionals with little or no experience in diagnosis of FASD to successfully diagnose or rule out this disorder, to develop with the help of the Telemedicine Communications Center at the University of California, San Diego (UCSD), a wireless, interactive, audiovisual tele-consultation system that will provide the opportunity for a practitioner in a remote area to perform a comprehensive examination of a child considered to have Fetal Alcohol Spectrum Disorders (FASD) that could be simultaneously viewed, by an expert dysmorphologist at UCSD, and to document the prevalence of major malformations in children prenatally exposed to alcohol, and in so doing, delineate the extent of Alcohol Related Birth Defects (ARBD). Furthermore, the development of a training DVD to teach physicians and other health care providers an approach to diagnosis of FASD will help fill the gap in access to expert diagnosticians. Finally, given the significant morbidity and mortality associated with major structural defects, a rigorous evaluation for Alcohol Related Birth Defects (ARBD) will give important information regarding the need to screen children for these defects based on having been exposed prenatally to alcohol.
Relative to the relevance of this research to public health, through collaboration with other CIFASD projects, we will to delineate the full spectrum of defects that are associated with prenatal alcohol exposure. Only by accomplishing this will it be possible to determine the true incidence of problems that alcohol imposes on the developing human fetus, a requirement for developing and carrying out programs to prevent it.
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|Molteno, Christopher D; Jacobson, Joseph L; Carter, R Colin et al. (2014) Infant emotional withdrawal: a precursor of affective and cognitive disturbance in fetal alcohol spectrum disorders. Alcohol Clin Exp Res 38:479-88|
|Hess, Aaron T; Jacobson, Sandra W; Jacobson, Joseph L et al. (2014) A comparison of spectral quality in magnetic resonance spectroscopy data acquired with and without a novel EPI-navigated PRESS sequence in school-aged children with fetal alcohol spectrum disorders. Metab Brain Dis 29:323-32|
|Nguyen, Tanya T; Glass, Leila; Coles, Claire D et al. (2014) The clinical utility and specificity of parent report of executive function among children with prenatal alcohol exposure. J Int Neuropsychol Soc 20:704-16|
|Ware, Ashley L; Glass, Leila; Crocker, Nicole et al. (2014) Effects of prenatal alcohol exposure and attention-deficit/hyperactivity disorder on adaptive functioning. Alcohol Clin Exp Res 38:1439-47|
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|Glass, Leila; Ware, Ashley L; Crocker, Nicole et al. (2013) Neuropsychological deficits associated with heavy prenatal alcohol exposure are not exacerbated by ADHD. Neuropsychology 27:713-24|
|Ware, Ashley L; O'Brien, Jessica W; Crocker, Nicole et al. (2013) The effects of prenatal alcohol exposure and attention-deficit/hyperactivity disorder on psychopathology and behavior. Alcohol Clin Exp Res 37:507-16|
|Suttie, Michael; Foroud, Tatiana; Wetherill, Leah et al. (2013) Facial dysmorphism across the fetal alcohol spectrum. Pediatrics 131:e779-88|
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