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Research

Comparing diagnostic classification of neurobehavioral disorder associated with prenatal alcohol exposure with the Canadian fetal alcohol spectrum disorder guidelines: a cohort study

James L. Sanders, Rebecca E. Hudson Breen and Nicole Netelenbos
March 01, 2017 5 (1) E178-E183; DOI: https://doi.org/10.9778/cmajo.20160137
James L. Sanders
Faculties of Health Sciences (Sanders, Hudson Breen) and Arts & Science (Netelenbos), University of Lethbridge, Lethbridge, Alta.
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Rebecca E. Hudson Breen
Faculties of Health Sciences (Sanders, Hudson Breen) and Arts & Science (Netelenbos), University of Lethbridge, Lethbridge, Alta.
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Nicole Netelenbos
Faculties of Health Sciences (Sanders, Hudson Breen) and Arts & Science (Netelenbos), University of Lethbridge, Lethbridge, Alta.
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    Table 1: Diagnostic outcome comparisons between the DSM-5 and the 2005 Canadian FASD guidelines
    ND-PAE diagnosis
    from DSM-5, no. (%)
    Total, no. (%)
    NoYes
    FASD diagnosis from multidisciplinary 2005 Canadian guidelinesNo diagnosis22 (100.0)0 (0.0)22 (100.0)
    ARND22 (47.8)24 (52.2)46 (100.0)
    pFAS9 (69.2)4 (30.8)13 (100.0)
    FAS1 (100.0)0 (0.0)1 (100.0)
    Total54 (65.9)28 (34.1)82 (100.0)

    Note: ARND = alcohol-related neurodevelopmental disorder, FAS = fetal alcohol syndrome, FASD = fetal alcohol spectrum disorder, ND-PAE = neurobehavioural disorder associated with prenatal alcohol exposure, pFAS = partial FAS.

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      Table 2: Proportions of patients with significant impairment* in neurobehavioural disorder associated with prenatal alcohol exposure areas of the DSM-5 separated by Canadian fetal alcohol spectrum disorder diagnostic classification
      DSM-5 areas of significant impairmentNo. (%)
      No diagnosisARNDpFASFAS
      Neurocognitive
          Global intelligence0 (0.0)18 (39.1)6 (46.2)0 (0.0)
          Executive function4 (18.2)33 (71.1)9 (69.2)1 (100.0)
          Learning5 (22.7)37 (80.4)10 (76.9)0 (0.0)
          Memory0 (0.0)25 (54.3)7 (53.8)0 (0.0)
          Visual-spatial reasoning0 (0.0)19 (41.3)6 (46.2)0 (0.0)
      Self-regulation
          Mood or behavioural regulation6 (27.3)22 (47.8)6 (46.2)0 (0.0)
          Attention deficit14 (63.6)32 (69.6)9 (69.2)1 (100.0)
          Impulse control11 (50.0)20 (43.5)7 (53.8)1 (100.0)
      Adaptive functioning
          Communication3 (13.6)28 (60.9)8 (61.5)0 (0.0)
          Social communication and interaction9 (40.9)26 (56.5)7 (53.8)0 (0.0)
          Daily living skills4 (18.2)24 (52.2)5 (38.5)0 (0.0)
          Motor skills4 (18.2)10 (21.7)0 (0.0)0 (0.0)

      Note: ARND = alcohol-related neurodevelopmental disorder, DSM-5 = Diagnostic and Statistical Manual of Mental Disorders, 5th edition, FAS = fetal alcohol syndrome, pFAS = partial FAS.

      *Two or more standard deviations below the mean.

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      Comparing diagnostic classification of neurobehavioral disorder associated with prenatal alcohol exposure with the Canadian fetal alcohol spectrum disorder guidelines: a cohort study
      James L. Sanders, Rebecca E. Hudson Breen, Nicole Netelenbos
      Feb 2017, 5 (1) E178-E183; DOI: 10.9778/cmajo.20160137

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      Comparing diagnostic classification of neurobehavioral disorder associated with prenatal alcohol exposure with the Canadian fetal alcohol spectrum disorder guidelines: a cohort study
      James L. Sanders, Rebecca E. Hudson Breen, Nicole Netelenbos
      Feb 2017, 5 (1) E178-E183; DOI: 10.9778/cmajo.20160137
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