Terms and Definitions

 

 

In 1996 a five-category system was suggested by the Institute of Medicine in the United States to describe the range of effects that can be caused by prenatal alcohol exposure.

 

They are as follows:

 

 

1.                  Fetal Alcohol Syndrome (FAS). 

The characteristics needed to define FAS are:

 

a)                 facial anomalies which include small eye openings, flat, thin upper lip, little or no philtrum ( the groove between nose and lip), and a flattened mid-face.

 

b)                 Growth retardation in at least one of the following ways:

 

·        Low birth weight

·        Weight loss which is not due to poor nutrition

·        Low weight to height ratio

 

c)                  Central Nervous System abnormalities in at least one of the following areas:

 

·        Small head size at birth

·        Structural abnormalities in the brain

·        Poor fine motor skills; poor eye-hand coordination; hearing loss which is not related to injury or illness; poor gait when walking.

 

In addition to the evidence of these characteristics the doctor must have knowledge of maternal alcohol consumption.

 

 

2.                  Fetal Alcohol Syndrome
diagnosed without knowledge of mother’s alcohol consumption providing all other characteristics necessary to diagnose Fetal Alcohol Syndrome are present.

 

3.                  Partial Fetal Alcohol Syndrome (PFAS)

The following criteria are necessary to describe Partial Fetal Alcohol Syndrome:

 

a)                 knowledge that there was maternal alcohol consumption

 

b)                 some of the facial anomalies which are characteristic of Fetal Alcohol Syndrome.

One of the following three characteristics:

 

c)                  growth retardation in at least one of the following ways:

 

·        low birth weight

·        weight loss which is not due to poor nutrition

·        low weight to height ratio

 

d)                 Central Nervous System abnormalities in at least one of the following areas:

·        Small head size at birth

·        Structural abnormalities in the brain

·        Poor fine motor skills, poor eye-hand coordination, hearing loss which is not related to injury or illness, poor gait when walking.

 

e)                 a pattern of behaviour or cognitive abnormalities that are not age-appropriate and cannot be explained by heredity or environment alone.  These abnormalities may include:


·        poor school performance

·        deficits in language, both expression and comprehension, and

·        specific mathematical skills

·        poor abstract thinking ability

·        poor impulse control

·        inability to interpret and respond to social situations

·        problems with memory, attention and judgement.

 

4.                  Alcohol-Related Birth Defects (ARBD). 
This term describes congenital abnormalities related to:

 

a)                 the heart

b)                 the skeleton

c)                  the kidneys

d)                 the eyes

e)                 the ears


To relate these abnormalities to alcohol, there must be knowledge of maternal alcohol consumption.

 

5.                  Alcohol-Related Neurodevelopmental Disorder (ARND). 
This term describes the presence of one or both of the following:

 

a)                 central nervous system abnormalities in at least one of the following areas:

·        small head size at birth

·        structural abnormalities in the brain

·        poor fine motor skills, poor eye-hand coordination, hearing loss which is not related to injury or illness, poor gait when walking.

 

 

b)                 a pattern of behaviour or cognitive abnormalities that are not age-appropriate and cannot  be explained by heredity or environment alone.  These abnormalities may include:

·        poor school performance

·        deficits in language, both expression and comprehension, and specific mathematical skills

·        poor abstract thinking ability

·        poor impulse control

·        inability to interpret and respond to social situations

·        problems with memory, attention and judgment

 

 

To relate these abnormalities to alcohol, there must be knowledge of maternal alcohol consumption.

 

 

 

 

Note:

 

Fetal Alcohol Effects (FAE) is another term which has been used commonly to describe a condition which does not meet all of the criteria needed to diagnose FAS.  The Institute of Medicine in the United States has recommended that the term Partial FAS be used since the term FAE causes confusion among professionals and the public.  The use of the word “partial” does not imply that the condition is less severe than FAS.

 

 

 

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