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Two cohorts (ages 5 to 17\u00a0years) completed a comprehensive neurobehavioral battery and a standard dysmorphology exam: a development cohort (DC; <jats:italic>n<\/jats:italic>\u00a0=\u00a0325) and a comparative cohort (CC; <jats:italic>n<\/jats:italic>\u00a0=\u00a0523). Both cohorts included two groups: those with histories of heavy prenatal alcohol exposure (AE\u2010DC, <jats:italic>n<\/jats:italic>\u00a0=\u00a0121; AE\u2010CC, <jats:italic>n<\/jats:italic>\u00a0=\u00a0177) and a control group that included subjects with minimal or no prenatal alcohol exposure (CON\u2010DC, <jats:italic>n<\/jats:italic>\u00a0=\u00a0204; CON\u2010CC, <jats:italic>n<\/jats:italic>\u00a0=\u00a0346). Behavioral assessments and physical exam data were combined using regression techniques to derive a risk score indicating the likelihood of prenatal alcohol exposure. Subjects were then divided into two subgroups: (1) low risk and (2) high risk. Chi\u2010square (<jats:italic>\u03c7<\/jats:italic><jats:sup>2<\/jats:sup>) determined classification accuracy and ROC curves were produced to assess the predictive accuracy. Correlations between risk scores and intelligence quotient and executive function scores were calculated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Subjects were accurately classified in the DC (<jats:italic>\u03c7<\/jats:italic><jats:sup>2<\/jats:sup>\u00a0=\u00a078.61, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001) and CC (<jats:italic>\u03c7<\/jats:italic><jats:sup>2<\/jats:sup>\u00a0=\u00a086.63, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001). The classification model also performed well in the DC (ROC\u00a0=\u00a00.835 [SE\u00a0=\u00a00.024, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001]) and CC (ROC\u00a0=\u00a00.786 [SE\u00a0=\u00a00.021, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001]). In the AE\u2010CC and CON\u2010CC, there were modest but significant associations between the risk score and executive function (AE\u2010CC: <jats:italic>r<\/jats:italic>\u00a0=\u00a0\u22120.20, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.034; CON\u2010CC: <jats:italic>r<\/jats:italic>\u00a0=\u00a0\u22120.28, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001) and intelligence quotient (AE\u2010CC: <jats:italic>r<\/jats:italic>\u00a0=\u00a0\u22120.20, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.034; CON\u2010CC: <jats:italic>r<\/jats:italic>\u00a0=\u00a0\u22120.28, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion(s)<\/jats:title><jats:p>The risk score significantly distinguished alcohol\u2010exposed from control subjects and correlated with important cognitive outcomes. It has significant clinical potential and could be easily deployed in clinical settings.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acer.14749","type":"journal-article","created":{"date-parts":[[2021,11,22]],"date-time":"2021-11-22T04:32:06Z","timestamp":1637555526000},"page":"52-65","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Development and validation of a postnatal risk score that identifies children with prenatal alcohol exposure"],"prefix":"10.1111","volume":"46","author":[{"given":"Gemma A.","family":"Bernes","sequence":"first","affiliation":[{"name":"Center for Behavioral Teratology San Diego State University  San Diego California USA"},{"name":"Department of Psychology San Diego State University  San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9231-647X","authenticated-orcid":false,"given":"Natasia 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