{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T12:45:10Z","timestamp":1793191510510,"version":"4.5.0"},"reference-count":64,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2020,6,18]],"date-time":"2020-06-18T00:00:00Z","timestamp":1592438400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Alcoholism Clin &amp;amp; Exp Res"],"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Individuals with fetal alcohol spectrum disorder (FASD) experience a range of problems in their cognitive, affective, and physical functioning following prenatal alcohol exposure (PAE), in addition to multiple complex difficulties in daily living that impact well\u2010being. Using the Canadian National FASD Database, we sought to profile a range of difficulties in daily living, along with risk factors, in a large cross\u2010sectional cohort of adolescents, transition\u2010aged youth, and adults with PAE, of which a subset was ultimately diagnosed with FASD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We summarized data for 9\n                      <jats:italic>current<\/jats:italic>\n                      difficulties in daily living reported at the time of diagnostic assessment for 726 individuals with PAE assessed at 26 FASD diagnostic clinics across Canada, including 443 adolescents (12 to 17\u00a0years), 135 transition\u2010aged youth (18 to 24\u00a0years), and 148 adults (25 to 60\u00a0years). Difficulties included problems related to school disruption, employment, independent living needs, supportive or sheltered housing, legal problems with victimization, legal problems with offending, incarceration, alcohol misuse, and other substance misuse. Risk factors included age, gender, living placement, postnatal trauma, and neurodevelopmental impairment.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Across the full PAE sample, adolescents, transition\u2010aged youth, and adults presented with high rates of difficulties in daily living, including independent living support needs (63%), alcohol misuse (38%), other substance misuse (46%), employment problems (37%), legal problems with offending (30%), assisted or sheltered housing (21%), school disruption (18%), legal problems with victimization (4%), and incarceration (3%). Difficulty rates were similar for those with FASD irrespective of diagnosis (e.g., with or without sentinel facial features), but rates greater for adults, and those with low overall intellectual functioning (IQ\u00a0&lt;\u00a070). Controlling for age and IQ, cumulative difficulty was independently associated with gender, living placement, and neurodevelopmental impairment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Adolescents, transition\u2010aged youth, and adults with FASD experienced a range of substantial and complex difficulties at the time of their diagnostic assessment, signaling a high level of service needs. These findings underscore the importance of developmentally informed assessment continued through childhood, as well as ongoing functional and needs\u2010based service provision as youth with FASD transition to adulthood and beyond.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/acer.14385","type":"journal-article","created":{"date-parts":[[2020,5,30]],"date-time":"2020-05-30T02:02:45Z","timestamp":1590804165000},"page":"1609-1624","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":138,"title":["Difficulties in Daily Living Experienced by Adolescents, Transition\u2010Aged Youth, and Adults With Fetal Alcohol Spectrum Disorder"],"prefix":"10.1111","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4569-7529","authenticated-orcid":false,"given":"Kaitlyn","family":"McLachlan","sequence":"first","affiliation":[{"name":"From the Department of Psychology (KM) University of Guelph Guelph Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"Flannigan","sequence":"additional","affiliation":[{"name":"Canada Fetal Alcohol Spectrum Disorder Research Network (KF, KU) Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6970-4637","authenticated-orcid":false,"given":"Valerie","family":"Temple","sequence":"additional","affiliation":[{"name":"Surrey Place (VT) Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathy","family":"Unsworth","sequence":"additional","affiliation":[{"name":"Canada Fetal Alcohol Spectrum Disorder Research Network (KF, KU) Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1936-0669","authenticated-orcid":false,"given":"Jocelynn L.","family":"Cook","sequence":"additional","affiliation":[{"name":"The Society of Obstetricians and Gynaecologists of Canada (JC) Ottawa Ontario Canada"},{"name":"Department of Obstetrics Gynaecology and Newborn Care (JC) University of Ottawa Ottawa Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,6,18]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1080\/09297049.2017.1302579"},{"key":"e_1_2_9_3_1","unstructured":"2018 Statistics Canada Ottawa ON M Allen Police Reported Crime Statistics in Canada 2017"},{"key":"e_1_2_9_4_1","unstructured":"2004 University of Washington Publication Services Seattle WA SJ Astley Diagnostic Guide for Fetal Alcohol Spectrum Disorders: The 4 \u2010Digit Diagnostic Code"},{"key":"e_1_2_9_5_1","first-page":"131","article-title":"An examination of three key factors: alcohol, trauma, and childwelfare: fetal alcohol spectrum disorder and the Northwest Territories of Canada. 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