Global DNA Methylation and Histone Posttranslational Modifications in Human and Nonhuman Primate Brain in Association with Prenatal Alcohol Exposure.

Background: Based upon experimental animal studies, the neurodevelopmental abnormalities associated with prenatal alcohol exposure (PNAE)/fetal alcohol spectrum disorder (FASD) have been attributed, at least in part, to epigenetic modifications. However, there are no direct analyses of human brain tissue.

Methods: Immunohistochemical detection of global epigenetic markers was performed on temporal lobe samples of autopsied fetuses and infants with documented PNAE.

FAST Club: The Impact of a Physical Activity Intervention on Executive Function in Children With Fetal Alcohol Spectrum Disorder.

Physical activity (PA) has been demonstrated to have positive effects on cognitive function, particularly executive function (EF) skills. Animal models suggest PA may be effective in ameliorating some of the neuropsychological effects of fetal alcohol spectrum disorder (FASD), but this approach has not been extended to humans. The purpose of this study was to develop a PA program, FAST Club, for children with FASD and to evaluate its effect on a measure of EF.

Using a Common Form for Consistent Collection and Reporting of FASD Data from Across Canada: A Feasibility Study.

Background: This study was undertaken to determine the feasibility of collecting information on individuals newly diagnosed with Fetal Alcohol Spectrum Disorder (FASD) in multi-disciplinary diagnostic programs across Canada.

Objective: To determine the frequencies of specific diagnoses within the spectrum, the frequencies and patterns of specific functional deficits, and the range of recommendations made for intervention and management for children and adults.

Methods: All qualifying clinics in Canada were invited to join this project and complete questionnaires on the patients that were seen during the research period.

Salivary cortisol levels are elevated in the afternoon and at bedtime in children with prenatal alcohol exposure.

Prenatal alcohol exposure can cause dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis, which may underlie some of the behavioral and adaptive problems seen in individuals with Fetal Alcohol Spectrum Disorders (FASD). Infants prenatally exposed to alcohol show altered basal and post-stress cortisol levels, but it is unknown if this persists beyond 2 years of age. It is also unknown if cortisol levels can be normalized through intervention programs.

Cost of fetal alcohol spectrum disorder diagnosis in Canada.

Background: Fetal Alcohol Spectrum Disorder (FASD) is underdiagnosed in Canada. The diagnosis of FASD is not simple and currently, the recommendation is that a comprehensive, multidisciplinary assessment of the individual be done. The purpose of this study was to estimate the annual cost of FASD diagnosis on Canadian society.

The Canadian guidelines and the interdisciplinary clinical capacity of Canada to diagnose fetal alcohol spectrum disorder.

Background: In 2005, the CMAJ published the Fetal alcohol spectrum disorder: Canadian guidelines for diagnosis. The intent of this publication was to encourage a more consistent interdisciplinary team approach and diagnostic procedure for FASD diagnoses. That same year, the Canada Northwest FASD Research Network (CanFASD Northwest) determined the locations and capacity for interdisciplinary FASD diagnosis across Canada.

Developing effective, culturally appropriate avenues to FASD diagnosis and prevention in northern Canada.

This article describes 2 research initiatives that are being undertaken by members of the Canada Northwest FASD Research Network, involving collaborations between researchers, clinicians, service providers and community members in the Canadian North. Improving both the diagnosis and prevention of FASD requires evidence-based approaches to clinical and social service delivery that are capable of accounting for the unique contours of the geographic, regional and cultural diversities in which women become pregnant and in which families live. Although FASD has been a priority for communities and governments in northern Canada, research capacity has not been available to support the development of the context-specific knowledge needed to inform policy and practice in this region.

Fetal alcohol spectrum disorders: gene-environment interactions, predictive biomarkers, and the relationship between structural alterations in the brain and functional outcomes.

Prenatal alcohol exposure is a major, preventable cause of behavioral and cognitive deficits in children. Despite extensive research, a unique neurobehavioral profile for children affected by prenatal alcohol exposure remains elusive. A fundamental question that must be addressed is how genetic and environmental factors interact with gestational alcohol exposure to produce neurobehavioral and neurobiological deficits in children.

Normal distribution of palpebral fissure lengths in Canadian school age children.

Background: Fetal alcohol syndrome (FAS) includes the facial dysmorphic feature of short palpebral fissures (PFs) and short PFs are a key physical marker for identifying children with FAS and some other rarer conditions. There is concern that normative data on PFs now available may not reflect all racial/ethnic groups and might be inaccurate in general.

Objectives: To accomplish a large population based study that would accurately determine normative PF values across the full diversity of the Canadian school age population.

Development of Canadian screening tools for fetal alcohol spectrum disorder.

Background: Fetal alcohol spectrum disorder (FASD) is the most common cause of neurobehavioural handicap in North America. Screening for FASD may facilitate diagnosis and hence management of these children. We present a variety of screening tools for the identification of children at risk for FASD.

Building clinical capacity for fetal alcohol spectrum disorder diagnoses in western and northern Canada.

Background: Fetal alcohol syndrome and fetal alcohol spectrum disorder are common problems. In response to this problem the Canada Northwest FASD Research Network was established in 2005 by the Canada Northwest FASD Ministerial Partnership. This study was conducted to determine the FASD clinical activity in Canada Northwest.

Preventing fetal alcohol spectrum disorders. Preconception counseling and diagnosis help.

Question: By the time women find out they are pregnant and see a family physician, they might have already consumed alcohol during the pregnancy and affected the development of their fetuses. How can family physicians better prevent exposure to alcohol during pregnancy?

Answer: Women of childbearing age should be counseled about the risks associated with alcohol consumption during pregnancy before they become pregnant. Diagnosing children who have fetal alcohol spectrum disorders can help identify birth mothers who are at risk of other alcohol-exposed pregnancies and who need support to change their behaviour.

Variation in health care provider definitions of moderate consumption of alcohol as related to recommendations regarding alcohol consumption during pregnancy: results from a Canadian survey.

Women rely on health care providers for general health care and preconception counseling, including advice on alcohol consumption. Definitions of moderate consumption may differ by individual provider, resulting in inconsistency in advice and lack of clarity for patients both before and during pregnancy. The objective of this study was to determine if health care providers' definition of moderate alcohol consumption was associated with advice to pregnant women regarding alcohol use during pregnancy and to describe health care providers' communication regarding alcohol consumption.

Clinical practice characteristics and preconception counseling strategies of health care providers who recommend alcohol abstinence during pregnancy.

Objective: National initiatives on fetal alcohol syndrome in Canada and the United States aimed at prevention, identification, and treatment of individuals who are affected by alcohol exposure in utero recommend that women abstain from consuming alcohol during pregnancy. Health care providers are key educators regarding appropriate alcohol use. The objective of this study was to describe characteristics of physicians who recommend alcohol abstinence during pregnancy with regard to knowledge of fetal alcohol syndrome and preconception counseling strategies.

Application of the fetal alcohol syndrome facial photographic screening tool in a foster care population.

We determined the prevalence of fetal alcohol syndrome (FAS) in a foster care population and evaluated the performance of the FAS Facial Photographic Screening Tool. All children enrolled in a Washington State Foster Care Passport Program were screened for three conditions: (1) the FAS facial phenotype from a photograph, (2) evidence of brain damage with prenatal alcohol exposure from their Health and Education passport, and/or (3) other syndromes identifiable from a facial photograph. Screen-positives received diagnostic evaluations at a FAS Diagnostic and Prevention Network clinic.