Assessment of Fetal Alcohol Spectrum Disorders (FASD) Using Novel Web-Based Tools

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The detrimental effects of prenatal alcohol exposure, including cognitive, behavioral, and physical impacts, have been well documented over several decades. They include long-standing effects on multiple domains of function. Alcohol-affected individuals often go unrecognized. In addition, wait times for evaluation can be quite long, further delaying the accurate identification of affected individuals. Effective online screening tools can decrease wait times and streamline evaluations in specialty clinics. Prenatal alcohol exposure continues to represent a significant public health concern and increased efforts at documenting risk, improving identification, and providing clinically-efficient tools are paramount. As such, the overarching aim of this proposal is to improve the screening for prenatal alcohol exposure and fetal alcohol spectrum disorder (FASD) by deploying web-based tools that aid in clinical evaluation. Two main tools will be used, the FASD-Tree and the Brief Assessment of Individual Neurobehavior – online version (BRAIN-online). Both tools use web-based technology for collecting data and provide the clinician with information about the individual’s physical, behavioral, and cognitive attributes. Specifically, the FASD-Tree records physical and behavioral data, and BRAIN-online measures impulsivity, attention, problem-solving, processing speed, memory, spatial working memory, and set-shifting. To achieve the aims of this study, child subjects (6-17y) will be evaluated using either the combination of FASD-Tree and BRAIN-online or BRAIN-online alone (Aim 1-3). Parents will complete online questionnaires regarding their child’s background, demographics, and behavior and some children will be given a standardized in-person neuropsychological test battery. In Aim 1, we will examine the relation between FASD-Tree and BRAIN-online, including classification accuracy, sensitivity, and specificity for each tool and their combination. In Aim 2, data from these novel tools will be combined with traditional and advanced (e.g., MorpheusQ and 3D facial imaging) physical measurements collected through other CIFASD projects. The combination of measures used in the proposed research will result in a convenient, scalable, and cost-effective adjunct to standard diagnostic tools.