This is a summary of the recent research article called Teacher-Reported Prevalence of FASD in Kindergarten in Canada: Association of Child Development and Problems at Home. The work was done in collaboration with multiple organizations and institutions throughout Ontario, Manitoba, Alberta, and British Columbia. For a detailed understanding of this subject matter, please read the full paper.

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Background

Fetal Alcohol Spectrum Disorder (FASD) is difficult to diagnose given the unique patterns of cognitive challenges faced by each individual. In addition, individuals with FASD often have co-occurring mental health concerns, such as Attention Deficit/Hyperactivity Disorder or Autism Spectrum Disorder, which complicates further the provision of an accurate diagnosis. When unrecognized, individuals with FASD may struggle to meet expectations, and experience significant challenges in school, and in some cases may experience adverse outcomes as they get older, including involvement with the justice system, and/or substance use. By recognizing FASD in early childhood, and ensuring the children receive the proper supports and intervention early in life, these risks may diminish, and the road to healthy outcomes better identified.

The authors of the current study had two primary objectives: (1) to determine the prevalence of teacher-reported diagnosis of FASD in kindergarten children; and (2) to determine the developmental health of children with FASD. A secondary objective of the study was to compare the prevalence of problems at home between children with FASD and children with other neurodevelopmental disabilities (NDD).

The authors used data collected with the Early Development Instrument (EDI) included in the Canadian Children’s Health in Context Study. The EDI assesses five domains of developmental health including physical health and wellbeing, social competence, emotional maturity, language and cognitive development, and communication skills and general knowledge, in addition to problems at home.

Main Findings

Prevalence

Across Canada (excluding New Brunswick and Nunavut), 523 children were diagnosed with FASD-only, 135 were diagnosed with FASD along with at least one additional diagnosis (FASD+), and 8,465 were diagnosed with another neurodevelopmental disorder (NDD).

The prevalence of FASD-only ranged from 0.01% in Quebec to 0.22% in British Columbia. The prevalence of FASD+ ranged from 0.01% in Ontario to 0.10% in Alberta. The prevalence of NDD ranged from 0.61% in the Northwest Territories to 1.92% in Newfoundland and Labrador.

Developmental Status

National

• Children with FASD-only had better scores on all 5 domains of the EDI compared to children with other NDD.
• Children with FASD-only had better scores on social competence compared the FASD+ group.
• The FASD+ group had better scores on communication skills and general knowledge compared to the NDD group.

Provincial

Data from British Columbia, Alberta, Manitoba and Ontario data were each examined individually.

• All provincial results mirrored those of the national results with the FASD-only group outperforming the NDD group on most or all EDI domains.
• The score of the FASD+ group fell between the FASD-only and NDD groups’ scores.

Prevalence of Problems at Home

Children with FASD-only and FASD+ had more problems at home compared to children in the NDD group.

Recommendations

• There is a need to increase educators’ ability to recognize or screen for FASD, which may lead to earlier identification and implementation of appropriate supports.
• It is important to continue national efforts to accurately identify children with FASD as early as possible so that they can receive the necessary supports to facilitate success.
• Schools may provide a safe and stable environment for children with FASD who also have a high number of problems at home
• The education system may act as an access point to professional services that would benefit the FASD affected children.

Take home message
There is a high level of consistency in diagnostic practices across Canada as indicated by the comparable domain scores between national and provincial data. Importantly, this may reflect consistent use and implementation of the Canadian Guideline for FASD diagnosis. Although children with FASD tend to have better developmental health outcomes compared to children with other NDDs, they experience more problems at home, which can adversely affect their school performance. Informing educators about FASD and how they may be able to recognize both the disorder and adverse home experiences should increase the chances that the children impacted will be connected with the necessary supports that they require earlier in life. This is in line with the recently developed Towards Healthy Outcomes intervention model for individuals with FASD, which includes recommended interventions and practices across the lifespan.

Authors: Jacqueline Pei, Caroline Reid-Westoby, Ayesha Siddiqua, Yomna Elshamy, Devyn Rorem, Teresa Bennet, Catherine Birken, Rob Coplan, Eric Duku, Mark A. Ferro, Barry Forer, Stelios Georgiades, Jan Willem Gorter, Martin Guhn, Jonathon Maguire, Heather Manson, Rob Santos, Marni Brownell, Magdalena Janus

Journal: Journal of Autism and Developmental Disorders

Date: 29 May 2020

Organization: This was a collaboration between multiple institutions in Alberta, British Columbia, Manitoba, and Ontario.

Read the full article (open access)