52 Describing Characteristics Typical to Adolescents with Fetal Alcohol Spectrum Disorder (FASD): A Pilot Study

Caused by prenatal exposure to alcohol, Fetal Alcohol Spectrum Disorder (FASD) is a serious physical and neuro-developmental disorder. Fetal Alcohol Spectrum Disorder includes the full Fetal Alcohol Syndrome (FAS), Partial FAS (PFAS), Alcohol Related Neurodevelopmental Disorder (ARND) and Alcohol Related Birth Defects (ARBD). The terms PFAS and ARND are used to describe cases of lesser severity in terms of cognitive function and organ anomalies, but often with very serious evidence of neurotoxicity.

While past research describes the typical profile of the child with FASD, there is a paucity of literature that describes characteristics specific to adolescents.

To describe the typical characteristics of FASD that present in adolescents.

Research Design: A prospective cohort research design was used.

Sample and Setting: Participants 13 to 18 years old, referred to St. Michael's Hospital (SMH), Toronto, FASD diagnostic clinic since November 2002 (n=12).

Data Collection: A 13 page intake and diagnostic form, and a detailed physical examination and history were used to collect data on prenatal alcohol history, school and/or work history, behavioral problems, neuro-psychological profile, FAS facial features, physical health, and growth of each of the participants.

Data Analysis: Content analysis of the data obtained in the intake form and the written physical examination was conducted.

Twelve adolescents ages 13 to 18 years old (mean=15.2 years) participated in the pilot study. All of the participants had a significant history of prenatal alcohol exposure although none had been diagnosed with FAS or other alcohol related disorders prior to entering the SMH diagnostic clinic. One adolescent (8.3%) had full Fetal Alcohol Syndrome, and 11 (91.7%) had alcohol-related neuro-developmental disorder. Five (42%) of the participants had some facial features, and one (8.3%) had growth –height, weight, and head circumference – below the 3rd percentile. Six (50%) of the adolescents had IQs less than 80. Of those in school (67%), keeping up with age appropriate peers was an ongoing challenge because of problems in memory and attention, and motivation. All of the participants had significant behavioral problems including aggressiveness, lying, stealing, alcohol and drug abuse, or risk taking behaviours.

This study highlights the importance of taking a perinatal alcohol history in adolescents with major developmental, behavioral or mental health problems. The results of this pilot study also support implementation of a Canadian-wide study of adolescents referred to FASD diagnostic clinics.