Can Fetal Alcohol Syndrome be distinguished by doctors and is there a test that can be performed to help with the diagnosis?
Significant exposure to alcohol during pregnancy to an infant may be associated with a broad spectrum of developmental problems that can range from learning disabilities to severe mental retardation. In order to properly make the diagnosis of Fetal alcohol syndrome, there should be documented prenatal maternal alcohol consumption as well as some of the following signs and symptoms:
The diagnosis of both fetal alcohol syndrome and ARND is usually made over time because the developmental delay may be in apparent until the child reaches the age of 2 or 3 years. This delay in clinical manifestations is what makes the diagnosis of FAS and ARND a medical challenge. Many times denial of alcoholism makes it even more difficult to elicit a prenatal history from the mother. Alcohol exposed children are usually placed in foster care and usually the foster parents do not have access to the medical history.
In cases of international adoption, this lack of history is even more compounded by the fact that many of these children are abandoned at birth with no birth history and the prevalence of alcohol abuse (especially in Eastern Europe ) is quite high.
Facial features of FAS should include at least two of the following:
Growth delay may occur prenatal or postnatal period or both. The typical pattern is as follows:
Behavioral problems are usually the most problematic issues that families experience. As infants, these babies are hyperirritable and have a poor wake- sleep pattern. Older children tend to become over stimulated in social situations. Sometimes this hypersensitivity can be mistaken to be mood swings or aggression. Children with FAS have a high incidence of ADHD or attention deficit disorder. Some times care givers describe these children as hard headed or anti-social.
As one can imagine, it is extremely difficult to make a diagnosis of FAS or ARBD in a patient during a live physical exam. This diagnosis is even more difficult to make in an International adoption consultation by reviewing the medical record, growth parameters and video recording. Unfortunately, there is no one test that can make the diagnosis of FAS. Diagnosis is generally made by a good history and physical examination. These disorders are life long disabilities, but with early identification and interventions, many of these children can be help to function properly in society.
The information and advice provided is intended to be general information, NOT as advice on how to deal with a particular child's situation and or problem. If your child has a specific problem you need to ask your pediatrician about it - only after a careful history and physical exam can a medical diagnosis and/or treatment plan be made. This Web site does not constitute a physician-patient relationship.
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© George Rogu, M.D.
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