Background: This project was undertaken as a feasibility study to determine
the possibility of screening for fetal alcohol syndrome (FAS) in early sch
ool-age children for epidemiological and interventional purposes.
Methods: All elementary schools in two counties in Washington State were as
ked to screen first graders for possible FAS. A child was screen positive i
f found to be growth deficient, to have certain specific facial abnormaliti
es, or have a known history of substantial alcohol exposure in gestation. A
ll screen-positive children were invited to "special diagnostic clinics" fo
r final diagnosis and treatment planning.
Results: In County A, virtually all students were screened. In County B onl
y about 25% of children were screened. This difference was related to the n
umber of schools that agreed to participate in the project and the methods
employed by each county to obtain parental permission. In each county, only
about one-half of the screen-positive children were seen in the special cl
inics for diagnostic considerations. Only one of the seven children found t
o have FAS had been diagnosed previously. The minimal prevalence of FAS in
County A was 3.1 in 1,000 students. The minimal prevalence of FAS in County
B could not be calculated. The most efficient component in the screening p
rocess leading to a diagnosis of FAS was finding the specific facial featur
es of the disorder. The diagnosis of FAS was generally helpful in improving
educational planning.
Conclusions: This study demonstrated that population-based FAS screening wi
thin a school system may be possible, but participation is dependent on loc
al trust and understanding of the project before its inception within the s
chools and the community at large. Teratology 63.3-10, 2001. (C) 2001 Wiley
-Liss, Inc.