Tests to distinguish between FASD and ADHD

[ConcertaParent]

In a study published last month (August 25) in the Journal of Neurology, scientists show that subtle differences in eye movement patterns can be utilized to identify patients with Parkinson’s, fetal alcohol syndrome, or attention deficit disorder, providing hope for a quick and noninvasive strategy to aid in diagnosing these, and possibly other, neurological diseases.

“I am very impressed with the use of this eye tracking as a potential behavioral biomarker,” said Edward Riley, who studies fetal alcohol syndrome at San Diego State University, but did not participate in the research.
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Itti and his team next looked at whether eye movements could identify between children with ADHD or FASD. Once again, they showed the children videos and recorded their eye movements, then devised a model to predict any behavioral abnormalities. Sure enough, the model could classify ADHD children with 83 percent accuracy, FASD children with 79 percent accuracy, and distinguished between the two patient groups with 90 percent accuracy.
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“The ability to really differentiate between ADHD and FSD was really compelling to me,” said Luna, noting that ADHD often co-occurs with many other disorders, including FASD, which can make it difficult to accurately diagnose children. If a child’s impulse control stems from ADHD, she explained, they’ll require different medication and intervention than a child whose primary problem is caused by prenatal alcohol exposure, making accurate diagnosis paramount.

Who here has undergone clinical neurological evaluation, structured behavioural tasks AND neuroimaging to make sure you have ADHD instead of FASD (fetal alcohol spectrum disorder) or other neurological disorder? My DD's ADHD psychiatrist wants her referred to a major hospital's paediatric clinic to rule out FASD. Has anybody here ever had their ADHD diagnosis changed to FASD instead or both?

[SquarePeg]

Have you asked why? I think that FASD caused problem in learning material whereas kids with adhd often don´t have trouble learning material, just recalling it.

How much alcohol does it take for a fetus to be affected. I didn´t know I was pregnant and it was around Xmas when I conceived. I didn´t drink huge amounts at all and not very often but now I´m worried that it´s all my fault.

[ConcertaParent]

ADHD and FASD have a lot of the same symptoms so I think he's just being thorough. When I mentioned that DD likes to comfort herself by rocking back and forth when not in school or hitting her head on the pillow before sleeping, he asked a lot of autism screening questions, but eventually did not give an ASD diagnosis.

An ENT specialist listened to DD's complaints about her red ears, which became a reoccuring problem when she started ADHD medication, so she has been referred to yet another specialist to check for peridonchritis which could be caused by an auto-immune disorder.

Dyslexia and other learning disabilities also have high co-morbodities with ADHD. DD has trouble with both learning and recalling material. I have bought Orton-Gillingham software called "Language Tune-up Kit At Home" to try to improve her dyslexia.

Originally Posted by SquarePeg

Have you asked why? I think that FASD caused problem in learning material whereas kids with adhd often don´t have trouble learning material, just recalling it.

[Amtram]

I think that there's a pretty good precedent already in place for distinguishing between fetal alcohol syndrome and ADHD, and that would be high levels of alcohol consumption by the mother while pregnant. FAS is not caused by even moderate consumption, and there are physical and mental characteristics that accompany it that bear no resemblance whatsoever to ADHD and which cannot be addressed by ADHD medications.

[mctavish23]

FASD is strictly treated as a Medical Diagnosis. Having been trained at the University

of Minnesota, which has an excellent FASD Clinic, I was part of a rural FASD / Develop -

-mental / Behavioral Clinic, for about 15 years. The "key" to a genuine FASD diagnosis,

is the cooperation and participation of the birth mother in the diagnostic process. That

is paramount.

When the diagnosis is made, they usually employ the University of Washington's

numerical system. As far as the symptoms go, FASD is manifested as the most severe

form of (acquired) ADHD Combined Type, and is usually treated accordingly .

Hope that helps.

tc

mctavish23

(Robert)

[Lunacie]

Originally Posted by Amtram

I think that there's a pretty good precedent already in place for distinguishing between fetal alcohol syndrome and ADHD, and that would be high levels of alcohol consumption by the mother while pregnant. FAS is not caused by even moderate consumption, and there are physical and mental characteristics that accompany it that bear no resemblance whatsoever to ADHD and which cannot be addressed by ADHD medications.

That's what I thought when I saw this thread title.

Neither of my parents drank alcohol - at all. Neither did I or my hubby.

My daughter drank occasionally, not enough to cause FASD.
Her ex only drank occasionally as well.

It's pretty clear to me that ADHD is a genetic trait in my family.

[ginniebean]

While a mother doesn't have to drink high levels of alcohol, (mine didn't drink at all) those with fasd look visually fasd.

Alterations in facial appearance, not as pronounced az down syndrome can be seen just by looking.

[hanikamiya]

Originally Posted by Amtram

FAS is not caused by even moderate consumption, and there are physical and mental characteristics that accompany it that bear no resemblance whatsoever to ADHD and which cannot be addressed by ADHD medications.

The only thing that would make sense is that they are talking about children with FAS without additional ADD, and children with FAS with additional ADD on top. If they could detect ADD in children where it is masked by their FAS, it might be possible to help them improve more than by just doing more of the same, FAS-only therapy.

[ConcertaParent]

We spent several hours at an FASD genetics clinic. DD had a physical exam including the nose, lips and hands for FASD signs; measurements such as eyes and head circumference; photocopies taken of previous tests and assessments such as MRI and copy number variants (CNV); and new blood tests. The INITIAL opinion is that her disorders may be GENETIC-based as opposed to alcohol.

After the blood/genetic tests are analyzed, we will get a copy of the report in a couple of months. It was recommended that we go to the #1 FASD clinic in the country for a more thorough behavioural analysis. The genetics specialist repeated the importance of distinguishing between FASD and genetic ADHD, including treatment differences, Hopefully, the next clinic will have state-of-the-art tools such as eye movement patterns and 3D facial imaging.

[Nate W]

Not me unfortunately. This is the first time I read about being able to differientiate between FASD and ADHD. Most interesting.

I was diagnosed in the 1960s with "minimal brain dysfunction" (term used instead of ADHD back then) and I exhibited all the classic symptoms. I struggled with it all my life. About 5 years ago I was surfing the 'net and I came accross Wikipedia's entry on fetal alcohol syndrome. Man, did the description fit what happened to me and my symptoms (it fits ADHD pretty well too, but is more broad, almost as if ADHD is a subset of FASD, if caused by it). And at that time, I concluded (whether correct or not) my mother's drinking while pregent caused it. It was a revelation. And my mother was a VERY heavy drinker. My aunt lived with my parents when I was born and a few years ago, when I started putting two and two together, I asked my aunt, "Did my mother drink when she was pregnent with me?", "Well, yes..." was the answer. I asked how much and she could not answer (my aunt was about 12 at the time).

But what is confusing is my mother exhibits the traits of ADHD and her parents did not drink excessively and my son has ADHD (officially diagnosed too) and his mother did not drink, and ADHD is not on my dad's side of the family, so I actually am not sure what caused it in my case, and it could well be genetic. I'm an only child, so I do not have siblings to compare to.

What I did find disconcerning was the amount of alcohol ingestion believed to cause FASD, it's something like 3 drinks/day or more, and I know my mother drank well over 3 a day.

I read above that the course of meds are different if one has FASD vs. ADHD. All I know is the classic stimulant meds work great for me. So I'm leaning torawds ADHD and whether or not FASD made it worse, I don't know.

I'll have to look into this. Thanks for the insight.

ConcertaParent wrote, "Dyslexia and other learning disabilities also have high co-morbodities with ADHD. DD has trouble with both learning and recalling material. I have bought Orton-Gillingham software called "Language Tune-up Kit At Home" to try to improve her dyslexia."

I had dyslexia too, big time. Reversed my bs, ds, and ps.

ginniebean wrote, "While a mother doesn't have to drink high levels of alcohol, (mine didn't drink at all) those with fasd look visually fasd. Alterations in facial appearance, not as pronounced az down syndrome can be seen just by looking."

I looked pretty normal as a baby, per pictures of me under a year old, but I did have a wandering left eye (could see it in early photos) and I had amblyopia (lazy eye) and a growth on that eye.

--Nate

[Lunacie]

Originally Posted by Nate W

>

But what is confusing is my mother exhibits the traits of ADHD and her parents did not drink excessively and my son has ADHD (officially diagnosed too) and his mother did not drink, and ADHD is not on my dad's side of the family, so I actually am not sure what caused it in my case, and it could well be genetic. I'm an only child, so I do not have siblings to compare to.
>

--Nate

Chances are you have inherited ADHD from your mom's family,

and could have some FASD added on to complicate things.

Many who have undiagnosed ADHD turn to alcohol or drugs to self-medicate.

Especially those of your mom's generation,

before ADHD was diagnosed in adults.

[Nate W]

"Many who have undiagnosed ADHD turn to alcohol or drugs to self-medicate."

I did that too. Although diagnosed, I was never given medication for ADHD because my parents did not believe in it and when 18, I self medicated with alcohol and it worked for a long time and then it turned on me. So I am an alcoholic, but by the grace of God and the 12 Steps I am sober 7 years with no desire to drink.

Now, I am on medication.

--Nate

[sarahsweets]

Im confused...does this mean you can had fasd without the mother consuming alcohol?

[daveddd]

Originally Posted by sarahsweets

Im confused...does this mean you can had fasd without the mother consuming alcohol?

no

but i guess the confusion comes in when

the mother drank and the baby has adhd

but really the mothers drinking was because of her genetic adhd(prone to substance abuse)

so correlation doesnt mean causation

the genetics is the causation

although consuming alcohol can make the adhd worse

and the child would have adhd if the mother drank or not(genetics)

[Amtram]

It would fall under the category of concurrent causes. The symptoms of ADHD are consistent with decreased function and/or size of particular areas of the brain. This would be a genetic cause - your brain is built by the genes you inherit from your parents just like your heart and your liver and your eyes and your teeth. However, introduce a chemical into the maternal bloodstream that is known to kill off brain cells, and the same difference in function or size can be chemically induced during fetal development.

However, since ADHD is a collection of symptoms that originate in more than just one part of the brain, damage to the brain can produce ADHD-like symptoms without actually causing ADHD, because it isn't affecting the whole collection, only the ones that are impaired by the cell damage.