{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T22:55:00Z","timestamp":1776207300095,"version":"3.50.1"},"reference-count":39,"publisher":"American Academy of Pediatrics (AAP)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,10,1]]},"abstract":"<jats:sec>\n                  <jats:title>BACKGROUND AND OBJECTIVES<\/jats:title>\n                  <jats:p>To date, there has been no large, population-based study estimating the prevalence of psychotropic medication use and cooccurring medical conditions among children with fetal alcohol syndrome disorder (FASD). In addition, it is not known how psychotropic medication use varies by mental health status of the children with FASD and their health insurance coverage. This study attempts to fill this gap by analyzing a large health insurance claims database covering Medicaid and private insurance.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>The study used the 2017 IBM Watson Health MarketScan Multistate Medicaid and Commercial Claims databases. The sample for the analysis includes children between the ages of 0 and 17 with either an FASD diagnosis or a mental health diagnosis (N = 848\u2009721 Medicaid; N = 511\u2009061 private insurance).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>More than half of the children with an FASD diagnosis were prescribed psychotropic medications (63% Medicaid; 57% private). Utilization rates of psychotropic medication among children with cooccurring FASD and a mental health condition (79% Medicaid; 71% private) were higher compared to children with a mental health diagnosis but no FASD (57% Medicaid; 57% private). Stimulants were the most commonly prescribed. Encephalopathy, attention deficit hyperactivity disorder, and epilepsy were the 3 most common cooccurring diagnosis among children with FASD using psychotropic medication under Medicaid compared to encephalopathy, attention deficit hyperactivity disorder, and anxiety with private insurance.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>These results exemplify the complexity of the neurobehavioral profile of children with FASD and the challenge of treatment. Future studies may determine how supportive services for these children will affect psychotropic medication use.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1542\/peds.2022-056797","type":"journal-article","created":{"date-parts":[[2022,9,27]],"date-time":"2022-09-27T08:11:31Z","timestamp":1664266291000},"source":"Crossref","is-referenced-by-count":10,"title":["Psychotropic Medication Utilization Among Children Diagnosed With Fetal Alcohol Spectrum Disorder"],"prefix":"10.1542","volume":"150","author":[{"given":"Yasmin","family":"Senturias","sequence":"first","affiliation":[{"name":"aAtrium Health, Developmental and Behavioral Pediatrics of the Carolinas Charlotte, Charlotte, North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mir M.","family":"Ali","sequence":"additional","affiliation":[{"name":"bUS Department of Health and Human Services, Office of the Assistant Secretary for Planning & Evaluation, Washington, District of Columbia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristina","family":"West","sequence":"additional","affiliation":[{"name":"bUS Department of Health and Human Services, Office of the Assistant Secretary for Planning & Evaluation, Washington, District of Columbia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","published-online":{"date-parts":[[2022,9,27]]},"reference":[{"issue":"4","key":"2023110816470880600_B1","doi-asserted-by":"crossref","first-page":"e20151553","DOI":"10.1542\/peds.2015-1553","article-title":"Neurobehavioral disorder associated with prenatal alcohol exposure","volume":"138","author":"Hagan","year":"2016","journal-title":"Pediatrics"},{"issue":"5","key":"2023110816470880600_B2","doi-asserted-by":"crossref","first-page":"855","DOI":"10.1542\/peds.2013-3319","article-title":"Prevalence and characteristics of fetal alcohol spectrum disorders","volume":"134","author":"May","year":"2014","journal-title":"Pediatrics"},{"issue":"4","key":"2023110816470880600_B3","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1016\/j.cppeds.2013.12.009","article-title":"Managing children and adolescents with fetal alcohol spectrum disorders in the medical home","volume":"44","author":"Senturias","year":"2014","journal-title":"Curr Probl Pediatr Adolesc Health Care"},{"issue":"2","key":"2023110816470880600_B4","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1097\/DBP.0000000000000523","article-title":"Comparison of alcohol-related neurodevelopmental disorders and neurodevelopmental disorders associated with prenatal alcohol exposure diagnostic criteria","volume":"39","author":"Johnson","year":"2018","journal-title":"J Dev Behav Pediatr"},{"issue":"8","key":"2023110816470880600_B5","doi-asserted-by":"crossref","first-page":"1632","DOI":"10.1111\/acer.14127","article-title":"Forty years of assessing neurodevelopmental and behavioral effects of prenatal alcohol exposure in infants: what have we learned?","volume":"43","author":"Garrison","year":"2019","journal-title":"Alcohol Clin Exp Res"},{"issue":"6","key":"2023110816470880600_B6","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1007\/s10597-017-0104-0","article-title":"Fetal alcohol spectrum disorders: characteristics, complications, and treatment","volume":"53","author":"Wilhoit","year":"2017","journal-title":"Community Ment Health J"},{"issue":"4","key":"2023110816470880600_B7","first-page":"436","article-title":"The utility of psychotropic drugs on patients with Fetal Alcohol Spectrum Disorder (FASD): a systematic review","volume":"28","author":"Mela","year":"2018","journal-title":"Psychiatry and ClinPsychopharmacol"},{"issue":"3","key":"2023110816470880600_B8","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1177\/1087054705283880","article-title":"Association of attention deficit hyperactivity disorder and gestational alcohol exposure: an exploratory study","volume":"9","author":"Bhatara","year":"2006","journal-title":"J Atten Disord"},{"issue":"6","key":"2023110816470880600_B9","doi-asserted-by":"crossref","first-page":"697","DOI":"10.1016\/j.ntt.2003.07.014","article-title":"Fetal alcohol syndrome: neuropsychiatric phenomics","volume":"25","author":"Burd","year":"2003","journal-title":"Neurotoxicol Teratol"},{"key":"2023110816470880600_B10","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1196\/annals.1418.016","article-title":"Prenatal alcohol exposure increases vulnerability to stress and anxiety-like disorders in adulthood","volume":"1144","author":"Hellemans","year":"2008","journal-title":"Ann N Y Acad Sci"},{"issue":"5","key":"2023110816470880600_B11","doi-asserted-by":"crossref","first-page":"656","DOI":"10.1111\/j.1530-0277.1990.tb01223.x","article-title":"Attention deficits in children exposed to alcohol prenatally","volume":"14","author":"Nanson","year":"1990","journal-title":"Alcohol Clin Exp Res"},{"issue":"3","key":"2023110816470880600_B12","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1177\/1087054705283880","article-title":"Association of attention deficit hyperactivity disorder and gestational alcohol exposure: an exploratory study","volume":"9","author":"Bhatara","year":"2006","journal-title":"J Atten Disord"},{"issue":"3","key":"2023110816470880600_B13","doi-asserted-by":"crossref","first-page":"e733","DOI":"10.1542\/peds.2006-1606","article-title":"Evaluation of psychopathological conditions in children with heavy prenatal alcohol exposure","volume":"119","author":"Fryer","year":"2007","journal-title":"Pediatrics"},{"issue":"6","key":"2023110816470880600_B14","doi-asserted-by":"crossref","first-page":"1084","DOI":"10.1111\/j.1530-0277.2010.01184.x","article-title":"The remarkably high prevalence of epilepsy and seizure history in fetal alcohol spectrum disorders","volume":"34","author":"Bell","year":"2010","journal-title":"Alcohol Clin Exp Res"},{"issue":"4","key":"2023110816470880600_B15","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1089\/cap.2007.0121","article-title":"Medication effects on symptoms of attention-deficit\/hyperactivity disorder in children with fetal alcohol spectrum disorder","volume":"18","author":"Doig","year":"2008","journal-title":"J Child Adolesc Psychopharmacol"},{"issue":"3","key":"2023110816470880600_B16","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1007\/s40272-015-0118-4","article-title":"Pharmacological treatment of disruptive behavior in children with fetal alcohol spectrum disorder","volume":"17","author":"Koren","year":"2015","journal-title":"Paediatr Drugs"},{"key":"2023110816470880600_B17","volume-title":"Statistical Power Analysis for Behavioral Sciences","author":"Cohen","year":"1988","edition":"2nd ed."},{"issue":"4","key":"2023110816470880600_B18","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1177\/070674370204700405","article-title":"Clinical implications of a link between fetal alcohol spectrum disorder and attention-deficit hyperactivity disorder","volume":"47","author":"O\u2019Malley","year":"2002","journal-title":"Can J Psychiatry"},{"issue":"3","key":"2023110816470880600_B19","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1016\/S0002-7138(09)60501-X","article-title":"Young adult outcome of hyperactive children who received long-term stimulant treatment","volume":"23","author":"Hechtman","year":"1984","journal-title":"J Am Acad Child Psychiatry"},{"issue":"4","key":"2023110816470880600_B20","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1016\/j.cppeds.2013.12.012","article-title":"Fetal alcohol spectrum disorders: an overview for pediatric and adolescent care providers","volume":"44","author":"Senturias","year":"2014","journal-title":"Curr Probl Pediatr Adolesc Health Care"},{"issue":"3","key":"2023110816470880600_B21","doi-asserted-by":"crossref","first-page":"e20152542","DOI":"10.1542\/peds.2015-2542","article-title":"Prenatal alcohol exposure, FASD, and child behavior: a meta-analysis","volume":"137","author":"Tsang","year":"2016","journal-title":"Pediatrics"},{"issue":"6","key":"2023110816470880600_B22","doi-asserted-by":"crossref","first-page":"791","DOI":"10.1016\/j.neubiorev.2009.06.004","article-title":"Prenatal alcohol exposure: fetal programming and later life vulnerability to stress, depression and anxiety disorders","volume":"34","author":"Hellemans","year":"2010","journal-title":"Neurosci Biobehav Rev"},{"key":"2023110816470880600_B23","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1016\/j.bbr.2016.05.004","article-title":"Acute alcohol exposure during neurulation: Behavioral and brain structural consequences in adolescent C57BL\/6J mice","volume":"311","author":"Fish","year":"2016","journal-title":"Behav Brain Res"},{"issue":"6","key":"2023110816470880600_B24","doi-asserted-by":"crossref","first-page":"791","DOI":"10.1016\/j.neubiorev.2009.06.004","article-title":"Prenatal alcohol exposure: fetal programming and later life vulnerability to stress, depression and anxiety disorders","volume":"34","author":"Hellemans","year":"2010","journal-title":"Neurosci Biobehav Rev"},{"issue":"6","key":"2023110816470880600_B25","doi-asserted-by":"crossref","first-page":"1084","DOI":"10.1111\/j.1530-0277.2010.01184.x","article-title":"The remarkably high prevalence of epilepsy and seizure history in fetal alcohol spectrum disorders","volume":"34","author":"Bell","year":"2010","journal-title":"Alcohol Clin Exp Res"},{"issue":"6","key":"2023110816470880600_B26","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1080\/09297049.2012.727791","article-title":"Autism characteristics in children with fetal alcohol spectrum disorders","volume":"19","author":"Stevens","year":"2013","journal-title":"Child Neuropsychol"},{"issue":"6","key":"2023110816470880600_B27","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1111\/ppe.12404","article-title":"Prenatal alcohol exposure in relation to autism spectrum disorder: findings from the Study to Explore Early Development (SEED)","volume":"31","author":"Singer","year":"2017","journal-title":"Paediatr Perinat Epidemiol"},{"issue":"1","key":"2023110816470880600_B28","doi-asserted-by":"crossref","first-page":"42","DOI":"10.5042\/amhid.2011.0015","article-title":"Autism and autistic traits in people exposed to heavy prenatal alcohol: data from a clinical series of 21 individuals and nested case control study","volume":"5","author":"Mukjerjee","year":"2011","journal-title":"Adv Ment Health Intellect Disabil"},{"key":"2023110816470880600_B29","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/j.alcohol.2018.06.002","article-title":"Neurodevelopmental outcomes in individuals with fetal alcohol spectrum disorder (FASD) with and without exposure to neglect: Clinical cohort data from a national FASD diagnostic clinic","volume":"76","author":"Mukherjee","year":"2019","journal-title":"Alcohol"},{"key":"2023110816470880600_B30","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1016\/j.sleep.2016.06.002","article-title":"Sleep and melatonin secretion abnormalities in children and adolescents with fetal alcohol spectrum disorders","volume":"23","author":"Goril","year":"2016","journal-title":"Sleep Med"},{"issue":"4","key":"2023110816470880600_B31","doi-asserted-by":"crossref","first-page":"421","DOI":"10.5664\/jcsm.2038","article-title":"Sleep problems in children with fetal alcohol spectrum disorders","volume":"8","author":"Chen","year":"2012","journal-title":"J Clin Sleep Med"},{"key":"2023110816470880600_B32","unstructured":"Use of Psychotropic Medication Among Medicaid Beneficiaries\n          . MACPAC. Available at: https:\/\/www.macpac.gov\/wp-content\/uploads\/2015\/06\/Use-of-Psychotropic-Medications-among-Medicaid-Beneficiaries.pdf. Published June 2015. Accessed May 27, 2022"},{"key":"2023110816470880600_B33","unstructured":"FDA\n          . Suicidality in children and adolescents being treated with antidepressant medication. Available at: https:\/\/www.fda.gov\/drugs\/postmarket-drug-safety-information-patients-and-providers\/suicidality-children-and-adolescents-being-treated-antidepressant-medications. Accessed June 12, 2021"},{"issue":"2","key":"2023110816470880600_B34","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1001\/jamapsychiatry.2018.3421","article-title":"Association of antipsychotic treatment with Risk of unexpected death among children and youths","volume":"76","author":"Ray","year":"2019","journal-title":"JAMA Psychiatry"},{"issue":"5","key":"2023110816470880600_B35","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1111\/dar.12519","article-title":"Profile of children diagnosed with a fetal alcohol spectrum disorder: A retrospective chart review","volume":"36","author":"Reid","year":"2017","journal-title":"Drug Alcohol Rev"},{"issue":"5","key":"2023110816470880600_B36","doi-asserted-by":"crossref","first-page":"986","DOI":"10.1016\/j.ridd.2009.02.003","article-title":"Interventions for children with fetal alcohol spectrum disorders (FASDs): overview of findings for five innovative research projects","volume":"30","author":"Bertrand","year":"2009","journal-title":"Res Dev Disabil"},{"issue":"1","key":"2023110816470880600_B37","first-page":"64","article-title":"Behavioral interventions for children and adolescents with fetal alcohol spectrum disorders","volume":"34","author":"Paley","year":"2011","journal-title":"Alcohol Res Health"},{"issue":"4","key":"2023110816470880600_B38","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1097\/IYC.0000000000000151","article-title":"State Variability in Diagnosed Conditions for IDEA Part C Eligibility","volume":"32","author":"Barger","year":"2019","journal-title":"Infants Young Child"},{"issue":"1","key":"2023110816470880600_B39","first-page":"e25","article-title":"Fetal alcohol research caring for patients with prenatal alcohol exposure: a needs assessment","volume":"24","author":"Smith","year":"2017","journal-title":"J Popul Ther Clin Pharmacol"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/doi\/10.1542\/peds.2022-056797\/1562068\/peds_2022056797.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/doi\/10.1542\/peds.2022-056797\/1562068\/peds_2022056797.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,8]],"date-time":"2023-11-08T16:48:25Z","timestamp":1699462105000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/150\/4\/e2022056797\/189569\/Psychotropic-Medication-Utilization-Among-Children"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,27]]},"references-count":39,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2022,9,27]]},"published-print":{"date-parts":[[2022,10,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.2022-056797","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"value":"0031-4005","type":"print"},{"value":"1098-4275","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9,27]]},"article-number":"e2022056797"}}