The FAS DPN core site at the University of Washington maintains a comprehensive, confidential database on all patients evaluated at the FAS DPN with patient consent and University of Washington and WA State Human Subjects Review Board approval. The data allows the FAS DPN to:

• Track regional demand for services and diagnostic outcomes over time.
  
• Develop new state-of-the-art screening and diagnostic tools.
  
• Support intervention research that could directly benefit patients and their families.
  

Investigators:
Susan J. Astley, Ph.D., Professor of Epidemiology, Principal Investigator
Heather Carmichael Olson, Ph.D., Child-Clinical Psychologist
Truman Coggins, Ph.D., Associate Professor, Speech Language Pathologist
Tracy Jirikowic, Ph.D., O.T.R./L., Occupational Therapist
Allison Brooks, Ph.D., Licensed Psychologist
Elizabeth Aylward, Ph.D., Professor of Radiology, Neuroimaging Psychologist
Kimberly Kerns, Ph.D., Neuropsychologist
Todd Richards, Ph.D., Professor of Radiology, MRI/S Physicist
Kenneth Maravilla, M.D., Professor of Radiology, Radiologist

Fetal alcohol syndrome (FAS) is a permanent birth defect syndrome caused by maternal drinking during pregnancy. FAS is characterized by growth deficiency, a unique facial phenotype and central nervous system (CNS) damage/dysfunction. The cognitive/behavioral problems in this condition stem from prenatal organic brain damage. Not all individuals with prenatal alcohol exposure suffer brain damage and not all who do suffer brain damage have FAS. The degree of brain damage among individuals with prenatal alcohol exposure may vary from microcellular and neurochemical aberrations to gross structural anomalies. Similarly, cognitive/behavioral dysfunction varies considerably. Teratogenic physical findings in individuals with FAS lend credence to the clinical judgment that their cognitive and behavioral dysfunction is due, in part, to organic brain damage. But without the physical features of FAS or at least a severe expression of brain damage, the injury often goes undiagnosed and unserved.

Magnetic resonance (MR) technology offers non-invasive methods for in vivo assessment of neuroabnormalities. A comprehensive neuropsychological/psychiatric, MR imaging, (MRI), MR spectroscopy (MRS), and functional MRI (fMRI) assessment was administered to children with fetal alcohol spectrum disorders (FASD) to determine if global and/or focal abnormalities could be identified across the spectrum. The four study groups included: 1) FAS/Partial FAS; 2) Static Encephalopathy/Alcohol Exposed (SE/AE); 3) Neurobehavioral Disorder/Alcohol Exposed (ND/AE) diagnosed with the FASD 4-Digit Code; and 4) healthy peers with no prenatal alcohol exposure. Results will be presented in a series of four reports: Part 1: FASD diagnostic and neuropsychological/psychiatric contrasts; Part II: MRI; Part III: MRS, and Part IV: fMRI.

Abstract published by Research Society of Alcoholism, 2006. Overall Preliminary Results.

Four manuscripts submitted to a medical journal for review/publication.
Part I: FASD Diagnostic and Neuropsychological and Psychiatric Contrasts [Abstract].
Part II: MRI Outcomes [Abstract].
Part III: MRS Outcomes [Abstract].
Part IV: fMRI Outcomes [Abstract].

The FAS DPN is currently funded by the CDC to evaluate the effectiveness of two interventions targeted to children with the full spectrum of disorders associated with prenatal alcohol exposure, and their families. Study period: 2001-2005

Investigators:
Susan J. Astley, Ph.D., Professor of Epidemiology
Heather Carmichael Olson, Ph.D., Child-Clinical Pscyhologist
Lesley Olswang, Ph.D., Professor of Speech and Hearing Sciences
Truman Coggins, Ph.D., Associate Professor of Speech and Hearing Sciences.
Tracy Jirikowic, Ph.D., O.T.R./L., Occupational Therapist
Allison Brooks, Ph.D., Licensed Psychologist
Julie Gelo, Family Advocate/Resource Advisor
Beth Gendler, M.S.W., Social Worker

School-aged children with FAS/ARND are an essential group to target when building empirically-based intervention models. The age range of 5 to 11 years is a period when a large group of children with FAS/ARND can be identified, and there are pressing clinical needs. In these school years, alcohol-affected children's deficits in areas such as executive functioning and behavioral regulation, memory, and social communication are clearly emerging and beginning to negatively impact their adaptive function and life success. These are the years when behavior problems - and especially difficulties with peers and disruptive behavior- are widely reported among children with FAS/ARND by their parents and teachers. These caregivers struggle to understand the children's challenging, maladaptive, or atypical behavior, and apply treatment techniques that do not always yield expected success. In these years, when home and school are a child's main life settings and developmental outcomes can be meaningfully improved, parents and teachers need access to effective interventions. These can either be multimodal interventions providing caregiver support, education, assistance with advocacy, and access to a menu of services such as behavioral consultation- or high-yield, single-modality treatments that target critical domains of deficit shown by children with FAS/ARND.

The current proposal responds to this important clinical need by refining and testing two promising intervention models for school-aged children with FAS/ARND that are built on published "clinical wisdom," nine years of FAS diagnostic clinic experience, pilot intervention studies, and selected empirically-supported child treatment techniques: (1) An individualized, supportive, behavioral consultation intervention for parents and school staff of children with FAS/ARND; and (2) A school-based social communication intervention provided directly to children with FAS/ARND that targets critical deficits in social communication and peer relations. These interventions will be assessed through two randomized control trials on a total of 128 children with FAS/ARND.