18| Fetal Alcohol Spectrum Disorder – With Dr. Jeffrey Wozniak

Today we give an overview of Fetal Alcohol Spectrum Disorder (FASD), which includes a collection of disorders that occur when a fetus is exposed to alcohol.  We discuss this topic with Jeffrey Wozniak, Ph.D., a neuropsychologist with extensive research and clinical experience in FASD.

A pdf of the transcript for this episode is available here.

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Show Notes (with time stamps):

• Overview of the terminology used in FASD literature (2:48)
• Prevalence of FASD and relevant descriptive statistics (5:19)
• Maternal risk factors for FASD (6:14)
• Threshold of drinking use (8:25)
• Risk factors for FASD (9:43)
• Are children with FASD protected under the Individuals with Disabilities Education Act and The Child Abuse Preventionand Treatment Act? (10:57)
• Core terminology in the FASD literature (i.e., FAS, partial FAS, etc.) (12:06)
• Should FASD be considered a neurobehavioral or neurodevelopmental disorder? (17:06)
• Risk of false negatives (i.e., how to identify children with prenatal alcohol exposure who do not have FAS facial morphology) (18:31)
• The relationship between alcohol and facial abnormalities (23:13)
• Are neural tube abnormalities the mechanism of cognitive impairment in FASD? (26:19)
• Neuropsychological battery and cognitive profile in FASD (29:15)
• Risk factors for cognitive impairment (34:32)
• Co-morbidities and differential diagnosis in neurodevelopmental disorders (36:25)
• Overview of behavioral and neurocognitive deficits in FASD (38:36)
• Neuroimaging and neurocognitive data in FASD (40:39)
• Breast feeding in FASD (43:50)
• Should a woman be concerned if she had one or two alcoholic beverages before knowing she was pregnant? (46:17)
• Washington State Fetal Alcohol Spectrum Disorder Interagency Work Group (FASD IAWG) (48:12)
• Treatment recommendations for FASD and important social/cultural factors to consider (i.e., low SES, foster care, low access to healthcare, etc.) (51:19)
• Implications of intervention (55:00)
• Implications of early screening (57:54)
• The literature examining the efficacy of diagnosing FAS based on facial morphology (59:49)
• FASD across the lifespan (1:03:02)

About Jeff

Dr. Wozniak is a Professor, Head of the Psychology Division, and a clinical child neuropsychologist in the Department of Psychiatry at the University of Minnesota where he sees patients with a variety of neurodevelopmental, neurological, and psychiatric conditions.  He also trains graduate students and clinical psychology interns in the practice of clinical neuropsychology.   Dr. Wozniak’s research focuses on Fetal Alcohol Spectrum Disorders.  He directs the University’s FASD Research Program, which conducts neuroimaging, neurocognitive, and intervention studies in FASD.  He is the past-president of the Fetal Alcohol Spectrum Disorders Study Group (FASDSG) and is involved with the Collaborative Initiative on FASD (CIFASD), which is an ongoing multi-site imaging, neurobehavioral, genetic, and facial dysmorphology project.

Dr. Wozniak and his team also work to inform the public about the dangers of prenatal alcohol exposure and to train local physicians and other professionals in diagnosing and assisting affected individuals. More information about his work can be found at: https://www.psychiatry.umn.edu/bio/psychiatry/jeffrey-wozniak

Selected References

Doyle, L. R., Moore, E. M., Coles, C. D., Kable, J. A., Sowell, E. R., Wozniak, J. R., et al. (2018). Executive functioning correlates with communication ability in youth with histories of heavy prenatal alcohol exposure. Journal of the International Neuropsychological Society, 24(10), 1026-1037.

Hendrickson, T. J., Mueller, B. A., Sowell, E. R., Mattson, S. N., Coles, C. D., Kable, J. A., et al. (2018). Two-year cortical trajectories are abnormal in children and adolescents with prenatal alcohol exposure. Dev Cogn Neurosci, 30, 123-133.

Hoyme, H. E., Kalberg, W. O., Elliott, A. J., Blankenship, J., Buckley, D., Marais, A.-S., et al. (2016). Updated clinical guidelines for diagnosing fetal alcohol spectrum disorders. Pediatrics, 138(2), e20154256.

Lupton, C., Burd, L., & Harwood, R. (2004). Cost of fetal alcohol spectrum disorders. Paper presented at the American Journal of Medical Genetics Part C: Seminars in Medical Genetics.

Suttie, M., Wetherill, L., Jacobson, S. W., Jacobson, J. L., Hoyme, H. E., Sowell, E. R., et al. (2017). Facial Curvature Detects and Explicates Ethnic Differences in Effects of Prenatal Alcohol Exposure. Alcohol Clin Exp Res, 41(8), 1471-1483.

Suttie, M., Wozniak, J. R., Parnell, S. E., Wetherill, L., Mattson, S. N., Sowell, E. R., et al. (2018). Combined Face-Brain Morphology and Associated Neurocognitive Correlates in Fetal Alcohol Spectrum Disorders. Alcohol Clin Exp Res, 42(9), 1769-1782.

Tan, C. H., Denny, C. H., Cheal, N. E., Sniezek, J. E., & Kanny, D. (2015). Alcohol use and binge drinking among women of childbearing age—United States, 2011–2013. Morbidity and Mortality Weekly Report, 64(37), 1042-1046.

Wilhoit, L. F., Scott, D. A., & Simecka, B. A. (2017). Fetal Alcohol Spectrum Disorders: Characteristics, Complications, and Treatment. Community Ment Health J, 53(6), 711-718.

Williams, J. F., Smith, V. C., & ABUSE, C. O. S. (2015). Fetal Alcohol Spectrum Disorders. Pediatrics, 136(5), e1395-1406.

Wozniak, J. R., Mueller, B. A., Mattson, S. N., Coles, C. D., Kable, J. A., Jones, K. L., et al. (2017). Functional connectivity abnormalities and associated cognitive deficits in fetal alcohol Spectrum disorders (FASD). Brain Imaging Behav, 11(5), 1432-1445.