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Suggested Citation:"Index." Institute of Medicine. 1996. Fetal Alcohol Syndrome: Diagnosis, Epidemiology, Prevention, and Treatment. Washington, DC: The National Academies Press. doi: 10.17226/4991.
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Index

A

Aarskog syndrome, 79

Abstinence during pregnancy, 27, 103, 105

counseling for, 11, 146

encouraged as means of FAS prevention, 9, 17, 27, 118

Academic performance, 69, 159, 163-164, 165; see also Adolescence and post-puberty development

Acetaldehyde adducts, 129-130

Active surveillance, 7, 91, 94-96, 97

linkages to treatment, 8, 97

proxy measures, 7, 95-96

Adaptive functioning, 73, 159, 163

Adolescence and post-puberty development, 6, 36, 80, 158

behavior patterns, 165-166, 168-169

catch-up growth, 73, 75

Adoption, 13, 15, 67, 74, 171, 172, 181, 186

Adulthood, 19, 75, 166

Affected individuals, see Behavioral patterns; Cognitive performance; Developmental stages and life span; Diagnostic criteria; Growth deficiency; Incidence and prevalence of FAS; Physical anomalies; Secondary disabilities; Treatment and intervention for FAS children

African Americans

FAS rates, 83

maternal drinking patterns, 103

Age

and drinking patterns, 106, 107, 108-109, 121

and subsequent pregnancies, 136

see also Developmental stages and life span

Aggression 163

Alanine aminotransferases (ALT), 128-129

Alcohol abuse, 117

among FAS adolescents, 158

biological markers, 9, 109, 126-131

diagnostic definition, 5n, 29-30, 68, 74, 77n

social-environmental factors, 88-89, 100-102, 108-109

stigma of, 92, 94, 96, 112, 146

Suggested Citation:"Index." Institute of Medicine. 1996. Fetal Alcohol Syndrome: Diagnosis, Epidemiology, Prevention, and Treatment. Washington, DC: The National Academies Press. doi: 10.17226/4991.
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see also Drinking among women; Drinking during pregnancy; Heavy drinking; Treatment and prevention of alcohol abuse

Alcoholics Anonymous (AA), 140

Alcohol-related birth defects (ARBD), 3, 5, 7, 77, 78-79, 80, 97

incidence and prevalence, 84, 97

Alcohol-related effects (diagnostic category), 4-5, 76-77, 78-79, 80. see also ''Fetal alcohol effects"

diagnostic criteria, 4-5, 67, 70, 76-77, 78

Alcohol-related neurodevelopmental disorder (ARND), 3, 5, 7, 77, 78-79, 80, 81, 97

incidence and prevalence, 97

Alkaline phosphatase (AP), 129

Aminotransferases, 128-129

Anger, 80

Animal models and studies intervention and prevention strategies, 11-12, 15, 45-47, 144, 147, 155, 186

paternal alcohol exposure, 121

teratogenic effects, 6, 20, 22, 28, 37-41, 81

Antisocial behavior, 80

Anxiety, 80, 107, 108

Asian Americans, FAS rates, 83

Aspartate aminotransferases (AST), 128-129

Aspirin, 45-46

Attention, 15, 73, 159, 163, 164, 168, 186

Attention-deficit hyperactivity disorder (ADHD), 69, 161, 164, 177, 182

Autopsy studies, 72

B

Babies, see Newborn period and infancy

Bartenders, 122

Baseline data, 7, 89-90, 97

Behavioral patterns, 4, 5, 17, 43-44, 73, 75, 76, 77, 81, 158-166

across developmental stages, 69, 159-166, 168-169

as diagnostic criteria, 3, 67, 69

etiology, 166-167, 169-173

of FAS adolescents, 165-166, 168-169

of newborns and infants, 160-161

research needs, 15, 186

research studies, 158-159

specificity to FAS, 13, 79, 167, 173

vignettes, 56-58

see also Alcohol-related neurodevelopmental disorder (ARND)

Behavioral Risk Factors Surveillance Surveys (BRFSS), 100, 104, 105, 106

Binge drinking, 44, 68, 106, 165, 166

Biological markers, 6, 72, 81, 115, 126-131, 135, 169

of alcohol abuse, 9, 109, 126-131

research needs, 6, 9, 81, 109

Birth, see Newborn period and infancy

Birth control, 11, 136, 146-147

Birth Defects Monitoring Program (BDMP), 22, 83, 91

Birth registries, 83, 84, 90

Birth to Three Project, 142

Blood alcohol levels, 127

Bloom syndrome, 79

Brain damage, 4, 38, 39-40, 44, 68, 71, 72-73, 74, 75, 76, 81, 157, 169, 173

Brain stem auditory evoked response (BAER) test, 157

Breast-feeding, 142, 157

Breath analyzer, 127

Brief interventions, 10, 123-124, 131-135

C

CAGE test, 124, 126

Carbohydrate-deficient transferrin (CDT), 130-131

Cardiac defects, 38, 156

Caregiving environment, 13, 53, 163, 165, 169-173

Case management, 11, 142, 147

Categories, see Alcohol-related birth defects (ARBD); Alcohol-related neurodevelopmental disorder

Suggested Citation:"Index." Institute of Medicine. 1996. Fetal Alcohol Syndrome: Diagnosis, Epidemiology, Prevention, and Treatment. Washington, DC: The National Academies Press. doi: 10.17226/4991.
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(ARND); Diagnostic categories; FAS with confirmed maternal alcohol exposure; FAS without confirmed maternal alcohol exposure; Partial FAS

Caucasians/whites

FAS rates, 83

maternal drinking, 106, 107

Center for Substance Abuse Prevention (CSAP), 23

Center for Substance Abuse Treatment (CSAT), 23

Centers for Disease Control and Prevention (CDC)

risk factor surveys, 100, 104, 105

screening check lists, 72

surveillance and prevention programs, 22, 28, 83-84, 91, 97, 136, 144-145, 176, 195

Central nervous system (CNS) dysfunction, 4, 33, 38, 39, 71, 75, 76, 91

Cerebellar hypoplasia, 69, 73

Child abuse, 53, 102, 142, 170, 173

Cigarettes, see Smoking

Clinical practice guidelines, 15, 186

Clinic-based studies, 8, 102, 103, 158

FAS incidence and prevalence estimates, 83, 84-87

Cocaine, 21, 23, 36, 105, 137; see also Crack cocaine

Cognitive-behavioral interventions, 140

Cognitive performance, 4, 5, 17, 19, 73, 75, 76, 77, 81, 158, 159, 161, 163-164

see also Alcohol-related neurodevelopmental disorder (ARND); Mental retardation

Community involvement, 114-115, 122, 185

Computed tomography (CT), 69, 72

Confidentiality, 92, 141, 176, 186

Congenital rubella syndrome (CRS), 20-21

Contraceptive services, 11, 136, 146-147

Coordination of services, 15-16, 176, 183-184, 194-196

Coordination problems, 73

Corpus callosum

callosal dysgenesis, 69, 73

Counseling

for abstinence during pregnancy, 11, 146

brief interventions, 10, 123-124, 131-135

contraceptive services, 11, 136, 146-147

Crack cocaine, 21, 105, 137

Cranial size, 4, 68, 70, 76

Creatine phosphokinase (CPK), 127

Cross-sectional research, syndrome characteristics over life span, 80

Culture, see Ethnic groups; Social-environmental factors

Custody losses and retention, 11, 21, 142, 171-173; see also Foster care

D

Dental abnormalities, 156, 157

Depression, 80, 102, 107-108

Developmental delay, 6, 19, 73, 81, 135, 154, 161, 184

research needs, 6, 81

Developmental stages and life span

behavioral patterns across, 69, 159-166, 168-169

diagnoses performed over, 6, 67, 70, 73-74, 80, 92

interventions over, 15, 166, 167-169, 174-175, 186

research needs, 6, 80, 167

variability in outcomes, 13, 167-168

worsening of effects over, 168-169

see also Adolescence and post-puberty development; Adulthood; Newborn period and infancy; Preschool period; School age

Developmental toxicity, 33-37

Diagnoses and diagnostic labels

consistency of, 64-65, 91-92

history of FAS definition, 17-19, 70-73

as marker for preventive interventions, 79-80

problems in surveillance, 64, 84, 90, 91-92

Suggested Citation:"Index." Institute of Medicine. 1996. Fetal Alcohol Syndrome: Diagnosis, Epidemiology, Prevention, and Treatment. Washington, DC: The National Academies Press. doi: 10.17226/4991.
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and secondary disability prevention, 80, 182

uses of, 2, 63-64, 79-80

at various developmental stages, 6, 67, 70, 73-74, 80, 92

see also Biological markers

Diagnostic and Statistical Manual (DSM), 29-30, 64

Diagnostic categories, 3, 4-5, 74-79

Diagnostic criteria, 2-6, 64-70, 182, 185

for alcohol abuse and dependence, 5n, 29-30, 68, 74, 77n

alcohol-related effects, 4-5, 67, 70, 76-77, 78

application across life span, 3, 6, 67, 70, 80

behavioral and cognitive features, 3, 67, 69

clinical applications, 64, 66, 67, 80

documented exposure to alcohol, 2, 3, 4, 6, 67-68, 74-75, 76, 80

physical features, 2, 67, 68

reliability and validity, 64-65, 71-72

research applications, 64, 66, 67, 80

research needs, 6, 80-81

role of imaging technology, 3, 67, 69, 69-70, 72-73

Dietary and nutrition factors, 9, 102, 109 fat intake, 46

Diethylbestrol (DES), 41

Differential diagnosis, 64, 79

Diphenylhydantoin (DPH, phenytoin), 34, 35, 41

Dose-response relationships, 41-45, 103, 112

Drinking among women, 9, 22, 100, 102, 105, 108, 109-110

heavy drinkers, 88, 105

low and moderate intake, 105

stigmatizing effects, 112, 146

Drinking contexts, 107

Drinking during pregnancy, 8-9, 103, 100-107

bingeing, 44, 68, 106, 165, 166

documentation of, 2, 3, 4, 6, 67-68, 74-75, 76, 80, 132

factors influencing, 9, 100-102, 106-107, 109, 121, 147

fetal protection mechanisms, 9, 12, 109, 147

first trimester, 106-107

heavy drinking, 27, 89, 100-101, 106, 120, 121

low and moderate intake, 2, 26-27, 116, 117-118, 120

and multiple-substance use, 21, 109

as proxy indicator of FAS, 95-96, 143

reduction of intake, 105-106, 119-120, 133-134

research needs, 9, 107-110

variation among ethnic groups, 103, 108-109

vignettes, 53-62

see also Abstinence during pregnancy

Drugs, see Illicit drug use during pregnancy

"Drunk" baby, 19

Dubowitz syndrome, 79

Dysmorphism, see Physical anomalies

E

Early intervention programs, 175, 176, 177

Eating disorders, 107

Education, see Academic performance; Parenting education; Professional training and education; Public education campaigns

Educational interventions, 15, 186

for children with prenatal drug exposure, 15, 186

for secondary disabilities, 14, 155, 174-175, 177-179

Eligibility for services, 155, 156, 182-183

Embryonic period, 38-39

Emotional health, 15, 173, 186

Environment, see Caregiving environment; Social-environmental factors

Epicanthal folds, 72

Epidemiology and surveillance, 6-7, 89-97

active surveillance, 7, 91, 94-96, 97

Suggested Citation:"Index." Institute of Medicine. 1996. Fetal Alcohol Syndrome: Diagnosis, Epidemiology, Prevention, and Treatment. Washington, DC: The National Academies Press. doi: 10.17226/4991.
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drinking among women, 9, 22, 100, 105, 108, 109-110

drinking during pregnancy, 8-9, 22, 100-109

FAS baseline data, 7, 89-90, 97

and FAS diagnostic problems, 64, 84, 90, 91-92

passive surveillance, 6-7, 83, 91-94

role in prevention programs assessment, 89-90, 97

use of multiple data sources, 84, 90-91

see also Clinic-based studies; Incidence and prevalence of FAS; Longitudinal studies; Population-based epidemiologic studies; Registry-based studies

Erythrocyte delta-aminolevulinic acid (ALA) dehydrase, 127-128

Ethnic groups

biomodal patterns of alcohol abuse, 88-89, 103

and maternal drinking, 103, 108-109, 121

variation in FAS prevalence estimates, 7, 90, 97

see also African Americans; Asian Americans, FAS rates; Caucasians/whites; Hispanics, FAS rates; Native Americans

Etiology, of behavioral patterns, 166-167, 169-173

Eyebrows, 72

Eye defects, 38, 72, 73, 157

F

Facial anomalies, 17, 38, 68, 70, 72, 73, 165

in diagnosis, 4, 73, 74, 75, 76

presence at birth, 71, 73, 160

Failure to thrive, 73, 157, 161

Families

alcohol abuse history in, 53, 102, 107

interventions and support, 11, 14, 14-15, 117, 142, 180-181, 185

involvement in mothers' alcohol reduction and cessation, 10, 11, 115, 122, 146, 147

stability of, 53, 170

see also Caregiving environment

FAS with confirmed maternal alcohol exposure (diagnostic category), 3, 4, 74, 76

FAS without confirmed maternal alcohol exposure (diagnostic category), 3, 4, 74-75, 76

Fathers, see Partners of women; Paternal alcohol exposure

"Fetal alcohol effects" (FAE), 3, 63, 67, 70, 78. see also Alcohol-related effects

Folic acid deficiency, 21

Follow-up in treatment, 15, 183, 186

Foster care, 11, 13, 74, 142, 171, 172, 181

Fragile-X syndrome, 69, 74, 79

G

Gamma glutamyl transferase (GGT), 128, 131

Gatekeeping, 66, 79, 182

Gender differences

alcohol treatment effectiveness, 139

biological markers for alcohol abuse, 128, 130-131

growth, 73

prenatal dose-response effects, 44

Genetic susceptibility, 40-41, 90

D-Glucaric acid, 127

Growth deficiency, 40, 71, 73-74, 157, 160

in diagnosis, 4, 70, 75, 76, 92, 160

low birthweight, 4, 40, 41, 68, 69-70, 76, 92-93

H

Head Start, 175, 177

Health care interventions, 12, 147, 176-177

brief interventions, 10, 123-124, 131-135

referrals, 10, 11, 15, 131-132, 135, 147, 184

screening for maternal alcohol use, 124-131

Suggested Citation:"Index." Institute of Medicine. 1996. Fetal Alcohol Syndrome: Diagnosis, Epidemiology, Prevention, and Treatment. Washington, DC: The National Academies Press. doi: 10.17226/4991.
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secondary disabilities, 174, 176-177

selective, 10, 123-133

training, 11, 15, 123, 132-133, 147, 184

universal, 118-119

Health Resources and Services Administration (HRSA), 23, 143, 195

Healthy People 2000 goals, 20, 89-90

Hearing problems, 73, 157

Heavy drinking, 29, 30-31, 88, 105

definitions, 106

during pregnancy, 27, 89, 100-101, 106, 120, 121

identification, 11, 123, 124-126, 132-133, 147

Heroin, 35

Hispanics, FAS rates, 83

Hospital discharge data, 83, 84, 91

Hydronephrosis, 156

Hyperactivity, 159, 160, 161, 163, 164, 182

I

Ibuprofen, 46

Illicit drug use during pregnancy, 21, 103, 105, 109

educational interventions for children, 15, 186

forced treatment and incarceration, 21, 137

Imaging techniques, 45, 69, 71

role in establishing diagnostic criteria, 3, 67, 69-70, 72-73

Impulse control, 164

Incarceration, of substance-abusing mothers, 21, 137

Incidence and prevalence of FAS

alternative estimates, 1, 6, 19, 27, 82-91

among ethnic minorities, 7, 83, 97

Income and socioeconomic status, 89, 103, 106, 107, 108-109, 116-117, 121, 155

Indian Health Service, 23, 144, 195

Indicated prevention interventions, 10, 11-12, 115, 135-141, 145-147

alcohol abuse treatment as, 9, 10, 11, 107-108, 115, 135, 138-141, 141, 145, 154

for mothers of FAS children, 79, 135, 136-137

reproductive counseling and contraceptive services, 11, 136, 146-147

research needs, 11-12, 146-147

Indomethacin, 46

Infants, see Newborn period and infancy

Integration and coordination of services, 15-16, 176, 183-184, 194-196

Intellect, see Cognitive performance

Interagency cooperation, 15-16, 195-196

national survey, 7, 16, 97, 196

task force, 16, 196

Intervention, see Educational interventions; Health care interventions; Prevention interventions and measures; Treatment and intervention for FAS children; Treatment and prevention of alcohol abuse

IQ scores, 159, 163

Iron deficiency anemia, 131

Isolation, 80

Isotreinoin, 42

J

Judgment, 73, 158, 163

K

Kidney anomalies, 156

L

Labeling, see Diagnoses and diagnostic labels; Warning labels

Language development and deficits, 15, 73, 159, 161-163, 186

Lead, 34, 35

Learning disabilities, 73

Suggested Citation:"Index." Institute of Medicine. 1996. Fetal Alcohol Syndrome: Diagnosis, Epidemiology, Prevention, and Treatment. Washington, DC: The National Academies Press. doi: 10.17226/4991.
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Liver damage, 127

Longitudinal studies, 19, 80, 86-87, 167

Low and moderate drinking, 105

during pregnancy, 2, 26-27, 116, 117-118, 120

Low birthweight, 4, 40, 41, 68, 69-70, 76, 92-93

M

Magnetic resonance imaging (MRI), 45, 69, 71

Maintenance and aftercare, 114, 142

Males, see Gender differences; Partners of women

Mandatory drug testing, 21

March of Dimes, 133

Marijuana, 34, 36, 42

Marital status, 107, 121, 122

Maternal and Child Health Bureau (MCHB), 23, 143

Maternal Health Practices and Child Development (MHPCD) Project, 93, 102

Maternal mortality, 171

Maternal PKU, 79

Math ability, 73, 159, 163-164, 166, 168

Mean corpuscular volume (MCV), 129

Media campaigns, 116, 147

Medical interventions, see Health care interventions

Medical records, 84, 90, 92, 94

Memory, 163

Mental retardation, 19, 159, 169, 173

FAS as leading nongenetic cause, 7, 97

Methadone, 35

Methylmercury, 34, 35

Methylphenidate, 177

Metropolitan Atlanta Congenital Defects Program (MACDP), 83-84

Michigan Alcoholism Screening Test (MAST), 126

Microcephaly, 69, 72, 92

Middle class populations, 89, 103, 155

Minorities, see Ethnic groups

Moderate drinking, see Low and moderate drinking

Motivational interviewing, 140

Multidisciplinary approaches to service, 15, 16, 194-196

Muscle tone, 73

N

National Fetal Mortality Survey, 104

National Health and Nutrition Examination Survey, 104

National Institute on Alcohol Abuse and Alcoholism (NIAAA), 16, 21-22, 28, 144, 195, 196

National Institute on Drug Abuse (NIDA), 21, 22

pregnancy survey, 104, 105

National Institutes of Health (NIH), 21-22

National Longitudinal Alcohol Epidemiologic Study, 104

National Longitudinal Survey of Youth (NLSY), 104, 105

National Maternal and Infant Health Interview Survey (NMIHS), 104, 105, 106

National Natality Survey, 104

National Organization on Fetal Alcohol Syndrome (NOFAS), 133

National Pregnancy and Health Survey, 22, 104, 105

National surveys, 7, 97, 108, 109

on drinking and pregnancy, 9, 102-103, 104, 108, 109

interagency cooperation in, 7, 16, 97, 196

Native Americans

incarceration of pregnant women, 137

maternal drinking patterns, 88-89, 103

substance abuse treatment programs, 23

surveillance, 83, 87-89, 93

Neglect, 53, 142, 157, 170, 171, 173

Neonatal withdrawal syndrome, 135, 160

Neural tube defects, 21

Neurobehavioral deficits, see Behavioral patterns

Neurobiological indicators, see Biological markers

Neurotoxicity, 33-36, 38, 39-40, 157

Suggested Citation:"Index." Institute of Medicine. 1996. Fetal Alcohol Syndrome: Diagnosis, Epidemiology, Prevention, and Treatment. Washington, DC: The National Academies Press. doi: 10.17226/4991.
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Newborn period and infancy

associated health conditions, 156

behavior patterns, 160-161

blood alcohol levels, 19

diagnosis during, 19, 70, 75, 91, 93-94, 168

environment enrichment, 46

low birthweight, 4, 40, 41, 68, 69-70, 76, 92-93

Non-steroidal anti-inflammatory (NSAI) agents, 46

Noonan's syndrome, 79

Normative standards, 68, 69

O

Obstetrician gynecologists, 118-119, 124, 133, 194

Occupational therapy, 176, 177

Ocular problems, see Eye defects

Opiates, 34, 35-36

Opitz syndrome, 79

Organogenesis, 38

Otitis media, 157, 161

Outcomes research, alcohol treatment for women, 138-141

P

Palpebral fissures, 4, 72, 76

Parenting education, 15, 180-181, 185

Parity, 47, 136

Partial FAS (diagnostic category), 3, 4, 75, 76, 78

Partners of women

drinking behavior, 102, 107, 108, 121

stability of relations with, 53, 107, 122

targeted for interventions, 10, 11, 117, 121-122, 142, 146

Passive surveillance, 6-7, 83, 91-94, see also Registry-based studies

direct measures, 92

indirect measures, 92-94

Paternal alcohol exposure, 121-122

Pattern recognition, 72

Pediatric specialties, 176, 194

Peers and friendships, 163

of pregnant women, 10, 122

Perinatal 20 demonstration project, 22

Phenylketonuria, 79

Physical anomalies, 17-19, 156-157, 159

as diagnostic criteria, 2, 67, 68

prenatal development, 37-40

see also Alcohol-related birth defects (ARBD); Facial anomalies; Growth deficiency

Physical therapy, 176, 177

Physician involvement, see Health care interventions

Placental growth, 69, 70

Polychlorinated biphenyls (PCBs), 34, 35

Population-based epidemiologic studies, 7, 87-89, 96

drinking during pregnancy, 83, 95, 102-103

Poverty areas and inner cities, 89, 103, 155

Prader-Willi syndrome, 74

Predifferentiation period, 37-38

Pregnancy, see Abstinence during pregnancy; Drinking during pregnancy

Pregnancy Risk Assessment Monitoring System (PRAMS), 106

Pregnant and Postpartum Women and Their Infants (PPWI) initiative, 23, 142-143

Prenatal care, 107, 124, 126-127, 133-135

Prenatal development, susceptibility over, 36, 37-40

Preschool period

behavior patterns, 161-163, 168

services, 174, 177, 183

Prevalence, see Incidence and prevalence of FAS

Prevention interventions and measures, 9-12, 112-113

birth defects, 20-21

case management approaches, 114, 142, 147

comparison among programs, 11, 146

Suggested Citation:"Index." Institute of Medicine. 1996. Fetal Alcohol Syndrome: Diagnosis, Epidemiology, Prevention, and Treatment. Washington, DC: The National Academies Press. doi: 10.17226/4991.
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evaluation of impacts, 11, 16, 113, 119-120, 142-144, 146, 147, 196

indicated, 10, 11-12, 115, 135-141, 145-147

models of, 113-114

research needs, 11-12, 113, 146-147

research programs, 22-23, 144-145

secondary disabilities, 13-15, 80, 154, 173-181, 182-183, 185-186, 196

selective, 9-10, 12, 115, 120-135, 145, 147

universal, 9, 12, 114-115, 116-120, 145, 147

Problem solving, 163

Professional training and education

diagnosis of FAS, 66, 91, 92, 94, 133, 182

identification of heavy drinking, 11, 123, 132-133, 147

in prevention of FAS, 15, 132-133, 136, 179-180, 185

referral for treatment, 11, 15, 147, 184

Prospective studies, 83, 84, 86-87, 158-159

on effects of maternal substance use, 7, 26-27, 93, 94

Prostaglandin (PG), 45-46

Protective factors

against fetal injury, 9, 12, 45-46, 109, 147

women's drinking reduction, 9, 109, 147

Proxy indicators

of prevention activities impacts, 119, 143-144

surveillance criteria, 7, 92-94, 95-96

validation, 96

Psychological factors, 9, 102, 107, 109, 147

Psychotherapeutic drugs, 105, 177

Ptosis, 72

Puberty, see also Adolescence and post-puberty development

Public education campaigns, 9, 20, 116

Public Health Service (USPHS), 19, 20, 21-23

R

Racial groups, see Ethnic groups

Radiation, 34, 35

Referrals, 10, 11, 15, 131-132, 135, 147, 184

professional training in, 11, 15, 147, 184

Registry-based studies, 7, 83-84

Research needs

alcohol abuse, 9, 27-28, 102, 107-110, 138, 139, 141

behavioral patterns, 15, 186

biological markers, 6, 9, 81, 109

developmental stages, 6, 80, 167

diagnostic criteria, 6, 80-81

prevention interventions, 11-12, 113, 146-147

Research programs and studies, 21-23, 144-145

behavioral patterns, 158-159

coordination of, 15-16, 107, 194-196

prevention interventions, 22-23, 144-145

teratogenic effects, 19-20, 27, 37-45, 158

see also Animal models and studies; Clinic-based studies; Cross-sectional research; Epidemiology and surveillance; Longitudinal studies; National surveys; Population-based epidemiologic studies; Prospective studies; Research needs

Residential Treatment for Women and Their children, 23

Retrospective studies, 83, 84, 86, 158

Risk factors, see Dietary and nutrition factors; Social-environmental factors

Rubella, 20-21

S

Salicylate, 42

School age, 163-165, 168, 183

Suggested Citation:"Index." Institute of Medicine. 1996. Fetal Alcohol Syndrome: Diagnosis, Epidemiology, Prevention, and Treatment. Washington, DC: The National Academies Press. doi: 10.17226/4991.
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School performance, see Academic performance

Screening tools, 11, 146; see also Biological markers

Secondary disabilities, 12, 13-14, 80, 154-155, 173-181

and caregiving environment, 155, 169-173

educational interventions, 14, 155, 174-175, 177-179

medical interventions, 174, 176-177

Seizures, 73, 157-158

Selective prevention interventions, 9-10, 12, 115, 120-135, 145, 147

biological markers, 126-131

brief interventions, 123-124, 131-135

health care professionals' roles, 10, 123-133

and prenatal care, 133-135

professional training, 132-133

referrals, 131-132

research needs, 12, 147

screening instruments, 124-126

targeting of demographic subgroups, 12, 147

targeting of family, 115, 122, 147

targeting of women's partners, 121-122

Self-esteem, 102, 107, 140

Self-help groups, 140

Sensory integration, 15, 161, 163, 186

Skeletal anomalies, 38, 156

Sleep disturbances, 160

Smoking, 34, 36, 101, 105, 121

Social-environmental factors, 9, 90, 109, 147

in alcohol abuse, 88-89, 100-102, 108-109

role in modifying fetal alcohol exposure, 15, 46-47, 186

Socioeconomic status, see Income and socioeconomic status

Species susceptibility, 40

Speech delays, 73, 157

Stability of relationships, 53, 107, 121, 171-173

State-based surveys, 22, 97

State government agencies, 195

Stigma

of alcohol abuse, 92, 94, 96, 112, 146

of FAS diagnosis, 2, 66

Substance Abuse and Mental Health Services Administration (SAMHSA), 23, 143, 195

Support groups, 140, 181

Surgeon General's warning, 2, 22, 27, 118

Surveillance, see Epidemiology and surveillance

Sweden, FAS rate, 84

T

T-ACE test, 125, 126

Targeting, see Indicated prevention interventions; Selective prevention interventions

Teratogenic effects, 33-36, 73, 101, 121, 159-160

dose-response effects, 41-45

low-level alcohol use, 27

multifactorial model, 47-48

research studies, 19-20, 27, 37-45, 158

Thalidomide, 41, 42

Therapeutic intervention, 176-177

Tobacco, see Smoking

Training, see Professional training and education

Treatment and intervention for FAS children, 12-14, 27-28, 173-186

availability of services, 156, 175-176

barriers to services, 155-156, 175-176, 181-184

community outreach programs, 185

coordination of services, 15, 16, 195, 196

early identification, 14, 80, 155, 168, 182, 185

eligibility for services, 155, 156, 182-183

follow-up, 15, 183, 186

local and regional clusters, 14, 185

planning, 166-173

Suggested Citation:"Index." Institute of Medicine. 1996. Fetal Alcohol Syndrome: Diagnosis, Epidemiology, Prevention, and Treatment. Washington, DC: The National Academies Press. doi: 10.17226/4991.
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Treatment and prevention of alcohol abuse

availability of services, 10-11, 137, 138, 141

in drug treatment programs, 21

evaluation of effectiveness, 138-141, 143-144

forced, 21, 137

intensive, 10-11, 140-141, 146

as a preventive intervention for FAS, 9, 10, 107-108, 115, 135, 138, 145, 154

referrals, 10, 135

research needs and barriers, 27-28, 102, 138, 139, 141

Tremors, 73

Turner's syndrome, 79

TWEAK test, 125, 126

Twin studies, 41, 121

U

Universal prevention interventions, 9, 12, 114-115, 116-120, 145, 147

health care professionals' roles, 118-119

research needs, 12, 147

Urinary dolichol, 127-128

Urine testing, 21, 127-128

Urogenital problems, 38, 156

V

Velocardiofacial syndrome, 79

Vigilance, 164

Violence against women, 102, 107, 108

Vision problems, 73, 156, 157

Vitamin A, 42

W

Warning labels, 118, 119-120

Whites, see Caucasians/whites

Wiedemann-Beckwith syndrome, 74

Williams syndrome, 79

Women's drinking, see Drinking among women; Drinking during pregnancy

Suggested Citation:"Index." Institute of Medicine. 1996. Fetal Alcohol Syndrome: Diagnosis, Epidemiology, Prevention, and Treatment. Washington, DC: The National Academies Press. doi: 10.17226/4991.
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Fetal Alcohol Syndrome: Diagnosis, Epidemiology, Prevention, and Treatment Get This Book
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It sounds simple: Women who drink while pregnant may give birth to children with defects, so women should not drink during pregnancy. Yet in the 20 years since it was first described in the medical literature, fetal alcohol syndrome (FAS) has proved to be a stubborn problem, with consequences as serious as those of the more widely publicized "crack babies."

This volume discusses FAS and other possibly alcohol-related effects from two broad perspectives: diagnosis and surveillance, and prevention and treatment. In addition, it includes several real-life vignettes of FAS children.

The committee examines fundamental concepts for setting diagnostic criteria in general, reviews and updates the diagnostic criteria for FAS and related conditions, and explores current research findings and problems associated with FAS epidemiology and surveillance.

In addition, the book describes an integrated multidisciplinary approach to research on the prevention and treatment of FAS. The committee:

  • Discusses levels of preventive intervention.
  • Reviews available data about women and alcohol abuse and treatment among pregnant women.
  • Explores the psychological and behavioral consequences of FAS at different ages.
  • Examines the current state of knowledge about medical and therapeutic interventions, education efforts, and family support programs.

This volume will be of special interest to physicians, nurses, mental health practitioners, school and public health officials, policymakers, researchers, educators, and anyone else involved in serving families and children, especially in high risk populations.

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