TITLE:
Relationships between Fetal Alcohol Spectrum Disorder, Adverse Childhood Experiences, and Neurodevelopmental Diagnoses
AUTHORS:
Bradley J. Conant, Anne Sandstrom, Mariah Jorda, Marilyn G. Klug, Larry Burd
KEYWORDS:
Fetal Alcohol Spectrum Disorder, Adverse Childhood Experiences, Foster Care, Residential Care, Developmental Diagnosis
JOURNAL NAME:
Open Journal of Pediatrics,
Vol.11 No.4,
October
28,
2021
ABSTRACT: Objective: Children
with fetal alcohol spectrum disorder (FASD) are overrepresented in early
intervention programs, foster care, special education, juvenile corrections,
and mental health services. In this study, we examine relationships between
FASD and non-FASD controls for adverse childhood experiences (ACEs), and
neurodevelopmental disorders. Methods: A chart review was conducted among patients seen at our clinic from
2010-2017 with data on FASD, ACEs, neurodevelopmental diagnoses, and foster or
residential care placement available. Results: Relative risk for FASD was increased in patients with increased ACE scores
(RR = 5.08), increased numbers of neurodevelopmental diagnoses (RR = 2.36), and
patients who have been in foster or residential care (RR = 9.53). FASD risk
increased as ACE scores or the number of neurodevelopmental diagnoses increased.
Patients with any ACEs were 3.96 times more likely to have FASD, and those with
eight or more ACEs were 6.31 times more likely to have FASD than those with no
ACEs. Patients with three or more neurodevelopmental diagnoses were 6.55 times
more likely to have FASD than those with two or fewer diagnoses. Nine or more
diagnoses increased the risk for FASD ten-fold (RR = 10.91). Conversely,
patients diagnosed with FASD were more likely to have at least three ACEs (RR =
3.71), at least five neurodevelopmental diagnoses (RR = 1.61), and high rates
of previous foster or residential care placement (RR = 5.39). Conclusion: This study
demonstrates that all children being considered for placement in foster care or
residential should be screened for FASD.