Evaluation of the German biographic screening interview for fetal alcohol spectrum disorder (BSI-FASD)

Abstract

Alcohol consumption during pregnancy may lead to permanent damage in the offspring, including fetal alcohol spectrum disorders (FASD), which have an estimated prevalence of 1–8% worldwide. In adulthood, diagnosing FASD is time-consuming and costly. This study aimed to evaluate the discriminatory power of a German screening instrument for FASD in adults—the biographic screening interview (BSI-FASD). In an open-label comparative cohort study wherein a one-time survey was administered per participant, we compared 22 subjects with confirmed FASD with control groups of 15 subjects diagnosed with attention deficit hyperactivity disorder (ADHD), 20 subjects with alcohol or opiate dependence, 18 subjects with depression, and 31 controls without prenatal alcohol exposure. The BSI-FASD was found to be resource-efficient, user-friendly, comprehensible, and easily applicable. It provided an overall good convergent and discriminant validity with a sensitivity of 0.77 (adapted 0.86) and specificities between 0.70 and 1.00. The BSI-FASD subdomains differed in their power to differentiate FASD from the groups. This study established that the BSI-FASD is an efficient instrument to screen adults with suspected FASD. The BSI-FASD may facilitate future diagnostic evaluation and thereby contribute to improved treatment of affected individuals.

Development and validation of a postnatal risk score that identifies children with prenatal alcohol exposure

“…Although some of these previous studies have higher accuracy and sensitivity rates compared with the findings from the current study, the previous identification tools required subjects to complete a battery of neuropsychological assessments (Klug et al, 2021;Mattson et al, 2010bMattson et al, , 2013, measures of intellectual functioning (Goh et al, 2016), required maternal information (Burd et al, 2010), or were created for use with adults only (Widder et al, 2021). In compari-…”

“…Additionally, a hierarchical decision tree model using similar measures as described herein had accuracy rates of 79.5% to 84.7% (Goh et al, 2016). Although some of these previous studies have higher accuracy and sensitivity rates compared with the findings from the current study, the previous identification tools required subjects to complete a battery of neuropsychological assessments (Klug et al, 2021; Mattson et al, 2010b, 2013), measures of intellectual functioning (Goh et al, 2016), required maternal information (Burd et al, 2010), or were created for use with adults only (Widder et al, 2021). In comparison, the risk score that we developed could be simply deployed in a clinical setting and therefore has significant clinical potential as an early screening tool.…”

“…Studies aimed at developing a neurobehavioral profile for FASD have previously reported the overall classification accuracy rates ranging between 71.5% and 84.7% (Mattson et al, 2010b(Mattson et al, , 2013. Studies assessing the utility of other FASD screening tools have reported accuracy rates of 71.3% to 89.6% (Klug et al, 2021) and 78.4% to 82% (Burd et al, 2010), and sensitivity rates of 86% (Widder et al, 2021). Additionally, a hierarchical decision tree model using similar measures as described herein had accuracy rates of 79.5% to 84.7% (Goh et al, 2016).…”

“…Therefore, the development of improved screening tools that can be used to identify children who may have been affected by prenatal alcohol exposure is essential. Some clinical tools have shown promise in their ability to aid in the identification of individuals with prenatal alcohol exposure (Burd et al, 2010;Klug et al, 2021;Mattson et al, 2010bMattson et al, , 2013Widder et al, 2021). However, these tools require a large amount of information which may not be readily available, including neurobehavior and intelligence quotient (IQ) data, maternal characteristics, and birth records.…”

Understanding the Relationship between Fetal Alcohol Spectrum Disorder (FASD) and Criminal Justice: A Systematic Review

“…Moreover, the selection of studies was performed evaluating the characteristics of the published paper. Based on older international guidelines [ 4 , 5 ], during the revision process, we have included the articles that have used following acronyms: FASD; Fetal alcohol syndrome (FAS); Partial FAS (pFAS) [ 17 ]; Alcohol-Related Neurodevelopmental Disorder (ARND [ 18 ]; and Alcohol-Related Birth Defects (ARBD) [ 19 ]. Retrospective and interviewed-based studies were included.…”