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Research Emphasis Area on Fetal Alcohol Spectrum Disorders

Coordinator: Susan Astley, Ph.D.

Fetal alcohol syndrome (FAS) is a permanent birth defect syndrome caused by maternal alcohol use during pregnancy. It is characterized by growth deficiency, a unique facial phenotype, and central nervous system damage/dysfunction. FAS is the leading known cause of intellectual and developmental disabilities and is entirely preventable. The prevalence of FAS is estimated to be 1 to 3 per 1,000 live births. The number of individuals with prenatal alcohol damage who do not have full FAS is several times greater. The full spectrum of outcomes associated with prenatal alcohol damage is referred to as fetal alcohol spectrum disorders (FASD).

Faculty investigators for the Research Emphasis Area on Fetal Alcohol Spectrum Disorders address six areas of concentration within an interdisciplinary framework:

• First, they seek to develop and test screening and diagnostic tools for accurate and reproducible identification of the full spectrum of disorders associated with fetal alcohol exposure. Research efforts are focused on rigorously testing the performance of the tools (e.g., sensitivity, specificity, predictive value positive, construct validity, test-retest) in clinical and population-based samples. Research efforts are also focused on assessing the diagnostic utility of magnetic resonance imaging (MRI), spectroscopy (MRS), functional MRI (fMRI), and fetal ultrasound. Accurate diagnoses not only lead to more appropriate interventions, but also to more accurate estimates of prevalence over time for assessment of primary prevention efforts.
• Second, investigators are engaged in FASD prevention and intervention research using randomized control trial methodology. The prevention research seeks to assess the efficacy of paraprofessional advocacy programs targeted to high-risk women. Key goals are reduction in alcohol use and improved family planning. The intervention research seeks to assess the efficacy of behavioral consultation and social communication intervention programs targeted to children with FASD, their parents, and their teachers. Key goals are increased parent/teacher skills in meeting the needs of their children and improved child social communication skills.
• A third area of concentration is descriptive research that seeks to elucidate the lifelong cognitive/behavioral profile(s) of individuals with prenatal alcohol exposure. This research is instrumental in setting public health policy for meeting the lifelong needs of these individuals.
• A fourth area of concentration is the study of newborn cerebrovascular responses to maternal alcohol use. This research will further elucidate the pathogenesis of brain damage associated with prenatal alcohol use.
• A fifth area of concentration is the study of sleep disorders in individuals with FASD utilizing the Pediatric Sleep Center Laboratory at Children's Hospital and Regional Medical Center's. "Sleep problems" are a common complaint for children with FASD. In-utero alcohol exposure may cause neurodevelopmental alterations of respiratory control, muscular tone, and midfacial anomalies that can result in sleep disordered breathing, including obstructive sleep apnea.
• A sixth area of concentration is developmental neurotoxicity of ethanol focusing on the effects of prenatal alcohol exposure on interactions between neurons and astrocytes. Astrocytes are glial cells that play an important role during brain development as they regulate neuronal survival, migration, and differentiation. Under investigation are novel mechanisms of astrocyte-neuron interactions relevant to brain development, and how ethanol affects these interactions by influencing the release of proteins and lipids from astrocytes, contributing to the brain injury observed in individuals with FASD

This REA will work closely with two UCEDD programs: the Teratogen Information System and the FAS Diagnostic and Prevention Network.

Faculty Investigators

• Susan Astley, Ph.D., Professor, Epidemiology, Coordinator
• Elizabeth Aylward, Ph.D., Professor, Radiology
• Julia Bledsoe, M.D., Clinical Associate Professor, Pediatrics
• Fred Bookstein, Ph.D., Professor, Statistics and Psychiatry and Behavioral Sciences
• Allison Brooks, Ph.D., Lecturer, College of Education
• Heather Carmichael Olson, Ph.D., Senior Lecturer, Psychiatry and Behavioral Sciences
• Maida Chen, M.D., Acting Assistant Professor, Pediatrics
• Truman Coggins, Ph.D., Associate Professor, Speech and Hearing Sciences
• Paul Connor, Ph.D., Assistant Professor, Psychiatry and Behavioral Sciences
• Julian Davies, M.D., Assistant Professor, Pediatrics
• Jean Deitz, Ph.D., Professor, Rehabilitation Medicine
• Christine Gleason, M.D., Professor, Pediatrics
• Therese Grant, Ph.D., Associate Professor, Psychiatry and Behavioral Sciences
• Marina Guizzetti, Ph.D. Research Scientist, Environmental Health
• Tracy Jirikowic, Ph.D., Postdoctoral Fellow, Lecturer, Rehabilitation Medicine
• Kim Kerns, Ph.D., Associate Professor, Psychology, University of Victoria
• Kenneth Maravilla, M.D., Professor, Radiology
• Lesley Olswang, Ph.D., Professor, Speech and Hearing Sciences
• Todd Richards, Ph.D., Professor, Radiology
• Paul Sampson, Ph.D., Research Professor, Statistics
• Dennis Shaw, Ph.D., Professor, Radiology
• Ann Streissguth, Ph.D., Professor Emeritus, Psychiatry and Behavioral Sciences
• Edward Weinberger, M.D., Professor, Radiology