{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T10:57:22Z","timestamp":1768474642098,"version":"3.49.0"},"reference-count":32,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2019,6,20]],"date-time":"2019-06-20T00:00:00Z","timestamp":1560988800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000027","name":"National Institute on Alcohol Abuse and Alcoholism","doi-asserted-by":"publisher","award":["U01AA019879 and supplement U01AA019879-05S2"],"award-info":[{"award-number":["U01AA019879 and supplement U01AA019879-05S2"]}],"id":[{"id":"10.13039\/100000027","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>The prevalence of fetal alcohol spectrum disorders (FASD) differs among populations and is largely unknown among minority populations. Prevalence and characterization of FASD is necessary for prevention efforts and allocation of resources for treatment and support. However, prevalence data are lacking, including among many minority populations. The aim of this study was to obtain an FASD prevalence estimate in a Southern California American Indian community employing active case-ascertainment. In 2016, American Indian children aged 5\u20137 years and their caregivers were recruited in collaboration with Southern California Tribal Health Clinic. Children were assessed using physical examinations and neurobehavioral testing. Parent or guardian interviews assessed child behavior and prenatal exposures including alcohol. Of 488 children identified as eligible to participate, 119 families consented and 94 completed assessments to allow a classification for FASD. Participating children (n = 94) were an average of 6.61 \u00b1 0.91 years old and half were female. Most interviews were conducted with biological mothers (85.1%). Less than one third (29.8%) of mothers reported consuming any alcohol in pregnancy and 19.1% met study criteria for risky alcohol exposure prior to pregnancy recognition. Overall 20 children met criteria for FASD, resulting in an estimated minimum prevalence of 41.0 per 1000 (4.1%). No cases of fetal alcohol syndrome (FAS) were identified; 14 (70.0%) met criteria for alcohol related neuro- developmental disorder (ARND). Minimum prevalence estimates found in this sample are consistent with those noted in the general population.<\/jats:p>","DOI":"10.3390\/ijerph16122179","type":"journal-article","created":{"date-parts":[[2019,6,20]],"date-time":"2019-06-20T10:49:59Z","timestamp":1561027799000},"page":"2179","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["The Prevalence of Fetal Alcohol Spectrum Disorders in An American Indian Community"],"prefix":"10.3390","volume":"16","author":[{"given":"Annika","family":"Montag","sequence":"first","affiliation":[{"name":"Department of Pediatrics, University of California San Diego, La Jolla, CA 92093-0828, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rhonda","family":"Romero","sequence":"additional","affiliation":[{"name":"Southern California Tribal Health Clinic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toni","family":"Jensen","sequence":"additional","affiliation":[{"name":"Southern California Tribal Health Clinic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amiyonette","family":"Goodblanket","sequence":"additional","affiliation":[{"name":"Southern California Tribal Health Clinic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ami","family":"Admire","sequence":"additional","affiliation":[{"name":"Southern California Tribal Health Clinic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Conner","family":"Whitten","sequence":"additional","affiliation":[{"name":"Southern California Tribal Health Clinic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Calac","sequence":"additional","affiliation":[{"name":"Southern California Tribal Health Clinic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5176-1593","authenticated-orcid":false,"given":"Natacha","family":"Akshoomoff","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of California San Diego, La Jolla, CA 92093-0828, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Sanchez","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of California San Diego, La Jolla, CA 92093-0828, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"MarLa","family":"Zacarias","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of California San Diego, La Jolla, CA 92093-0828, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3484-786X","authenticated-orcid":false,"given":"Jennifer","family":"Zellner","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of California San Diego, La Jolla, CA 92093-0828, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miguel","family":"del Campo","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of California San Diego, La Jolla, CA 92093-0828, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenneth","family":"Jones","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of California San Diego, La Jolla, CA 92093-0828, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christina","family":"Chambers","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of California San Diego, La Jolla, CA 92093-0828, USA"},{"name":"Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA 92093-0828, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2019,6,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1111\/acer.12939","article-title":"Worldwide prevalence of fetal alcohol spectrum disorders: A systematic literature review including meta-analysis","volume":"40","author":"Roozen","year":"2016","journal-title":"Alcohol. Clin. Exp. Res."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"948","DOI":"10.1001\/jamapediatrics.2017.1919","article-title":"Global prevalence of fetal alcohol spectrum disorder among children and youth: A systematic review and meta-analysis","volume":"171","author":"Lange","year":"2017","journal-title":"JAMA Pediatr"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"474","DOI":"10.1001\/jama.2017.21896","article-title":"Prevalence of fetal alcohol spectrum disorders in 4 US communities","volume":"319","author":"May","year":"2018","journal-title":"JAMA"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1683","DOI":"10.2105\/AJPH.93.10.1683","article-title":"Racial disparities in alcohol use: Comparison of 2 American Indian reservation populations with national data","volume":"93","author":"Beals","year":"2003","journal-title":"Am. J. Pub. Health"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1","DOI":"10.5820\/aian.1002.2001.1","article-title":"New data on the epidemiology of adult drinking and substance use among American Indians of the northern states: Male and female data on prevalence, patterns, and consequences","volume":"10","author":"May","year":"2001","journal-title":"Am. Indian Alask. Native Ment. Health Res."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1097\/01.ALC.0000153789.59228.FC","article-title":"Disparities in Patterns of Alcohol Use Among Reservation-based and Geographically Dispersed American Indian Populations","volume":"29","author":"Novins","year":"2005","journal-title":"Alcohol. Clin. Exp. Res."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1785","DOI":"10.1097\/01.ALC.0000095864.45755.53","article-title":"The prevalence of DSM-III-R alcohol dependence in two american indian populations","volume":"27","author":"Spicer","year":"2003","journal-title":"Alcohol. Clin. Exp. Res."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"8","DOI":"10.32799\/ijih.v14i1.31944","article-title":"Community-Specific Risk and Protective Factors for Risky Alcohol Consumption in American Indian Women of Reproductive Potential: Informing Interventions","volume":"14","author":"Montag","year":"2019","journal-title":"Int. J. Indig. Health"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1909","DOI":"10.3109\/10826081003682115","article-title":"Alcohol is something that been with us like a common cold: Community perceptions of american indian drinking","volume":"45","author":"Yuan","year":"2010","journal-title":"Subst. Use Misuse"},{"key":"ref_10","first-page":"126","article-title":"Preventing alcohol-exposed pregnancy among an american indian\/alaska native population: Effect of a screening, brief","volume":"39","author":"Montag","year":"2015","journal-title":"Intervention, and referral to treatment intervention. Alcohol. Clin. Exp. Res."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1572","DOI":"10.2105\/AJPH.2015.302688","article-title":"Effect of depression on risky drinking and response to a screening, brief intervention, and referral to treatment intervention","volume":"105","author":"Montag","year":"2015","journal-title":"Am. J. Public Health"},{"key":"ref_12","unstructured":"Elliot, C. (2007). Differential Abilities Scale-2nd edition (DAS-II) Manual, Harcourt Assessment, Inc."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1207\/S15326942DN2001_2","article-title":"Effects of age on neurocognitive measures of children ages 5 to 12: A cross-sectional study on 800 children from the United States","volume":"20","author":"Korkman","year":"2001","journal-title":"Dev. Neuropsychol."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Korkman, M., Kemp, S.L., and Kirk, U. (2001). Developmental assessment of neuropsychological function with the aid of the NEPSY. Specif. Learn. Disabil. Diffic. Child. Adolesc. Psychol. Assess. Eval., 347\u2013386.","DOI":"10.1017\/CBO9780511526794.012"},{"key":"ref_15","unstructured":"Korkman, M., Kemp, S.L., and Kirk, U. (2007). Administration Manual, Harcourt Assessment. NEPSY-II 2nd ed."},{"key":"ref_16","unstructured":"Beery, K. (2004). The Beery-Buktenica Developmental Test of Visual-Motor Integration (Beery VMI): Administration, Scoring, and Teaching Manual, NCS Pearson."},{"key":"ref_17","unstructured":"Beery, K.E. (2004). Beery VMI: The Beery-Buktenica Developmental Test of Visual-Motor Integration, NSC Pearson."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Beery, K.E., Buktenica, N.A., Beery, N.A., and Keith, E. (2010). Developmental Test of Visual-Motor Integration 6th Edition, NSC Pearson.","DOI":"10.1037\/t48947-000"},{"key":"ref_19","unstructured":"BA, B. (1998). Bracken Basic Concept Scale-Revised, The Psychological Corporation."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Sparrow, S.S., Cicchetti, D., and Balla, D.A. (2005). Vineland Adaptive Behavior Scales-2nd Edition Manual, NCS Pearson Inc.","DOI":"10.1037\/t15164-000"},{"key":"ref_21","unstructured":"Achenbach, T.M., and Rescorla, L. (2001). ASEBA School-Age Forms & Profiles, ASEBA."},{"key":"ref_22","unstructured":"Achenbach, T.M., and Rescorla, L.A. (2000). Child Behavior Checklist for Ages 1 1\/2\u20135, ASEBA, University of Vermont."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Achenbach, T., and Rescorla, L. (2001). Manual for the ASEBA School-Age Forms and Profiles (Child Behavior Checklist for Ages 6\u201318), ASEBA.","DOI":"10.1037\/t47452-000"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"e20154256","DOI":"10.1542\/peds.2015-4256","article-title":"Updated clinical guidelines for diagnosing fetal alcohol spectrum disorders","volume":"138","author":"Hoyme","year":"2016","journal-title":"Pediatrics"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1097\/00004703-200408000-00002","article-title":"Risk factors for adverse life outcomes in fetal alcohol syndrome and fetal alcohol effects","volume":"25","author":"Streissguth","year":"2004","journal-title":"J. Dev. Behav. Pediatr."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1542\/peds.2014-2171","article-title":"Misdiagnosis and missed diagnoses in foster and adopted children with prenatal alcohol exposure","volume":"135","author":"Chasnoff","year":"2015","journal-title":"Pediatrics"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1016\/j.drugalcdep.2015.12.015","article-title":"Muramoto, Alcohol use among Native Americans compared to whites: Examining the veracity of the \u2018Native American elevated alcohol consumption\u2019belief","volume":"160","author":"Cunningham","year":"2016","journal-title":"Drug Alcohol Depend."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1","DOI":"10.5820\/aian.1201.2005.1","article-title":"Culturally competent research with american indians and alaska natives: Findings and recommendations of the first symposium of the work group on american indian research and program. evaluation methodology","volume":"12","author":"Caldwell","year":"2005","journal-title":"Am. Indian Alask. Native Ment. Health Res. J. Natl. Cent."},{"key":"ref_29","unstructured":"Davis, J.D., and Keemer, K. (2002). A Brief History of and Future Considerations for Research in American Indian and Alaska Native Communities."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"435","DOI":"10.3200\/GENP.133.4.435-451","article-title":"Native Americans and alcohol: Past, present, and future","volume":"133","author":"Szlemko","year":"2006","journal-title":"J. Gen. Psychol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"409","DOI":"10.15288\/jsa.2004.65.409","article-title":"Discrimination, historical loss and enculturation: Culturally specific risk and resiliency factors for alcohol abuse among American Indians","volume":"65","author":"Chen","year":"2004","journal-title":"J. Stud. Alcohol"},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Walls, M.L., Whitesell, N.R., Barlow, A., and Sarche, M. (2017). Research with American Indian and Alaska Native populations: Measurement matters. J. Ethn. Subst. 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