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评估胎儿酒精谱系障碍。

Assessing for Fetal Alcohol Spectrum Disorder.

作者信息

Coons-Harding Kelly D, Flannigan Katherine, Burns Colleen, Rajani Hasmukhlal, Symes Brent

机构信息

Canada FASD Research Network.

出版信息

J Popul Ther Clin Pharmacol. 2019 Jan 23;26(1):e39-e55. doi: 10.22374/1710-6222.26.1.4.

Abstract

Background The recommended "gold standard" for Fetal Alcohol Spectrum Disorder (FASD) assessment involves a multidisciplinary diagnostic team and comprehensive battery of neuropsychological tests to evaluate functioning across 10 brain domains. The current Canadian Guideline for diagnosis of FASD outlines a list of test measures for assessment; however, very little research exists to explore which specific tools are being used in clinical practice. Objectives The purpose of the current study was to gain a better understanding of the testing measures used by FASD clinicians in Alberta, Canada.   Methods A survey was sent to coordinators of 23 Alberta FASD clinics requesting them to distribute the survey to their diagnostic team members, including physicians, psychologists, speech-language pathologists (SLPs), and occupational therapists (OTs).   Results A wide range of measures (both direct and indirect; n = 173) to assess brain domains were reported by clinics. Many tests were used to assess function across multiple brain domains. Most of the commonly used tests aligned with those suggested in the Canadian Guideline; however, there were many additional measures being used that were that were not listed in the Guideline.   Conclusions This study revealed important information about the use of testing measures in FASD assessment and sheds light on the commonalities in practice across clinics in Alberta. Results demonstrate strong convergence of direct and indirect measures to assess brain function. Ultimately, identifying a comprehensive, reliable, and usable testing battery of measures for FASD assessment will improve the clarity and accuracy of the diagnostic process and facilitate advancements in the field, as well as enable comparisons across clinics.

摘要

背景

胎儿酒精谱系障碍(FASD)评估的推荐“金标准”涉及多学科诊断团队以及一系列全面的神经心理学测试,以评估10个脑区的功能。加拿大当前的FASD诊断指南列出了评估的测试措施清单;然而,很少有研究探讨临床实践中正在使用哪些具体工具。目的:本研究的目的是更好地了解加拿大艾伯塔省FASD临床医生所使用的测试措施。方法:向艾伯塔省23家FASD诊所的协调员发送了一份调查问卷,要求他们将问卷分发给其诊断团队成员,包括医生、心理学家、言语语言病理学家(SLP)和职业治疗师(OT)。结果:诊所报告了广泛的评估脑区的措施(包括直接和间接的;n = 173)。许多测试用于评估多个脑区的功能。大多数常用测试与加拿大指南中建议的测试一致;然而,有许多额外使用的措施未在指南中列出。结论:本研究揭示了FASD评估中测试措施使用的重要信息,并阐明了艾伯塔省各诊所实践中的共性。结果表明,评估脑功能的直接和间接措施有很强的趋同性。最终,确定一套全面、可靠且可用的FASD评估测试组合将提高诊断过程的清晰度和准确性,促进该领域的进步,并实现各诊所之间的比较。

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