Published online June 1, 2005
PEDIATRICS Vol. 115 No. 6 June 2005, pp. 1787-1788 (doi:10.1542/peds.2005-0702)
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A Practical Clinical Approach to Diagnosis of Fetal Alcohol Spectrum Disorders: Clarification of the 1996 Institute of Medicine Criteria: In Reply

H. Eugene Hoyme, MD
Department of Pediatrics
Division of Medical Genetics
Stanford University School of Medicine
Stanford, CA 94305-5208

In Reply.—

I thank Dr Cordero for his kind comments regarding our consensus criteria clarifying the 1996 Institute of Medicine diagnostic criteria for fetal alcohol spectrum disorders (FASDs).1 I am aware of the Centers for Disease Control and Prevention's (CDC's) Fetal Alcohol Syndrome: Guidelines for Referral and Diagnosis,2 which unfortunately was released after our article was accepted for publication and thus was not referenced in our article. I agree that the methodology used in the CDC's guidelines is consistent in many aspects with the criteria that our article set forth. However, the CDC's guidelines as they currently exist define only the "tip of the iceberg" with respect to the complete continuum of FASDs. As we stated in our article, we have used our consensus clarifications of the Institute of Medicine criteria extensively in alcohol-exposed populations both within the United States and in international venues. We have found these criteria to be easily clinically applicable in pediatric settings and to completely define the continuum of adverse effects associated with maternal alcohol abuse. I agree that much work needs to be done to further delineate the phenotype of children with alcohol-related neurodevelopmental disorder, ie, structurally normal children with the behavioral and learning difficulties typical of those affected with FASDs. My colleagues and I look forward to working with investigators at the CDC and elsewhere to define the FASD continuum more completely and to work toward prevention of this common and devastating cause of disabilities in children.

REFERENCES

  1. Hoyme HE, May PA, Kalberg WO, et al. A practical clinical approach to diagnosis of fetal alcohol spectrum disorders: clarification of the 1996 Institute of Medicine criteria. Pediatrics. 2005;115 :39 –47[Abstract/Free Full Text]
  2. Centers for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities, National Task Force on Fetal Alcohol Syndrome and Fetal Alcohol Effects. Fetal alcohol syndrome: guidelines for referral and diagnosis. Available at: www.cdc.gov/ncbddd/fas/documents/FAS_guidelines_accessible.pdf. Accessed April 13, 2005
PEDIATRICS (ISSN 1098-4275). ©2005 by the American Academy of Pediatrics

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A Practical Clinical Approach to Diagnosis of Fetal Alcohol Spectrum Disorders: Clarification of the 1996 Institute of Medicine Criteria
José F. Cordero
Pediatrics 2005 115: 1787. [Extract] [Full Text]  



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