Psych Vivas · Intellectual disability — neurodevelopmental
Foetal alcohol spectrum disorder — structured clinical viva
Fellowship viva on FASD criteria frameworks, neurobehaviour, comorbidity care, Streissguth secondary disabilities, and alcohol-free pregnancy prevention.
On this page & tools
Target exams
Interpretation
Reveal interpretation
What is FASD / how diagnosed? Lifelong effects of prenatal alcohol exposure. Multidisciplinary diagnosis using a named framework (Hoyme domains; Cook Canadian with/without sentinel face; Astley 4-digit ranks). Document PAE, growth, face and neurobehavioural impairment — not a single blood test.[1][2]
Must he have the face? No. Sentinel triad (short palpebral fissures, smooth philtrum, thin upper lip) supports FAS-range diagnoses, but FASD without sentinel facial features is valid when PAE and severe brain dysfunction criteria are met.[2][1]
Medicine that fixes injury? No disease-modifying pharmacotherapy for core FASD. Treat comorbidities (ADHD, mood, sleep, substance use) carefully; antipsychotics only for severe behavioural risk after formulation and with monitoring.[4]
Impulsive if IQ average? Classic profile: executive function, attention, memory and adaptive skills often lag what IQ alone suggests — functional impairment is real.[5]
School and later law trouble. Scaffolding, accommodations, carer coaching, multiagency plan. Streissguth: high secondary disability rates; early diagnosis and stable nurturing care protect.[3][4]
Sister and pregnancy. No known safe alcohol amount in pregnancy; support alcohol-free conception/pregnancy; non-judgemental contraception and alcohol help if needed. Quote prevalence order of magnitude if asked (Lange ~7.7/1000 global FASD in children/youth).[4][6]
Name evidence. Hoyme 2016; Cook 2016; Williams AAP 2015; Mattson neurobehaviour; Streissguth 2004; Lange prevalence.[1][2][3][4][5][6]
Key points
[2] [3] [4]References
- [1]Hoyme HE, Kalberg WO, Elliott AJ, et al. Updated Clinical Guidelines for Diagnosing Fetal Alcohol Spectrum Disorders Pediatrics, 2016.PMID 27464676
- [2]Cook JL, Green CR, Lilley CM, et al. Fetal alcohol spectrum disorder: a guideline for diagnosis across the lifespan CMAJ, 2016.PMID 26668194
- [3]Streissguth AP, Bookstein FL, Barr HM, Sampson PD, O'Malley K, Young JK Risk factors for adverse life outcomes in fetal alcohol syndrome and fetal alcohol effects J Dev Behav Pediatr, 2004.PMID 15308923
- [4]Williams JF, Smith VC; Committee on Substance Abuse Fetal Alcohol Spectrum Disorders Pediatrics, 2015.PMID 26482673
- [5]Mattson SN, Bernes GA, Doyle LR Fetal Alcohol Spectrum Disorders: A Review of the Neurobehavioral Deficits Associated With Prenatal Alcohol Exposure Alcohol Clin Exp Res, 2019.PMID 30964197
- [6]Lange S, Probst C, Gmel G, Rehm J, Burd L, Popova S Global Prevalence of Fetal Alcohol Spectrum Disorder Among Children and Youth: A Systematic Review and Meta-analysis JAMA Pediatr, 2017.PMID 28828483