More than half of residents of the baby homes in Murmansk, Russia, have intermediate (45%) or high (13%) phenotypic expression scores suggesting prenatal exposure to alcohol. Despite good physical care, stable daily routine, availability of well-trained specialists, and access to medical care, these vulnerable children show significant growth and developmental delays compared with their institutionalized peers.

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Consumption of alcohol during pregnancy is well recognized as a risk factor associated with adverse fetal development. While precise safe or dangerous levels of maternal drinking have not been identified, it is clear that the women who drink most heavily are at the greatest risk. Prevention of alcohol-related birth defects requires development of programs directed to the special needs of addicted women and their families. The nature of addiction suggests that direct interventions focused on changing individual drinking behavior have the best chance of success.

Prenatal alcohol exposure can result in fetal alcohol spectrum disorders (FASD), which can include physical and neurobehavioral disorders, including cognitive, social, language, and motor impairments that can persist throughout life. In order for children with FASD to receive the full benefit of services, recognition of their disability needs to be made earlier and more accurately than is common today. Early identification of an FASD helps to focus targeted treatments, reduce unnecessary medical steps and redundancy in medical care, and increase the likelihood of efficacious interventions. This article describes an innovative, brief screening tool designed to test the feasibility of screening for FASD risk in early intervention (EI) settings. Feasibility was demonstrated by a screening rate of 1161 (61%) of the 1896 available children. The primary resources needed for implementing FASD screening in EI programs are a brief FASD Screening Tool, an FASD trainer, and training time. Replication efforts would benefit from cost-free cross-training between EI sites and designated pediatricians/diagnosticians who are interested in improving their skills around FASD, and development of linkages with alcohol use disorder outpatient/assessment programs for possible referrals for birth mothers. The authors assert that it is practical and feasible to screen children for FASD in EI settings. Key words: alcohol-related neurodevelopmental disorder, alcohol-related birth defects, alcohol use disorders, developmental delays, developmental screening, early intervention, fetal alcohol syndrome, prenatal alcohol exposure, fetal alcohol spectrum disorders, maternal alcohol histories ''O F ALL substances of abuse (including cocaine, heroin, and marijuana),