Poitra Betty A, Marion Shirley, Dionne Marilyn, Wilkie Esther, Dauphinais Paul, Wilkie-Pepion Marma, Martsolf John T, Klug Marilyn G, Burd Larry
Turtle Mountain Community Schools, and Turtle Mountain FAS Community Response Team, USA.
Neurotoxicol Teratol. 2003 Nov-Dec;25(6):725-9. doi: 10.1016/j.ntt.2003.07.007.
Fetal alcohol syndrome (FAS) is a common cause of birth defects and neuropsychiatric impairment. Identification of affected people is crucial for early entry into intervention programs and for the development of prevalence estimates. The objective of this project was to determine if screening for FAS in a community elementary school-based setting was feasible, to estimate prevalence in the screened population, and to determine if a screening program for FAS can be implemented using available personnel from the community. The FAS Screen was used to screen kindergarten students enrolled in a school system. Students with scores on the FAS Screen above the cutoff for a positive screen (20) were referred to one of several diagnostic clinics for evaluation. Over a 9-year period, 1384 students were screened and 69 (5%) had a positive screen (20 or above). These 69 children were then seen in a genetics/dysmorphology diagnostic clinic and 7 (10%) were found to have FAS (n=6) or partial FAS (n=1). The prevalence of affected children (FAS and partial FAS) was 1 per 198 students or 4.3 per 1000. The FAS Screen was completed annually by school staff, teachers, social workers, and psychologists. The test has acceptable epidemiologic performance characteristics in a community setting. The screening takes about 8-10 min. The procedure was well accepted in the community. This screening strategy was inexpensive to implement (less than US8.00 dollars per student), and can be easily included with the other screens completed at kindergarten entry.
胎儿酒精综合征（FAS）是出生缺陷和神经精神障碍的常见病因。识别受影响的人群对于尽早纳入干预项目以及进行患病率估计至关重要。本项目的目的是确定在社区小学环境中筛查FAS是否可行，估计筛查人群中的患病率，并确定是否可以利用社区现有人员实施FAS筛查项目。使用FAS筛查工具对就读于某一学校系统的幼儿园学生进行筛查。FAS筛查得分高于阳性筛查临界值（20分）的学生被转介至几家诊断诊所之一进行评估。在9年的时间里，共筛查了1384名学生，其中69名（5%）筛查结果为阳性（20分及以上）。这69名儿童随后在遗传学/畸形学诊断诊所接受检查，发现7名（10%）患有FAS（n = 6）或部分FAS（n = 1）。受影响儿童（FAS和部分FAS）的患病率为每198名学生中有1例，即每1000名学生中有4.3例。FAS筛查每年由学校工作人员、教师、社会工作者和心理学家完成。该测试在社区环境中具有可接受的流行病学性能特征。筛查大约需要8 - 10分钟。该程序在社区中得到了很好的接受。这种筛查策略实施成本低廉（每名学生不到8美元），并且可以很容易地纳入幼儿园入学时完成的其他筛查项目中。
