DOI: 10.1542/aapnews.2012339-18a2012;33;18AAP News 

AAP Division of Children with Special NeedsAAP endorses statement on alcohol-related neurodevelopmental disabilities

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from the AAP Division of Children with Special Needs

The Academy has endorsed a statement that recom-mends primary health care clinicians screen for alcohol-related neurodevelopmental disorders in children.

Prenatal exposure to alcohol is one of the leadingpreventable causes of birth defects, mental retardation and neurodevel-opmental disorders. An estimated 0.2 to 1.5 cases of fetal alcohol syn-drome (FAS) occur in every 1,000 live births in the United States, accord-ing to the Centers for Disease Control and Prevention (CDC)(www.cdc.gov/ncbddd/fasd/data.html). Since FAS refers to the mostseverely affected children, these figures are considered an underestimationof the prevalence of the broad range of harmful effects from prenatalalcohol exposure, including growth delay, physical malformations,mental and behavioral problems, and learning disabilities.

Fetal alcohol spectrum disorders (FASDs) is the umbrella term usedto describe the full range of damage from prenatal alcohol exposure. Itincludes the diagnoses of FAS and alcohol-related neurodevelopmentaldisorder (ARND), which describes conditions in which there is a historyof maternal alcohol exposure (defined as substantial regular intake orheavy episodic drinking) and an outcome validated by clinical or animalresearch to be associated with that exposure. FASDs last a lifetime, andthere is no cure. Early recognition, intervention and treatment can improvethe lives of affected children and their families.

To coordinate federal strategies to address FAS/ARND more effectively,the National Institutes of Health’s National Institute on Alcohol Abuseand Alcoholism established the Interagency Coordinating Committeeon Fetal Alcohol Syndrome (ICCFASD). The ICCFASD convened aconference in November 2011 to develop recommendations on whetherto encourage screening and diagnosis (or referral for diagnosis) of ARNDin primary health care of children.

The result was the consensus statement, Recognizing Alcohol-RelatedNeurodevelopmental Disorder (ARND) in Primary Health Care of Children,www.niaaa.nih.gov/sites/default/files/ARNDConferenceConsensusStatementBooklet_Complete.pdf. The statement was developed by a multi-disciplinary, independent panel that evaluated evidence presented byexperts in the field of ARND. The panel was chaired by Joseph F. Hagan

Jr., M.D., FAAP, co-editor of Bright Futures: Guidelines for Health Super-vision of Infants, Children, and Adolescents, Third Edition. It also includeddevelopmental-behavioral pediatricians Paul H. Lipkin, M.D., FAAP,Lisa Albers Prock, M.D., M.P.H., FAAP, and Carol Weitzman, M.D.,FAAP.

“Astute primary care pediatricians have long known that children areaffected by fetal alcohol exposure without showing the classic signs ofFAS,” Dr. Hagan said. “Developing a definition of ARND begins a newunderstanding of children and adults affected by in utero alcohol exposure,which will lead to better understanding of how to diagnose patients‘without the face’ of FAS and allow treatment programs to be developedand tested.”

In addition to participating in the development of the statement, theAcademy has undertaken an FASD initiative through the Program toEnhance the Health and Development of Infants & Children. The ini-tiative, a cooperative agreement with the CDC’s National Center onBirth Defects and Developmental Disabilities, seeks to educate healthcare professionals about FASDs and their potential lifelong implications.It also seeks to train professionals on recognizing the signs and symptomsfor early intervention to achieve the best possible outcome.

In the coming year, the Academy will lead the effort to further definecriteria for diagnosing ARND and continue to encourage pediatriciansto promote the healthiest choices to achieve optimal health of familiesand children.

AAP endorses statement on alcohol-relatedneurodevelopmental disabilities

• Enroll in the new PediaLink course, Fetal Alcohol Spectrum Disorders: Iden-tification and Management, at www.pedia link.org. • For more information about the Academy’s fetal alcohol spectrum disordersprogram, contact Faiza Khan, in the AAP Division of Children with SpecialNeeds, at 800-433-9016, ext. 4924, or fkhan@aap.org.

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DOI: 10.1542/aapnews.2012339-18a2012;33;18AAP News 

AAP Division of Children with Special NeedsAAP endorses statement on alcohol-related neurodevelopmental disabilities

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