Background
Method
Study design
Ethics
Recruitment
Eligibility
Representativeness
Participants
n (%) | n (%) | ||
---|---|---|---|
Age (M, SD) | 29.38 (5.34) | Completed Gr. 12/GED | 19 (23.8) |
Gender (% male) | 68 (85.0) | Adjudication Status | |
Ethnicity | Pre-adjudication | 50 (62.5) | |
Indigenousa | 62 (77.5) | Sentenced | 30 (37.5) |
Caucasian | 18 (22.5) | Custody Status | |
Marital Status | Custody | 70 (87.5) | |
% Single | 53 (66.3) | Community | 10 (12.5) |
History of Foster Care | 34 (42.5) |
Assessment and classification approach
Growth | Face | CNS | PAE | |
---|---|---|---|---|
FAS | Evidence of prenatal growth impairment, as in at least 1 of: - Birth weight/length ≤ 10th percentile for GA - Height/weight ≤ 10th percentile for age - Disproportionately low weight-height ratio (= 10th percentile) | Simultaneous presentation of all 3 sentinel facial features - Short palpebral fissure length (≤ 2 SD below mean) - Smooth or flattened philtrum (rank 4 or 5)a - Thin upper lip (rank 4 or 5)a | Evidence of impairment in ≥3 CNS domains: | Confirmed or unconfirmed PAE |
pFAS | – | Simultaneous presentation of 2 sentinel facial features (as above) | Impairment in ≥3 CNS domains | Confirmed PAE |
ARND | – | – | Impairment in ≥3 CNS domains | Confirmed PAE |
Measures
Medical intake interview
FAS facial photographic analysis software
Neurodevelopmental and cognitive assessments
Domain | Measures |
---|---|
Hard and Soft Neurological Signs | Medical intake interview Medical assessment Adolescent/Adult Sensory Profile [44] |
Brain Structure | Medical intake interview Medical assessment Head circumference |
Cognition (IQ) | Wechsler Adult Intelligence Scale-IV (WAIS-IV) [45] Subtests: Similarities, Vocabulary, Information, Block Design, Matrix Reasoning, Visual Puzzles, Digit Span, Arithmetic, Letter-Number Sequencing, Symbol Search, Coding |
Attention | Connors’ Continuous Performance Test – II (CPT-II) [46] |
Wechsler Adult Intelligence Scale-IV (WAIS-IV) [45] Subtests: Digit Span | |
Academic Achievement | Wide Range Achievement Test – Fourth Edition (WRAT-4) [47] Subtests: Word Reading, Sentence Comprehension, Spelling, Math Computation |
Memory | Wechsler Memory Scale – 4th Edition (WMS-IV) [48] Subtests: Logical Memory I & II, Design Memory I & II |
California Verbal Learning Test – 2nd Edition (CVLT-II) [49] | |
Rey Osterreith Complex Figure Test (RCFT) [50] | |
Language/ Communication | Wechsler Adult Intelligence Scale-IV (WAIS-IV) [45] Subtests: Vocabulary, Similarities, Information Medical Intake Interview |
Executive Functioning | Delis Kaplan Executive Function System (DKEFS) [49] Subtests: Sorting, Color-Word Interference, Verbal Fluency, Design Fluency, Trails |
Adaptive Functioning | Adaptive Behavior Assessment System – Second Edition (ABAS-II) [51] Subtests: Conceptual, Social, and Practical domains |
Statistical analyses
Results
FASD diagnosis
Current Sample (N = 80) n (%) | Justice-involved Adult Men [14] (N = 91) n (%) | Justice-involved Adult Womena [13] (N = 23) n (%) | |
---|---|---|---|
Diagnostic Outcomes | |||
FASD | 14 (17.5) | 9 (10.0) | 4 (17.4) |
FAS | 0 (0.0) | 0 (0.0) 1 (1.2) | 0 (0.0) |
pFAS | 2 (2.5) | 1 (4.3) | |
ARND | 12 (15.0) | 8 (8.8) | 3 (13.0) |
Deferred | 11 (13.8) | – | – |
Not Diagnosed | 55 (68.8) | – | – |
Prenatal alcohol exposure
Growth
Facial features
Neurodevelopmental dysfunction
FASD | Deferred | Not Diagnosed | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Four-Digit Code [n, (%)] | 1 | 2 | 3 | 4 | 1 | 2 | 3 | 4 | 1 | 2 | 3 | 4 |
Growth | 14 (100) | 0 (0) | 0 (0) | 0 (0) | 10 (91) | 1 (9) | 0 (0) | 0 (0) | 53 (69) | 1 (2) | 1 (2) | 0 (0) |
Face | 12 (86) | 2 (14) | 0 (0) | 0 (0) | 6 (54) | 5 (46) | 0 (0) | 0 (0) | 48 (87) | 6 (11) | 1 (2) | 0 (0) |
CNS | 0 (0) | 0 (0) | 14 (100) | 0 (0) | 0 (0) | 1 (9) | 10 (91) | 0 (0) | 5 (9) | 43 (78) | 7 (13) | 0 (0) |
PAE | 0 (0) | 0 (0) | 12 (86) | 2 (14) | 1 (9) | 10 (91) | 0 (0) | 0 (0) | 19 (35) | 30 (55) | 5 (9) | 1 (2) |
Medical findings | ||||||||||||
Height (cm) M (SD) | 176.5 (4.7) | 175.4 (6.9) | 174.7 (8.3) | |||||||||
Weight (kg) M (SD) | 87.5 (15.4) | 93.8 (20.1) | 84.6 (18.3) | |||||||||
BMI n (%) obese | 4 (29) | 5.0 (46) | 13.0 (24) | |||||||||
Occipital Circ. (cm) M (SD) | 56.9 (1.9) | 57.1 (1.6) | 57.0 (2.0) | |||||||||
Palpebral fissure length (mm) M (SD) [M z-score (SD)] | 29.0 (1.8) [.4 (1.2)] | 28.3 (2.2) [−.1 (1.5)] | 28.7 (2.2) [.2 (1.5)] | |||||||||
Intercanthal distance (mm) M (SD) [z-score] | 33.6 (3.3) [1.1 (1.1)] | 35.0 (3.1) [1.5 (1.3)] | 33.3 (3.4) [.8 (1.4)] | |||||||||
Smooth philtrum % Rank 4/5 n (%) | 2 (14) | 1 (9) | 2 (4) | |||||||||
Thin vermillion border M (SD) [n (%) Rank 4/5] | 53.7 (16.7) [2 (14)] | 67.0 (23.0) [4 (36)] | 59.6 (14.2) [5 (9)] | |||||||||
Ear anomalies n (%) | 0 (0) | 0 (0) | 5 (9) | |||||||||
Palate anomalies n (%) | 3 (21) | 4 (36) | 5 (9) | |||||||||
Poor dentition n (%) | 5 (38) | 5 (46) | 14 (26) | |||||||||
Spine anomaly n (%) | 2 (15) | 1 (9) | 3 (6) | |||||||||
Current medications n (%) | 6 (43) | 5 (46) | 28 (51) | |||||||||
Past suicide attempt n (%) | 6 (43) | 5 (46) | 22 (40) | |||||||||
Previous Head Injury n (%) | 11 (79) | 8 (73) | 30 (55) | |||||||||
Cognitive findings | ||||||||||||
Cognition n (%) sign. Imp. | 11 (79) | 9 (82) | 14 (26) | |||||||||
IQ M (SD)a | 65.4 (5.4) | 68.5 (4.7) | 83.1 (12.3) | |||||||||
IQ < 70 n (%)a | 10 (77) | 7 (64) | 10 (19) | |||||||||
Attention n (%) sign. Imp. | 6 (43) | 5 (50) | 12 (13) | |||||||||
Academics | 6 (43) | 4 (36) | 1 (2) | |||||||||
Memory | 6 (43) | 4 (36) | 6 (11) | |||||||||
Executive function | 10 (71) | 3 (27) | 3 (6) | |||||||||
Adaptive function | 14 (100) | 11 (100) | 50 (91) | |||||||||
# domains sign. Imp. /6 M (SD) | 3.8 (.2) | 3.3 (.3) | 1.6 (.1) |