In a new JAMA study of more than 6,000 first-graders, researchers estimate that between 1.1% and 9.8% of American children have developmental or neurological problems caused by fetal alcohol spectrum disorders (FASDs)—a significantly higher number than previous studies have reported. And out of the hundreds of children determined in the study to have FASD, only two had been previously diagnosed.
The estimate comes from school-based assessments, family interviews and in-person evaluations of 6- and 7-year-olds in four communities across the country: one in the Midwest, one in the Rocky Mountains, one in the Southeast and one in the Pacific Southwest. Previous studies, which have estimated the rate of FASD to affect just 1% of children, involved smaller groups of people from single communities or from people in doctors’ offices, say the authors of the new study.
FASD is an umbrella term for health abnormalities caused by exposure to alcohol in the womb; it includes fetal alcohol syndrome, partial fetal alcohol syndrome and alcohol-related neurodevelopmental disorder. FASDs are a leading cause of developmental disabilities around the world, and people with these conditions can experience growth deficiencies, facial abnormalities and organ damage. They often have physical, cognitive and social challenges throughout life, and have an increased risk of premature death.
Before the current study began, researchers established standardized classification criteria for FASD based on facial features, growth, and neurodevelopmental performance. Using that criteria, they then screened a random sampling of first-graders in public and private schools in the four chosen regions, and interviewed the children’s mothers and other close relatives.
Based on their findings, the authors determined that FASD affected between 11 and 50 out of every 1,000 children they examined. That translates to between 1.1 and 5%, which they say is a conservative estimate: It assumes that no additional FASD cases would be found in children in those communities that hadn’t participated in the study.