Prevalence and epidemiologic characteristics of FASD from various research methods with an emphasis on recent in-school studies

Authors

  • Philip A. May,

    Corresponding author
    1. Department of Sociology, The University of New Mexico, Albuquerque, New Mexico
    2. Department of Family and Community Medicine, The University of New Mexico, Albuquerque, New Mexico
    3. Center on Alcoholism, Substance Abuse, and Addictions, The University of New Mexico, Albuquerque, New Mexico
    • CASAA, 2650 Yale Boulevard SE, Albuquerque, NM 87106, USA
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  • J. Phillip Gossage,

    1. Center on Alcoholism, Substance Abuse, and Addictions, The University of New Mexico, Albuquerque, New Mexico
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  • Wendy O. Kalberg,

    1. Center on Alcoholism, Substance Abuse, and Addictions, The University of New Mexico, Albuquerque, New Mexico
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  • Luther K. Robinson,

    1. Department of Pediatrics, School of Medicine, State University of New York at Buffalo, Buffalo, New York
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  • David Buckley,

    1. Center on Alcoholism, Substance Abuse, and Addictions, The University of New Mexico, Albuquerque, New Mexico
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  • Melanie Manning,

    1. Department of Pediatrics, School of Medicine, Stanford University, Stanford, California
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  • H. Eugene Hoyme

    1. Department of Pediatrics, Sanford School of Medicine, University of South Dakota, Sioux Falls, South Dakota
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Abstract

Researching the epidemiology and estimating the prevalence of fetal alcohol syndrome (FAS) and other fetal alcohol spectrum disorders (FASD) for mainstream populations anywhere in the world has presented a challenge to researchers. Three major approaches have been used in the past: surveillance and record review systems, clinic-based studies, and active case ascertainment methods. The literature on each of these methods is reviewed citing the strengths, weaknesses, prevalence results, and other practical considerations for each method. Previous conclusions about the prevalence of FAS and total FASD in the United States (US) population are summarized. Active approaches which provide clinical outreach, recruitment, and diagnostic services in specific populations have been demonstrated to produce the highest prevalence estimates. We then describe and review studies utilizing in-school screening and diagnosis, a special type of active case ascertainment. Selected results from a number of in-school studies in South Africa, Italy, and the US are highlighted. The particular focus of the review is on the nature of the data produced from in-school methods and the specific prevalence rates of FAS and total FASD which have emanated from them. We conclude that FAS and other FASD are more prevalent in school populations, and therefore the general population, than previously estimated. We believe that the prevalence of FAS in typical, mixed-racial, and mixed-socioeconomic populations of the US is at least 2 to 7 per 1,000. Regarding all levels of FASD, we estimate that the current prevalence of FASD in populations of younger school children may be as high as 2–5% in the US and some Western European countries. © 2009 Wiley-Liss, Inc. Dev Disabil Res Rev 2009; 15:176–192.

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