Table 3.
Study characteristics and prevalence of FAS and FASD among correctional populations (n = 8), special education (n = 3), specialized clinical populations (n = 5) and Aboriginal populations (17) reported in the identified studies, by country.
| Reference | Country (State/Province/Territory) | Study year(s) | Type of institution(s)/Setting | Sample size | Number of cases of FAS | Prevalence of FAS (per 1000) | Number of cases of FASD | Prevalence of FASD (per 1000) | Diagnostic guidelines/Case definition | Sex (% male) | Age range (years) | Method |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Correctional populations | ||||||||||||
| Bower et al. 2018 66 | Australia (western Australia) | 2015–16 | Youth detention centre; 73.7% Aboriginal | 99 | – | – | 36 | 363.6 | Australian Guide to the Diagnosis of FASD 67 | 92.9 | 10–< 18 | ACA |
| Burd et al. 2003 68 | Canada | 2001–02 | Federal and provincial prisons | 148 797 | 13 | 0.1 | NA | NA | NA | 91.2 | NA | PS (survey) |
| Fast et al. 1999 69 | Canada (British Columbia and Yukon) | 1995–96 | In‐patient assessment unit of youth forensic psychiatric services | 287 | 3 | 10.5 | 67 | 233.5 | IOM criteria (Stratton et al. 1996 35) | NA | 12–18 | Clinic‐based |
| MacPherson et al. 2011 70 | Canada (Manitoba) | 2005–06 | Male‐only medium security penitentiary for adults | 91 | NA | NA | 9 | 98.9 | Canadian diagnostic guidelines (Chudley et al. 2005 65) | 100.0 | 19–30 | Mixed methods [ACA and PS (interview)] |
| McLachlan et al. 2017 71 | Canada (Yukon) | 2014–15 | Correctional centre, and offender and supervision Services | 80 | 0 | 0.0 | 14 | 175 | Canadian diagnostic guidelines (Chudley et al. 2005 65) | NA | 18–40 | ACA |
| Murphy et al. 2005 72 | Canada (British Columbia) | 2004 | Juvenile detention centres | 137 | NA | NA | 16 | 116.8 | NA | 89.8 | 14–19 | PS (survey) |
| Rojas & Gretton, 2007 73 | Canada (British Columbia) | 1985–2004 | Youth Sexual Offence Treatment Programme | 230 | NA | NA | 25 | 108.7 | Case definition provided (based on Boland et al. 2000 74) | 100.0 | 12–18 | PS |
| Burd et al. 2004 75 | United States | 2001–02 | Prison systems and community corrections facilities | 3 080 904 | 1 | 0.0003 | NA | NA | NA | 89.7 | NA | PS (survey) |
| Special educational populations | ||||||||||||
| Mena et al. 1986 76 | Chile (Concepción) | 1982 | Special schools for mentally handicapped children | 386 | 13 | 33.7 | 34 | 88.1 | Guidelines established by the Fetal Alcohol Study Group of the RSA (Rosett, 1980 31) | NA | NA | ACA |
| Mena et al. 1988 77 | Chile (Cautin, Concepción, Linares, Ranco) | 1985–86 | Special schools for mentally handicapped children | 475 | 10 | 21.1 | 36 | 75.8 | Guidelines established by the Fetal Alcohol Study Group of the RSA (Rosett, 1980 31) | NA | NA | ACA |
| Lee et al, 2016 78 | South Korea | NA | Institutions (children with mental retardation) | 307 | 13 | 42.3 | NA | NA | Case definition provided | NA | NA | ACA |
| Specialized clinical populations | ||||||||||||
| Grinfeld et al. 1999 79 | Brazil (São Paulo) | 1997 | Babies referred to genetic clinics | 16 640 | 17 | 1.0 | NA | NA | NA | NA | NA | PS |
| Bell & Chimata, 2015 80 | United States (Chicago) | 2013–14 | Psychiatric care population | 611 | NA | NA | 87 | 142.4 | DSM‐5 criteria of ND‐PAE (APA, 2013 81) | 43.0 | 4–78 | Clinic‐based |
| Cadle et al. 1996 82 | United States (Kentucky) | 1981–95 | Patients evaluated at genetic clinics | 4212 | 27 | 6.4 | NA | NA | NA | NA | NA | Clinic‐based |
| O'Connor et al. 2006 83 | United States | NA | Psychiatric care population | 122 | 10 | 82.0 | NA | NA | 4‐digit diagnostic code (Astley & Clarren, 1999 23) | 81.1 | NA | PS |
| Shanske & Kazi, 1980 84 | United States (New York) | NA | Developmentally disabled clinical population | 905 | 13 | 14.4 | 19 | 21.0 | NA | NA | 0–7 | Clinic‐based |
| Aboriginal populations | ||||||||||||
| Fitzpatrick et al. 2017 85 | Australia (northwestern) | 2010–11 | School‐aged children in very remote communities: community sites and local schools | 108 | 1 | 9.3 | 21 | 194.4 | Canadian diagnostic guidelines (Chudley et al. 2005 65) with adaptations to accommodate the cultural context | 52.8 | 7.5–9.6 | ACA |
| Harris & Bucens, 2003 86 | Australia (northern Territory) | 1990–2000 | Paediatric wing, hospital | 9077 | 18 | 2.0 | 43 | 4.7 | Adapted 4‐digit diagnostic code (Astley & Clarren, 1999 23) and the criteria by the AAP (2000 87) | NA | 0–10 | Mixed methods (PS & Clinic‐based) |
| Mutch et al. 2015 88 | Australia (western) | 1980–2010 | Children captured in the Western Australian Register of Developmental Anomalies | 45 078 | NA | NA | 188 | 4.1 | NA | NA | 0–15 | PS |
| Rothstein et al. 2007 89 | Australia (Queensland) | 2001–06 | Children for specialist paediatric follow‐up captured by the FNQ Paediatric Outreach Service | 2195 | NA | NA | 32 | 14.6 | NA | 55.0 | 0–18 | PS |
| Asante & Nelms‐Matzke, 1985 90 | Canada (northwest British Columbia and Yukon) | 1983–84 | Chronically handicapped children referred for assessment | 5065 | NA | NA | 166 | 32.8 | Guidelines established by the Fetal Alcohol Study Group of the RSA (Rosett, 1980 31) | 63.0 | 0–16 | ACA |
| Kowlessar, 1997 91 | Canada (Manitoba) | 1981–90 | Local school in First Nations community | 178 | 11 | 61.8 | 19 | 101.1 | IOM criteria (Stratton et al. 1996 35) | NA | 5–15 | ACA |
| Robinson et al. 1987 92 | Canada (British Columbia) | 1984–85 | Community‐based: Native Indian community | 116 | 14 | 120.7 | 22 | 189.7 | Guidelines established by the Fetal Alcohol Study Group of the RSA (Rosett, 1980 31) | 49.6 | 3–18 | ACA |
| Werk et al. 2013 93 | Canada | 2006 | Canadian census survey catered to Aboriginal children living off‐reserve | 11 868 | NA | NA | 83 | 7.0 | NA | NA | 0–5 | PS (survey) |
| Williams et al. 1999 94 | Canada (Manitoba) | 1994–96 | Live births occurring in Thompson General Hospital in 1994 | 696 | 5 | 7.2 | NA | NA | IOM criteria (Stratton et al. 1996 35) | NA | NA | Mixed methods (ACA & PS) |
| Chávez et al. 1988 95 | United States | 1981–86 | Birth Defects Monitoring Programme: hospitals with obstetric services | 19 412 | 58 | 3.0 | NA | NA | NA | NA | 0–1 (newborns) | PS |
| CDC, 1995 96 | United States (Iowa, Nebraska, North Dakota, South Dakota) | 1981–92 | Indian Health Service (IHS) and IHS contract facilities in tribal or American Indian communities | 22 222 | 60 | 2.7 | NA | NA | Criteria by Sokol & Clarren (1989 97) | NA | 0–31 | PS |
| Duimstra et al. 1993 98 | United States (Northern Plains) | 1987–90 | Indian Health Service facilities; IHS hospital out‐patient settings; home visits | 1022 | 4 | 3.9 | NA | NA | Guidelines established by the Fetal Alcohol Study Group of the RSA (Rosett, 1980 31) | NA | 5–18m | ACA |
| Egeland et al. 1998 99 | United States (Alaska) | 1977–92 | Paediatric practices that were referral centres for FAS; hospitals; regional native health corporations; state department of health and social services | 37 346 | 114 | 3.1 | NA | NA | Case definition provided | NA | 0–16 | PS |
| Fox et al. 2015 100 | United States (Arizona, Colorado, New York) | 2010 | Surveillance site using multiple data sources: genetic/developmental clinics; hospitals; health maintenance organizations; Medicaid; juvenile justice system | 13 938 | 28 | 2.0 | NA | NA | Case definition based on IOM criteria (Stratton et al. 1996 35) | NA | 7–9 | PS |
| May et al. 1983 101 | United States (southwestern USA: New Mexico, southern Colorado, southern Utah, northern Arizona) | 1980–82 | Children belonging to Navajo, Pueblo, and Plains culture tribes | 22 963 | 55 | 2.4 | 85 | 3.7 | Case definition provided | 55.6 | 0–14 | ACA |
| NBDPN, 2003 102 | United States (24 States) | 1996–2000 | State programmes providing surveillance data on birth defects | 77 630 | 32 | 0.4 | NA | NA | NA | NA | 0–1 (newborns) | PS |
| Quaid et al. 1993 103 | United States (central Oregon) | 1991 | Indian Health Service Clinic and assisting health/social services personnel; dysmorphology clinic | 429 | 4 | 9.3 | 8 | 18.7 | Criteria by Sokol & Clarren (1989 97) | NA | 0–3 | ACA |
ACA = active case ascertainment; DSM = Diagnostic and Statistical Manual of Mental Disorders; FAS = fetal alcohol syndrome; FASD = fetal alcohol spectrum disorder; IOM = Institute of Medicine; m: months; NA = not available; NBDPN = National Birth Defects Prevention Network; ND–PAE = neurodevelopmental disorder associated with prenatal alcohol exposure; PS = passive surveillance; RSA = Research Society on Alcoholism.