Factors predictive of a fetal alcohol spectrum disorder diagnosis: Parent and teacher ratings

ABSTRACT

Diagnostic assessment in Fetal Alcohol Spectrum Disorder (FASD) is informed by multidisciplinary assessment incorporating objective (i.e., test measures) and subjective means, such as parent and teacher behavior ratings. The purpose of this study was to extend our previous neuropsychological test findings by identifying parent and teacher ratings of academic achievement, attention, executive functioning, and adaptive functioning as predictors of an FASD diagnosis. The charts of 315 children and adolescents with prenatal alcohol exposure (PAE) who underwent assessment for FASD were retrospectively reviewed. Direct logistic regressions analyzed the contribution of different ratings on the likelihood of an FASD diagnosis. The results suggest that a number of rating measures do contribute toward accurately differentiating those with FASD from within a PAE population, including teacher ratings of learning problems, inattention, and adaptive skills. The classification accuracy for each regression was clinically significant (59.1–70.8%). Children with worse ratings on these variables are approximately 1.5 to 2 times more likely to receive an FASD diagnosis. Only teacher ratings (not parent) significantly contributed to whether a diagnosis was made, suggesting that teacher observational rating scales are a critical component of an FASD assessment. Together with our previous research examining neuropsychological evaluation and FASD diagnostic assessment, this study helps to further guide decisions to streamline care in multidisciplinary assessment and intervention planning.

KEYWORDS:

• Fetal alcohol spectrum disorder
• prenatal alcohol exposure
• rating scales
• diagnosis
• logistic regressions

Acknowledgments

Both the authors contributed equally to the development of this research project and manuscript. We appreciate the support that the Manitoba FASD Centre, the Department of Clinical Health Psychology, and the University of Manitoba have provided to our lab. We also extend our gratitude to Kevin Solar and Kristi MacDonald for their help with data entry and Nassim Tabri for his guidance regarding statistical analyses. Finally, we are most indebted to all those who participated in this study.

Disclosure statement

No potential conflict of interest was reported by the authors.