Talk:Fetal alcohol spectrum disorder

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Clarren

What is Dr. Clarren a doctor of, sociology? There is no presentation of the fact that some scientists believe that FAS is on par with phrenology and other pseudoscience.

There is no mention of the fact that genuine scientific study can not be conducted in the US because pregnant women are sanctioned from drinking in pseudo-legal manoeuvers that threaten their families, finances and freedom.

There is no mention of scientific studies which regard the fact that alcohol poisoning robs the body of oxygen, and the fact that foetal blood has a higher affinity for oxygen than maternal blood, and the fact that alcohol is metabolised relatively quickly in the body and that the placenta offers a blood barrier all suggesting that a foetus can not easily be affected by maternal alcohol consumption.

There is no mention of statistics about the frequency of 'identification incidents' relative to socio-economic status and race, which are strangely more correlative than with actual incidents of alcoholism. This is probably because there is no index for exposure to other home and workplace poisons in the FASD four digit diagnostic code. (posted by 195.137.78.175)

Hi 195.137.78.175, could you sign and date your posts please by typing four tildes after your post, like this ~~~~. Dr Sterling Clarren is one of the world's leading experts on FASD, based in the Fetal Alcohol and Drug Unit at the University of Washington in Seattle, which is the dept that first named the condition, along with a researcher in France. I believe he's a neurologist. If you can provide evidence of what you're saying, by all means do so, and if you're in doubt as to how to present it, post it here first, and someone will be glad to help out. SlimVirgin 01:54, Mar 19, 2005 (UTC)

More information on Sterling Clarren: he is the Robert A. Aldrich Professor of Pediatrics and former head of the Division of Congenital Defects at the University of Washington School of Medicine. Also currently the medical doctor for the University of Washington FAS Diagnostic and Prevention Network clinic and the director of Infant Inpatient Services for Children's Hospital and Regional Medical Center. He received his BA from Yale University and his MD from the University of Minnesota. His post-graduate training was in pediatrics, followed by a fellowship training in neuroembryology, teratology, and dysmorphology. He certainly counts as a good source for Wikipedia. SlimVirgin 02:13, Mar 19, 2005 (UTC)

Mr/Mrs 195.137.78.175, just to clarify a few mistakes you have made. (1) The placenta is completely permeable to alcohol. (2) Genuine scientific study can be conducted in the US, and is, using all sorts of non-human mammals, some of which share up to 97 percent of their genetic code with humans. These type of "genuine" scientific studies holds all variables constant except for alcohol/no-alcohol consumed during pregnancy. This is pretty much sine qua non in scientific investigation. Nothing new here. If you would like to believe that alcohol is not harmful to a developing fetus, it is your right to have faith in such an idea. But if you do a quick empirical journal search in Google scholar on "fetal alcohol syndrome" you get Results 1 - 20 of about 28,500 for fetal alcohol syndrome [definition]. (0.20 seconds) so you might want to back up what your saying with a little more than armchair commentary. Niubrad (talk) 04:11, 12 April 2009 (UTC)

Hi Slim, Why does he do statistics backwards by guessing a percentile and extrapolating diagnoses? Why do the attached statistics vary a hundredfold? Where has he been published?

A good opposing viewpoint is found in the work of Canadian Dr. Donna Mergler, but I don't have access to medline anymore.

Also, newspapers have had of accounts since the 80's of alcoholic women that have been incarcerated until they come to term, had their other children taken away under broad interpretations of child abuse laws, and women have even been charged with distributing controlled substances to a minor.

Even hard science has it's biases due to what one can obtain grant money to study, but "there are lies, white lies, and statistics" [195.137.78.175]195.137.78.175 14:25, 19 Mar 2005 (UTC)14:26, Mar 19, 2005

Normal drinking

Hey folks. The page mentions that normal drinking is safe - is this true? Most places recomend absolutly no drinking. Also, the word "normal" is a bit ambiguous ... If I always drink a fifth a day, does that make it normal, and thus safe? 128.104.102.148 21:29, 13 Jun 2005 (UTC)

I agree with the above comment as I have consistently read about complete abstinence in documents by researchers and the federal government. For example -- SAMHSA: “There is no proven safe amount of alcohol use during pregnancy.” Center for Disease Control: “There is no known safe amount of alcohol to drink while pregnant and there also does not appear to be a safe time to drink during pregnancy either.” Surgeon General: “No amount of alcohol consumption can be considered safe during pregnancy. … A pregnant woman should not drink alcohol during pregnancy.” DFurlani 18:18, 4 July 2006 (UTC)

To maintain a neutral point of view, the fact that most organizations (for lack of a better word) recommend total abstinence should be added (if it isn't already mentioned) and the fact that some studies seem to indicate that small amounts may not cause problems should also be included.

For a while the article had a short paragraph and linked to an off-site article about this, but a somewhat recent edit listed a huge number of studies one-by-one instead. On one hand, more sources are better than fewer, and stating the actual results of individual studies rather than a general interpretation of several put together is often more accurate. On the other hand, a long list may be overkill and the overwhelming length might itself be considered POV. I, for one, favor a return to an paragraph or two with an external link for those desiring more information. --Icarus 06:09, 5 July 2006 (UTC)

Expanding

I'm going to try expanding this article some more over the next few days/weeks. My apologies if it looks a little odd during the process, perhaps with points repeated in various sections. This is a feature of working on a little bit at a time. I'll try to tidy up as I go along. SlimVirgin ^(talk) 08:32, 21 January 2006 (UTC)

POV check

Fetal alcohol spectrum disorder needs to be checked. I doubt that the article presents a neutral point of view: the statement that "small amounts of alcohol during pregnancy might not pose a risk to the fetus" has disappeared. the article also lists links like this [1] --Melaen 22:19, 25 February 2006 (UTC)

Citation

Icarus, can you say what kind of paper this is, and whether this is a complete citation? "The American College of Obstetricians and Gynecologists. Alcohol and Your Unborn Baby. Washington, DC: American College of Obstetricians and Gynecologists, 1987" Cheers, SlimVirgin ^(talk) 03:38, 22 April 2006 (UTC)

The website that had the list of studies on the effects of light drinking is no longer around (though it exists in archive). I've selected one of the studies to use as the footnote for that section. Should others be included as well (so it doesn't look like it's one single rogue study that's never been duplicated, and is thus unreliable) or would that be overkill and/or unintentionally POV? Now that the site that was once linked to is down, it seems a shame for that compilation of sources to simply disappear if they can be preserved somehow. --Icarus 03:40, 22 April 2006 (UTC)

We'd need to know exactly what the source said. With something like this, it's best to cite a scholarly source. SlimVirgin ^(talk) 03:44, 22 April 2006 (UTC)

I've reverted because you don't know that the source said what you wrote: "Although some studies have shown that small amounts of alcohol during pregnancy might not pose a risk to the fetus, pregnant women are usually advised to abstain entirely as every fetus is different and there may be less visible (but still damaging) effects that these studies failed to pick up on." SlimVirgin ^(talk) 03:47, 22 April 2006 (UTC)

Correction: I was just browsing the "Further reading" section" and saw that while the link I knew of is now only available in archive, one of the links there is to a site with the same information. Maybe this external link can somehow be used instead of the one single citation. Would that be possible/stylistically appropriate? Here's the entire quote that had that particular source in the article I found it:

The American College of Obstetricians and Gynecologists concludes that "there is no evidence that an occasional drink is harmful. Women who drink heavily throughout pregnancy may have smaller babies with physical and mental handicaps, but women who drink moderately may have babies with no more problems than those women who drink rarely or not at all."

There are several other sources cited in that article. I just chose one for the sake of having something to put down for a reference. If another one has a wording that's easier to work into the article, then it can be changed to that one. I do not understand, however, why you thought it had to be removed from the article entirely. I'll leave it that way for right now to avoid accidentally starting an edit war, but please explain why the non-wikipedia article and/or its sources don't count as a source for this article. (Or was it just a case of you reverting it before I finished posting this? The letters crossing in the mail, so to speak.) --Icarus 03:55, 22 April 2006 (UTC)

Thanks, Icarus. If we're going to make medical or scientific points, we need to use the best sources to make them, and not websites about courses for nurses, because they may be worded loosely. If you can find such a source, by all means go ahead and add something, sticking closely to what the source says. This is a contentious point, so we need to get it right. Yes, I think we did have a bit of cross-posting there. :-) SlimVirgin ^(talk) 04:08, 22 April 2006 (UTC)

Famous and successful people with FASD

Do we know any famous or successful people who have foetal alcohol spectrum disorder, whether they be full FAS, FAE or ARND? Remember, ARND is diagnosed at 4-5 times the rate of full FAS. What have they done and what are they famous for? Any writers, artists, scientists ... --Bronwyn Gannan 09:13, 9 May 2006 (UTC).

I have wondered about this as well. It would be nice to know!

Though, I'll tell you this. I have Fetal Alcohol Effects and attend a two-to-five year college. I'm an aspiring author, web and office technologist. I'm far from famous, but I'd say I'm fairly successful, despite the burden of my disabilities.

Zetco 02:36, 16 September 2006 (UTC)zetco

I know of a local (Twin Cities) person who has FAS and speaks frequently to groups and trains others on FAS. His website is http://www.peoplefirstmn.org/misc/hunter_sargent.html

MLHarris 20:39, 4 February 2007 (UTC)

It has been suggested that Alfred E. Neuman, the mascot of Mad Magazine, manifests physical characteristics typical of Fetal Alcohol Syndrome. Will someone familiar with this please add the appropriate material to the article on Alfred E. Neuman. [email protected] 01:47, 23 February 2007 (UTC)

Picture and associated caption

As a disabled person, I am not altogether comfortable with the finger-pointing going on in the image demonstrating a FAS child and "blaming" him for the welfare costs. It vividly brings to mind the infamous T4 poster. It's perfectly fine to point out that FAS is costly, but let's not associate it with a person who bears no personal responsibility for his FAS. HuckFinn 22:42, 4 September 2006 (UTC)

It doesn't seem in the least like "blaming" of the baby to me. (The responsibility for FAS is quite clear, unlike many problems.) Nevertheless, I see it could be taken that way. Why don't you just move that part of the caption into the text, say into the last para of the intro? -R. S. Shaw 02:57, 5 September 2006 (UTC)

It's Ridiculous! It's clearly the mother's reponsibility not to poison the foetus during pregnancy. —The preceding unsigned comment was added by 172.143.38.170 (talk) 13:57, 13 December 2006 (UTC).

Good Article

This page is a good article because:

• It is well cited and referenced.
• It is very notable in modern society.
• It is well written.
• It is stable.
• It is well organized

Treatment Considerations

I would like to suggest adding a section about treatment of FASD. Public understand and awareness of FASD lag behind that of other, better known disorders, such as Autism, Down Syndrome, ADHD, and so forth. Although each disorder is unique, there seem to be some aspects of describing disorders that are common across all (or at least, many) of them. Paying particular attention to FASD in this regard will likely help increase understanding and awareness of it and bring its understanding up to par with that of other disorders. Given my experience in diagnosing and treating FASD, it seems like adding a treatment section might be the next logical step for this article. I would like to take a stab at that, but welcome any and all comments about it. Thanks. MLHarris 18:22, 28 January 2007 (UTC)

Diagnostic Considerations

Now that I think about it, the Diagnosis section could use some updating as well. There are essentially three U.S. diagnostic systems--the University of Washington's 4-digit code system (best documented), the CDC's system (an amalgamation of expert opinion and experience across the U.S.), and the OIM criteria. This does not include any Canadian systems or the Minnesota model of diagnosing FASD, both of which are related to and similar to the other three systems, but have a few peculiarities of their own. The current listings in the article do not account for these systems. I will attempt to add language that includes acknowledgement of these as well. MLHarris 04:29, 29 January 2007 (UTC)

Goal: Featured Article Status

I'd like to suggest that we aim for Featured Article status on FASD. I've looked at the A-Class article criteria, and that is doable; then FA-Class would be the natural next step. FASD is such a prevalent but relatively unknown disability that those with FASD deserve the best article possible. I'm planning to make a To-Do list after figuring out what should be listed. Any and all help, views, suggestions, or comments are welcomed. MLHarris 12:43, 5 February 2007 (UTC)

Additions have been made to diagnosis and treatment sections, as well as fleshing out other subsections. It seems appropriate to add a To-Do list to attract additional editors to review the article in preparation of submitting for FA-class review, and I will respectfully do so. MLHarris 17:17, 24 February 2007 (UTC)

I suggest before considering FA candidacy, the name and scope of the article will need to conform with established medical knowledge; there is no such medical condition as Fetal Alcohol Spectrum Disorder. SandyGeorgia (Talk) 16:10, 25 February 2007 (UTC)

I'm an Angry Puppy

My mother drank wine while she was pregnant with me and my sister. Finding out that caused FAS in my sister and me at age 12 totally sucks. Alcoholic Father + FAS Kids = Mega Disaster. Mummy dearest should have looked up drinking wine while pregnant a long time ago. Moofinluvr

Notes versus further reading

I'm noticing that the Notes and Further Reading sections might be a bit redundant in the way they are being used in this article. What about combining them into one section? (Probably Further Reading?) MLHarris 14:33, 17 February 2007 (UTC)

I went ahead and combined the sections. While doing so, I realized the article had been using two different citation styles (both Harvard and APA), which is probably why two ref lists arose. Being a psychologist, I'm more familiar and comfortable with the APA style and would like to recommend keeping that style... it keeps most information in the reference list, rather than in the text. It is also easier to "click" on the superscript to get the reference data, rather than having to scroll down the page, remember the author name, search alphabetically, etc. Hope this works for everyone.MLHarris 13:42, 18 February 2007 (UTC)

Have a look at WP:EL, WP:NOT and WP:GTL; I've pruned the External link farm (Wiki is not a Community resource guide, web directory, or a support group - there is probably a DMOZ category which can be linked to for support groups). External links, further reading, and references/notes are explained in the guide to layout. SandyGeorgia (Talk) 06:33, 13 March 2007 (UTC)

Thanks for your help and direction for proper formatting of this article.MLHarris 13:05, 14 March 2007 (UTC)

Article is incorrectly named

This article is incorrectly named, and incorrect wikilinks have been proliferated throughout Wiki. The recognized diagnosis and medical name of the condition is Fetal alcohol syndrome (acknowledged in the article). Almost all of the sources used refer to fetal alcohol syndrome. Google, Google Scholar, and PubMed all return orders of magnitude larger hits on Fetal alcohol syndrome than on Fetal Alcohol Spectrum Disorder, the condition is commonly known as FAS, so Wikipedia:Naming conventions (as well as WP:MEDMOS) suggest Fetal alcohol syndrome should be used as the article title. The main article should be FAS, referring as appropriate to the spectrum disorders.

• Google hits on FAS 1,090,000; FASD 136,000
• Google scholar hits on FAS 11,700; FASD 529
• Pubmed for FAS 3166; FASD 63

Also, every link from our MEDMOS-approved infobox uses FAS:

• (760.71) Fetal alcohol syndrome is the current ICD-9 diagnosis
• http://www.diseasesdatabase.com/ddb32957.htm
• http://www.nlm.nih.gov/medlineplus/ency/article/000911.htm
• http://www.emedicine.com/ped/topic767.htm
• http://www.nlm.nih.gov/cgi/mesh/2007/MB_cgi?field=uid&term=D005310

Where is there any official use of FASD as a recognized medical diagnosis?

The article should be moved back to Fetal alchohol syndrome, with FASD redirected to FAS (and a lot of wikis and redirects still need to be fixed). Also, someone has been changing links to referenced works about FAS to FASD (which is how this article came to my attention); please don't do that, as the other articles refer to referenced reliable sources that mention fetal alchohol syndrome, and changing the terminology alters the accuracy of other articles. SandyGeorgia (Talk) 06:33, 13 March 2007 (UTC)

In case it matters, editors here should also know that the editor who listed this article at GA [2] was blocked long ago for sockpuppetry, and disrupted FAC. The article still looks close to GA to me, but ... SandyGeorgia (Talk) 06:50, 13 March 2007 (UTC)

Also, note the GA was conferred to the correct name of Fetal alcohol syndrome. SandyGeorgia (Talk) 15:48, 13 March 2007 (UTC)

And, because the article was already moved once from the correct article name, admin help will be needed to get it (and history) correctly moved back. SandyGeorgia (Talk) 15:58, 13 March 2007 (UTC)

Another note; a review of WP:MEDMOS may be helpful in getting this article in shape—the TOC is a bit rambling and unfocused. SandyGeorgia (Talk) 15:19, 13 March 2007 (UTC)

These are all understandable comments. However, I would like to present an alternative point of view and idea. A new section after paternal effects begins that discussion. Thanks.MLHarris 13:05, 14 March 2007 (UTC)

Presenting what you call "an alternate point of view" in an FASD article about FASD is within Wikipedia policies; the problem here is that the alternate point of view has become the main article, against policies as outlined above. The main article (FAS) needs to be restored, and FASD presented in context, linked from FAS. There is a lot more work to do on restoring the links throughout Wiki. I hope you don't have aims on FAC soon, because a lot of work is needed here, and I would have to strongly object if it came to FAC in its current condition. The best place to start (after correcting the name and getting the article moved back to FAS) is to think in terms of article organizaiton of an encyclopedic entry and trimming the table of contents to conform more closely to WP:MEDMOS; the article rambles, has too much info crammed in, and could benefit from more tightly focused article organization. Also, there are many WP:MOS issues to be worked out still. The article is verging on issues of WP:NOT; the information presented is excellent, but encyclopedic focus is missing. I'll be traveling for a few weeks, but can help down the road; in the meantime, the name needs to be corrected. SandyGeorgia (Talk) 13:54, 14 March 2007 (UTC)

Thanks so much... additional information is presented below. I am committed to helping make this article the best it can be in concert with all the other editors, and would never submit it for FAC consideration before it is the right time, based on your and others' judgments. (The notes I made on the discussion page were intended to draw more editors in so that this very process would occur.) I don't want to sound defensive, but the FAS and FASD articles were merged before I submitted edits, so I just added information to the FASD article thinking that the article name matter had been settled before my time. I definitely understand and agree with the issues and suggestions you have brought forth and want to contribute in any positive way that I can. I can't tell you how much I appreciate your attention to this article.MLHarris 14:08, 14 March 2007 (UTC)

You've done an excellent job; nothing to be defensive about :-) The content is there; just needs some reorganization and focus, and some attention to some WP:MOS issues that can be hard to keep up with on Wikipedia, unless you're a regular FAC follower. When I first started working on Tourette syndrome, it was all over the place. I resisted for several months, but when I forced myself to organize it according to the sections in WP:MEDMOS, it did become more focused, with a cleaner Table of Contents and better article organization. I'm willing to help out in April; in the meantime, maybe you can consider separating the content into the FAS and FASD articles? SandyGeorgia (Talk) 14:20, 14 March 2007 (UTC)

PS, one of the things I can help with—in case you don't have time—is getting PMIDs added to all of your references; have a look at the references in Tourette syndrome. SandyGeorgia (Talk) 14:25, 14 March 2007 (UTC)

Thanks so much. I will review the recommended sections on style, recommended articles, and so forth to improve my contributions to our efforts here. I'm thinking that pruning and editing the FAS article would be the best next step for me in bringing improvement and separation to the FAS and FASD articles... I can work on that and would very much appreciate guidance on stylistic issues as I learn and clunk through the editing process. If you have time to address the PMIDs, SandyGeorgia, that would be great. I would really like to learn more about that over the course of this project but would be starting from scratch on that score. I'll catch on though. Looking forward to it, MLHarris 03:03, 15 March 2007 (UTC)

If you just focus on the text/content (which you clearly know well), I can work on stylistic things and PMIDs after I return from two weeks of travel—'til then. SandyGeorgia (Talk) 03:10, 15 March 2007 (UTC)

Paternal effect

I can find no mention of it here; PMID 15223537 SandyGeorgia (Talk) 20:25, 13 March 2007 (UTC)

This is a good point. There is emerging evidence of deleterious effects on offspring as a result of paternal alcohol use (aside from the better known environmental effects from growing up in an alcoholic family). Paternal effects seem limited to ADHD-like problems, learning problems (stemming from memory deficits as listed in the abstract of the article noted above), and a poor stress response (which I believe is partilly mediated by hormonal issues with cortisol, but I could be wrong on the exact mechanism). Technically, FAS and the other FASD conditions require maternal alcohol exposure (or unknown exposure) from a diagnostic perspective, so appreciation of paternal effects is only considered as part of central nervous system damage and not functionally or diagnostically distinguished from the maternal effects at this point in time. So, while this aspect of alcohol use is not directly related to FAS or FASD in the way that diagnostic criteria are currently established in the literature and in practice, noting this as an emerging area/concern is a great idea and reinforces that FASD is not just a mother's issue (i.e., mothers need support from partners' for prevention efforts). My thinking/suggestion is that a sentence or two on paternal effects would go into a broader FASD article, rather than a more specific FAS article. The reasoning for this is that FASD includes everything about fetal alcohol exposure, while FAS is very specific in its cause and expression.MLHarris 13:05, 14 March 2007 (UTC)

I'm going on memory here, and it sounds like you know the research thoroughly, but several years back (many years back?) I saw reports suggesting that FAS could be caused by paternal alcohol consumption. It stuck in my mind because it was the first time I had ever seen a photo of an FAS baby, and I recognized the features of a child whose mother was an acquaintance of mine who I don't believe drank in pregnancy, but whose father was alcoholic. Just wondering if there isn't more research in this area, or if my memory is wrong; the article I saw then was stating that paternal alcohol could be a cause of actual FAS, but I don't know/recall if it was a media report of a journal study. SandyGeorgia (Talk) 14:44, 14 March 2007 (UTC)

Maybe there are two articles

Background

Understandable comments about whether or not this is a correctly named article have been brought forth, and in many ways, this is a reflection of the somewhat unwieldy growth and emergence of the field. Unlike many medical conditions, fetal alcohol syndrome (FAS) was named after its cause by the person who discovered it in the early 1970s. This break from traditionally having eponymously named syndromes was made on the (now seen to be naive and incorrect) assumption that people would refrain from alcohol use during pregnancy if they knew it would cause such permanent disabilities in their children. Unfortunately, addictions do not often respond to logical persuasion, and the syndrome's name actually activated the shame and stigma of hurting one's children by (often incorrect) social conventions that a choice was involved in addictive behavior. This, of course, complicated accurate diagnosis, because many people with untreated addictions minimize or deny their addictive behaviors, making accurate diagnoses more challenging.

The situation was further complicated when it was later found that disabilities existed in individuals without the full expression of FAS. This condition was initially called fetal alcohol effects (FAE), to distinguish it from the "full-blown" condition. The problem, though, was that individuals with FAE often have more secondary disabilites than those with FAS. This occurs because such individuals have the central nervous system damage (and challenging functional behaviors) but no visual cues that they have a disability (i.e., facial characteristics, growth deficiency). They look "normal" but have disabilities which are often attributed to willfulness, and so they are typically misdiagnosed with ADHD, ODD, Autism, or other problems, rather than FAE, and fail to get proper treatment.

To correct this, "the field" began to talk about the higher risks of those with FAE, asserting (correct)statements that "FAE is not a lesser condition than FAS" (because of the higher rates of secondary disabilities). There began to be talk of doing away with the term FAE altogether (citation in the current article) because it misdirects a layperson into believing that less intervention is needed for FAE, when in fact the opposite is usually true.

Enter "Fetal Alcohol Spectrum Disorder" (FASD). This is a recent (within the last four years or so) effort to focus the field and laypersons on the deleterious effects of prenatal alcohol exposure without particular regard to facial features or growth deficiency (which have little or no obvious primary disability in and of themselves--they are signals of FAS and some FASD conditions, but not a causal factor of any functional challenge).MLHarris 13:54, 14 March 2007 (UTC)

There is of course the problem of the diagnostic criteria for FASD simply being some form of developmental, behavioural or intellectual problema in offspring of parents who ingested any alcohol before conception or prenatally. That this approach might overstate the problem in alcohol consuming societies is pretty obvious and has been written about. Although commenting on the quality of publications on FASD would constitute OR, a section dealing with this would be appropriate in the split off FASD article.FelixFelix ^talk 14:54, 4 April 2007 (UTC)

None of the criteria include alcohol consumed prior to conception (only after conception), and the "unknown consumption" criteria demand that facial features be sufficiently present to indicate that enough alcohol was used to create the dysmorphology. I can review the diagnostic section to see if this is unclear and make edits (I know it's still a bit unwieldy anyways at this point). However, your main point is well taken about adding a section that includes that point. I am not readily familiar with that channel of literature... perhaps a reference or two and I could investigate it a little? MLHarris 12:21, 9 April 2007 (UTC)

Current directions

Recent books and articles--indeed, two of the diagnostic systems have it in their title (4-Digit and Canadian), and the CDC guidelines acknowledge FASD in its contents--are all moving toward the term FASD, while including FAS within that spectrum. The effort is aimed at enhancing the attention and greater challenges of other FASD conditions while placing FAS in a more appropriate perspective. This would explain the greater number of article hits for searches on FAS than FASD, and is the basis of my proposal to have two articles--similar to that for Autism and Autism spectrum.

I have more thoughts, which I will add later, but I have to go to work now. In any event, this is a great discussion opportunity. Thank you.MLHarris 13:54, 14 March 2007 (UTC)

I'm not at all opposed to two articles; in fact, it's what I advocate. Fetal alcohol syndrome is the recognized condition; it needs to be the main article per naming conventions, supported by search data. FASD can expand the topic further, and would not be an insignificant article. But we do need to get this straightened out. The GA was problematic to begin with, and was conferred to FAS. After setting up the two articles correctly—including links to each other and the use of summary style—then you can decide which one goes to WP:FAC, but FAS needs to be the main article. SandyGeorgia (Talk) 14:10, 14 March 2007 (UTC)

Yep, I think that FAS should definately be separated from the much less well defined FASD, which has all kinds of poor diagnostic criteria, and a fairly large amount of poor quality publications based on said criteria. Some mention of that should be made in the article too. I've also softened the intro a little, which seemed to conflate FAS and FASD too much.FelixFelix ^talk 14:36, 4 April 2007 (UTC)

I'm willing to help is someone is going to begin the work, but it's not my area, so I don't feel qualified to do the work. I'd hope to see this straightened up soon, considering the elapsed time already. SandyGeorgia (Talk) 16:53, 4 April 2007 (UTC)

Update ?

It's been about three weeks since I first raised the problems with this article, but nothing has changed. It is incorrect, inaccurately uses sources that talk about FAS to discuss FASD, and we need to get it cleaned out so that *only* accurate and sourced info that actually discusses the hypothesized FASD is mentioned here. I'll wait a bit longer, and if nothing happens, will have to attempt the article merge/change myself. THIS article was not awarded Good article; FAS was, so I'll fix that soon. SandyGeorgia (Talk) 22:33, 7 April 2007 (UTC)

To preserve the edit histories, this is what I recommend: (1) delete Fetal alcohol syndrome and the associated talk page. (2) Move FASD to Fetal alcohol syndrome, to restore it to the title it had when it received the "good article" designation. (3) Create a smaller article at Fetal Alcohol Spectrum Disorder, which does not overlap with FAS, except to provide a summary. I will refrain from doing this for at least a week, to see if there is an overwhelming consensus against this (though I wouldn't object if someone else wanted to move more quickly.) --Arcadian 23:01, 7 April 2007 (UTC)

Sounds good. What is at FAS now is a corrected copy I put there; I can do those corrections again, but I know next to nothing on the topic (my changes were mostly WP:MOS, etc.) And, I don't know enough about either condition to create the FASD stub; someone will need to do that. SandyGeorgia (Talk) 23:16, 7 April 2007 (UTC) Also, I can help repair all the links. SandyGeorgia (Talk) 23:17, 7 April 2007 (UTC)

Correction to above. I just looked at FAS, and MLHarris did a LOT of work to it after I recreated it. I don't think we should overwrite it with this. It looks like it's in fairly good shape. We just have to figure out how to get the GA back to that article, and the talk page history back, while preserving that article. Then, prune this article back to what is specifically about FASD only. SandyGeorgia (Talk) 02:10, 8 April 2007 (UTC)

It was a *lot* of work to repair all the links; Fetal alcohol syndrome had been obliterated from Wiki, and FASD was mentioned in numerous places where the references directly mentioned FAS rather than FASD. I'm not up to the task of completely correcting the content of this article when it moves back to FAS; I don't know the field. I can make the first pass, though. SandyGeorgia (Talk) 02:06, 8 April 2007 (UTC)

As a first cut for FASD, we could cut the article down to the last paragraph of the introduction, include the content under Fetal_Alcohol_Spectrum_Disorder#Diagnosis, and delete everything else. Most of the rest is redundant to FAS, and if anything important was lost, it could always be retrieved from the article history. --Arcadian 02:43, 8 April 2007 (UTC)

How do we solve talk page history? I guess we could just move the GA, and put explanatory notes with diffs? (Now I know why they call it a mop :-) SandyGeorgia (Talk) 02:59, 8 April 2007 (UTC)

There is no solution which addresses every concern. You requested my assistance; this is the best I can offer. --Arcadian 16:11, 8 April 2007 (UTC)

Thanks, Arcadian; I'm going to fix the GA manually, so we can work on each of these articles without moving them. SandyGeorgia (Talk) 16:52, 8 April 2007 (UTC)

Since the earlier discussions a month or so ago, I have been a little "edit shy" (also very busy at work) as I try to better understand Wikipedia policy and standards, the important edits/contributions and points made in the discussion threads, the corpus of current literature and references to FAS and FASD, and my own understanding of the conditions and how that plays out in a clinical setting. Originally, I thought using the Autism and Autism Spectrum Disorder articles would serve as a potential model for this situation because of the similarities (historical development and conceptual model/format), but alas, the latter article does not yet appear, in my opinion, to be in a clinically fleshed out condition. I would not hope for the FAS and FASD articles to be similarly imbalanced. The main obstacle for me has been conceptualizing one article as a main article versus a supporting article, which has made it hard for me to offer or evaluate suitable edits (at least on a clinically consistent basis). However, the direction to continue editing the two articles separately (though not simply or mechanically pruning all material that looks inappropriate, as sometimes reframing or reshaping the information may suffice) seems a good course to take and helps me to resolve my own issues about it and feel that I can make worthwhile edits--the process is working. I don't have an opinion yet about the talk histories, but it does seem reasonable to have moved the GA back in the way that it happened. Finally, I suspect that some material/sections could be removed to a new/supporting article altogether (I'm thinking the diagnostic systems in particular). MLHarris 13:19, 9 April 2007 (UTC)

The biggest thing that we should tackle quickly is that statements referenced to published medical literature on FAS were changed to FASD. We need to re-source everything in the FAS article, removing references to FASD except in the very few cases where the literature actually discusses FASD (then re-evaluate if those are reliable enough to stay in the article). FASD has the same problem, and needs to be reduced to an article which specifically discusses FASD, with references to FASD. It, by definition, will be a much shorter article; most of what is here now is repetition of content that belongs on FAS, so the best place to start is to reduce this article to only that which is directly related to literature on FASD and doesn't repeat FAS content. Keep up the good effort :-)) SandyGeorgia (Talk) 14:23, 9 April 2007 (UTC)

Pause for status check

OK, since work seemed stalled, I went ahead and cleaned up this (the FASD) article. I removed everything that was specific to and redundant with the FAS article, but left large chunks that I'm not sure still belong here. I tried to leave everything that seemed specific to FASD, and different from FAS, but I think the article still needs more pruning. Can others please check ? Once we're sure this article has been reduced to only talking about FASD as it differs from FAS, then we can turn our attention to rebuilding FAS to an article that is only about FAS, not FASD. SandyGeorgia (Talk) 23:45, 10 April 2007 (UTC)

I removed a cite: WP:OR. [3] SandyGeorgia (Talk) 23:57, 10 April 2007 (UTC)

There are some unformatted footnotes, and some major deadlinks, but I think this is now generally an article which only discusses FASD as it differs (diagnostically) from FAS. Others should review. SandyGeorgia (Talk) 00:09, 11 April 2007 (UTC)

There are still numerous references to FASD and different diagnostic systems in the Fetal alcohol syndrome article. I don't know how/which to clean out of there. SandyGeorgia (Talk) 00:33, 11 April 2007 (UTC)

Fetal alcohol spectrum condition versus disorder

It seems that one editor has decided to unanimously change Fetal alcohol spectrum disorder to Fetal alcohol spectrum condition without notification, discussion nor consensus. Comments?Trilobitealive (talk) 18:25, 1 October 2012 (UTC)

Absolutely no consensus! Disorder is the accepted name, and I think this action needs to be reverted. Lova Falk talk 18:29, 1 October 2012 (UTC)

PS, If you don't move it back, I will. THEN the editor can start a discussion about the move, and if we agree it is a good idea, the article can be moved again. Lova Falk talk 18:35, 1 October 2012 (UTC)

Done! Lova Falk talk 19:43, 1 October 2012 (UTC)

It stays as Fetal Alcohol Spectrum Condition, because "I" say so. — Preceding unsigned comment added by 65.94.101.33 (talk) 01:21, 21 March 2013 (UTC)

Reviews that will likely be particularly helpful I have found

Hi people, I notice that some admins like to leave some good reviews they've found and left on the talk pages of medical articles so I thought I might try it for this article. If anyone objects to this or my other modifications (see my edit summary) to this page, please let me know, but don't just tell me my edit was wrong, but tell me what specifically you dislike about my edits on my talk page or here. Many of which has free full text available.

Generalized reviews

1. Nayak, RB; Murthy, P (December 2008). "Fetal alcohol spectrum disorder" (PDF). Indian Pediatrics. 45 (12): 977–83. PMID 19129565.
2. Mead, EA; Sarkar, DK (2014). "Fetal alcohol spectrum disorders and their transmission through genetic and epigenetic mechanisms". Frontiers in Genetics. 5: 154. doi:10.3389/fgene.2014.00154. PMC 4040491. PMID 24917878.{{cite journal}}: CS1 maint: unflagged free DOI (link)
3. Foltran, F; Gregori, D; Franchin, L; Verduci, E; Giovannini, M (November 2011). "Effect of alcohol consumption in prenatal life, childhood, and adolescence on child development". Nutrition Reviews. 69 (11): 642–59. doi:10.1111/j.1753-4887.2011.00417.x. PMID 22029831.

Aetiology (causality) and pathophysiology

1. Riley, EP; Infante, MA; Warren, KR (June 2011). "Fetal alcohol spectrum disorders: an overview". Neuropsychology Review. 21 (2): 73–80. doi:10.1007/s11065-011-9166-x. PMC 3779274. PMID 21499711.
2. Ungerer, M; Knezovich, J; Ramsay, M (2013). "In utero alcohol exposure, epigenetic changes, and their consequences". Alcohol Research. 35 (1): 37–46. PMC 3860424. PMID 24313163.

Diagnosis

1. Landgraf, MN; Nothacker, M; Heinen, F (September 2013). "Diagnosis of fetal alcohol syndrome (FAS): German guideline version 2013" (PDF). European Journal of Paediatric Neurology. 17 (5): 437–46. doi:10.1016/j.ejpn.2013.03.008. PMID 23618613.

Cancer risk

1. Burd, L; Peterson, L; Kobrinsky, N (May 2014). "Fetal alcohol spectrum disorders and childhood cancer: a concise review of case reports and future research considerations". Pediatric Blood & Cancer. 61 (5): 768–70. doi:10.1002/pbc.24886. PMID 24292988.

Brenton (contribs · email · talk · uploads) 21:27, 20 July 2014 (UTC)

Merged in FAS

FASD is bascially FAS plus milder forms of the disorder. Looking at the two pages there was a very large amount of overlap. Thus I went ahead and merged the two to the broader term, FASD. Still a fair bit of work to do but I think going in the right direction. Doc James (talk · contribs · email) 05:07, 10 June 2015 (UTC)

Proposed merge with Fetal alcohol spectrum disorder Australia

The articles are essentially the same, there is no need to have a specific one for Australia Ita140188 (talk) 09:13, 14 October 2015 (UTC)

Yup and merged. Doc James (talk · contribs · email) 11:21, 14 October 2015 (UTC)

Wiki database

There appears to be a wikidata issue with this article. I have written about it at Talk:Fetal alcohol syndrome#Interwiki links. Please respond there. ♫ RichardWeiss talk contribs 01:18, 13 December 2015 (UTC)

Bolded words in lead

Anyone have an issue if I move the bolded words at the end of the 1st lead paragraph to a footnote (similar to electronic cigarette) since FAS, pFAS, ARND, and ARBD are all explained and discussed in more detail in the body? Right now the first paragraph looks like this:

Fetal alcohol spectrum disorders (FASD) are a group of conditions that can occur in a person whose mother drank alcohol during pregnancy. Problems may include an abnormal appearance, short height, low body weight, small head, poor coordination, low intelligence, behavior problems, and problems with hearing or seeing. Those affected more commonly have trouble in school, have trouble with law enforcement, are frequently jailed, are involved in high risk sexual activity, and have trouble with alcohol or other drugs. The most severe form of the condition is known as fetal alcohol syndrome (FAS). Other types include partial fetal alcohol syndrome (pFAS), alcohol-related neurodevelopmental disorder (ARND) and alcohol-related birth defects (ARBD).

This is what I propose:

Fetal alcohol spectrum disorders (FASD) are a group of conditions that can result from prenatal alcohol exposure. Problems may include an abnormal appearance, short height, low body weight, small head, poor coordination, low intelligence, behavior problems, and problems with hearing or seeing. Those affected are more likely to have trouble in school, legal problems, participate in high-risk behaviors, and develop substance use disorders themselves.

[The rest of the article. Yada yada yada…]

FYI I tweaked the wording slightly in a few places. The first sentence definitely needs to be revised as it was taken verbatim from the CDC source, and according this Teahouse discussion, it's somewhat ambiguous if that factsheet is definitely in the public domain and even if it is, it's not properly attributed. PermStrump(talk) 22:00, 16 April 2016 (UTC)

On second thought... can we just unbold them? PermStrump(talk) 23:56, 16 April 2016 (UTC)

It is definitely in the public domain. And we reference it which is all they ask. So there is nothing wrong with doing this. Have restored some of it as the wording was easier to understand and less clinical. I am not a fan of hidding content in "notes" Doc James (talk · contribs · email) 14:00, 17 April 2016 (UTC)

Notes

References

References

References

Lead image

Anyone care if I flipflop the lead image for the one lower down on the page? I think it gives a better description and I like that it's not a real person. PermStrump(talk) 23:58, 16 April 2016 (UTC)

It fits in the infobox a lot less well. Doc James (talk · contribs · email) 14:03, 17 April 2016 (UTC)

Moved from article

Extended content

A pilot study in 2014 at St. Bernard's Hospital—in the heart of Englewood, one of the poorest African-American communities in Chicago—revealed that among 93 consecutively admitted patients, 32% met the DSM-5 criteria of Neurodevelopmental Disorders associated with Prenatal Alcohol Exposure (ND-PAE). Further, in a random sample of 20% of 500 outpatients consecutively seen at Jackson Park Hospital’s Family Medicine Center, 29% of patients met ND-PAE criteria . A more formal study of this problem on Chicago's South Side found an extraordinarily high prevalence of ND-PAE - Bell & Chimata found in a review of 611 randomly selected predominately low-income African-American patients (median income $33,809/year), 237( 39%) had clinical profiles consistent with Neurodevelopmental Disorders associated with Prenatal Alcohol Exposure defined by DSM - 5. Bell posits these high rates of FASD or ND-PAE are due to the plethora of liquor stores in low-income African-American communities on Chicago's South Side along with the reality the majority of women who were mother's the the patients in Bell and Chimata's study did not realize they were pregnant for the first 4 - 6 weeks of their pregnancy and engaged in social drinking.

As these are primary sources. We should be using secondary sources. Doc James (talk · contribs · email) 00:34, 14 August 2016 (UTC)

References

Dubious

CDoes the literature really support saying, in Wikipedia's voice, The only certain way to prevent FAS is to avoid drinking alcohol during pregnancy? I do not think that it does. See here, for example. --John (talk) 20:31, 24 September 2017 (UTC)

Yes it does per [4] among others.

Are you indicating that there is another sure way to prevent FASD well a women continues to drink alcohol during pregnancy? Doc James (talk · contribs · email) 20:34, 25 September 2017 (UTC)

The NHS certainly seems to think so. Likewise the Royal College of Obstetricians and Gynaecologists. Decent Guardian explainer, and here's a nice BBC article that cites a learned source. There certainly doesn't seem to be a worldwide consensus on this. --John (talk) 20:47, 25 September 2017 (UTC)

Not one of those contradicts "The only certain way to prevent FAS is to avoid drinking alcohol during pregnancy" Doc James (talk · contribs · email) 21:59, 25 September 2017 (UTC)

Really? I think Current scientific opinion points to there being no hard evidence that very small amounts of alcohol consumption during pregnancy are harmful to the mother and baby does contradict it. --John (talk) 22:04, 25 September 2017 (UTC)

I disagree. Avoiding all alcohol will prevent FAS and is the only certain way to do so. Yes there is uncertainty around small amounts (ie one might be able to get away with small amounts but this is unclear). That does not contradict the other statement. Doc James (talk · contribs · email) 22:16, 25 September 2017 (UTC)

References

Not sure what you are trying to say here

"Co-morbidities (which are often treatable) are also often present having been passed to the child when it becomes clear the at-risk birthmother was self medicating with alcohol for undiagnosed or diagnosed illnesses. "

User:LGGertz? Doc James (talk · contribs · email) 17:49, 12 September 2018 (UTC)

I think it's important to note that people with FASD's are often front loaded with comorbidities that predate their own biology based on the manner in which they were born FASD. I have a daughter with FASD. Her birthmother drank and drugged during pregnancy in an attempt to self medicate for undiagnosed mental illness (bipolar disorder). The child was not surprisingly diagnosed with bipolar disorder early at age 5 as a comorbidity to FASD. My point in the addition to the Wiki page is to note there is FASD, and then there are the impressions of what led to the FASD that is passed on genetically. Those comorbidities are often the symptoms that bring to the attention the potential for FASD as an underlying condition. It's important to recognize the FASD for treatment, but it must be viewed as an adjunct to or an underlying physiological condition to others that are often present in a situation where a birthmother is drinking during pregnancy. Hope that clarifies a bit. LGGertz (talk) 18:31, 12 September 2018 (UTC)

And which part of the review in question supports this? Doc James (talk · contribs · email) 19:26, 12 September 2018 (UTC)

References

Brave New World?

Perhaps it is worth noting that alcohol introduced into artificial wombs was how castes were created in this novel, written long before the 1970s. — Preceding unsigned comment added by 209.37.99.86 (talk) 02:16, 14 January 2019 (UTC)

[5] --87.162.173.116 (talk) 15:25, 6 March 2019 (UTC)

In Huxley's novel, the Bokanovsky Process is not the introduction of alcohol to the unborn fœtus, but the process by which the immature fertilised egg can be made to bud into cloned copies.

Nuttyskin (talk) 17:19, 16 August 2023 (UTC)

Asperger

• Fetal Alcohol Spectrum and Autism Spectrum Disorders --87.162.173.116 (talk) 15:25, 6 March 2019 (UTC)

Aggressive Behavior associated with my ARND

I just recently found out i had ARND where for a long time it was believed that i had Asperger's Syndrome and ADHD. It helps because it explains why i nearly killed my nephew with a large heavy rock when he kept annoying me(he was around 8 at the time), and why i threatened to kill(i threatened to snap her neck) a student volunteer in a social program when she kept asking me to go with her to another room the group was going to and ignoring my No's, and why i screamed at a group of boys for not leaving me alone in a room i found that was quiet enough for me to eat in. I almost reached the point where i would have disconfigured them to where they would have been unrecognizable(thankfully i didn't do it). if any one knows why this aggression is happening please give your opinions. Thanks-RaydenAG (talk) 20:51, 18 June 2019 (UTC)

Foundations II 2019, Group 2A goals

1. Expand on "Medication" subsection of "Treatment" to offer more specific information
2. Expand on "Cause" regarding pregnant women that drink less than 10 drinks a week
3. Expand on "Cause" regarding paternal alcohol consumption

Lyjanicee (talk) 22:16, 29 July 2019 (UTC)

Please make sure that all group members assign themselves to the article before making individual edits. Thanks. (added numbering formatting) Health policy (talk) 03:54, 31 July 2019 (UTC)

Foundations II Group 3a proposed edits

1.Expand on signs and symptoms of FASD Pkhouder (talk) 21:46, 1 August 2019 (UTC) 2. Add sub-section about biomarkers for early detection Pkhouder (talk) 21:25, 5 August 2019 (UTC)

Patricia's Peer Review from Foundations II 2019, Group 3c:

1. Do the group's edits improve the article as described in the Wikipedia peer review "Guiding framework?" Yes Ellenberkley (talk) 21:57, 5 August 2019 (UTC)
2. Has the group achieved its overall goals for improvement?

• • They have achieved their goal of adding the "Biomarkers" section under "Diagnosis," however, they have not yet expanded on the signs and symptoms section which I presume they will be doing soon. Ellenberkley (talk) 21:57, 5 August 2019 (UTC)
  • Haven't yet seen information regarding paternal alcohol consumption. Would like to see that added to the page, if possible. Jhpham (talk)

1. A: Does the draft submission reflect a neutral point of view? The draft submission reflects a neutral point of view. The additions were input with three citations to back up the method. Great addition under the "Diagnosis" section to include the "Biomarkers" section. When introducing "meconium" for the first time, you may consider linking it with the "meconium" Wiki page in order for viewers to be able to have the option to visit a more in-depth description of that term. When re-reading that section, some minor grammar edits such as comma placement and adding a (d)"...influence(d) by medication use..., etc. Ellenberkley (talk) 20:57, 5 August 2019 (UTC)
2. B: Are the points included verifiable with Wikipedia's manual of style? If not, specify... There are a few CDC citations used in this manuscript: 1, 4, 6, 15, 58, 60, 64. It's not aligned with Wikipedia to use these sources. In addition, citation 10 is a NIH citation. Citations 16, 18, 24, 38, and 42 are inaccessible due to paywalls or broken links. Rxbpherrera (talk) 21:41, 5 August 2019 (UTC)
3. C: The edits are consistent with Wikipedia's manual of style, but would suggest the following: cleaning up the structure by weaving in information from the last paragraph in the introductory body to the beginning of the article, moving the Fetal Alcohol Effects section to the introduction or mechanism, and possibly expanding upon or re-organizing epidemiology. With regards to epidemiology, there's data from Australia, but there's also data from U.S. and Western Europe in the introduction as well. Jhpham (talk)
4. D: The wording of the edited section was in layman's term and there were no signs of plagiarism.

Epidemiology Section Bad Citation

In the previous version of this article, the following sentence appears "Drinking large quantities, defined as 2 standard drinks a day, or 6 standard drinks in a short time, carries a 50% risk of a FAS birth." citing Popova 2017 which in turn cites Abel 1995, both of which say " This finding is corroborated by previous research, which estimated that 4.3% of children born among heavy-drinking pregnant women (defined as an average of two or more drinks per day, or five to six drinks per occasion) will have FAS41 —ie, one of every 23 heavy-drinking pregnant women will deliver a child with FAS, which is about three times greater than the quotient estimated among women in the general population who consumed any amount of alcohol during pregnancy."

This is a pretty huge mistake. — Preceding unsigned comment added by 31.164.93.132 (talk) 10:57, 4 February 2022 (UTC)