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Ann Pytkowicz Streissguth, PhD; Jon M. Aase, MD; Sterling K. Clarren, MD; Sandra P. Randels, RN, MSN; Robin A. LaDue, PhD; David F. Smith, MD

JAMA. 1991;265(15):1961-1967.

Abstract
Fetal alcohol syndrome is a specific recognizable pattern of malformation. Manifestations in 61 adolescents and adults suffering from alcohol teratogenesis are presented. After puberty, the faces of patients with fetal alcohol syndrome or fetal alcohol effects were not as distinctive. Patients tended to remain short and microcephalic, although their weight was somewhat closer to the mean. The average IQ was 68, but the range of IQ scores widely varied. Average academic functioning was at the second- to fourth-grade levels, with arithmetic deficits most characteristic. Maladaptive behaviors such as poor judgment, distractibility, and difficulty perceiving social cues were common. Family environments were remarkably unstable. Fetal alcohol syndrome is not just a childhood disorder; there is a predictable long-term progression of the disorder into adulthood, in which maladaptive behaviors present the greatest challenge to management.

(JAMA. 1991;265:1961-1967)

Author Affiliations
From the Departments of Psychiatry and Behavioral Sciences (Drs Streissguth and LaDue and Ms Randels) and Pediatrics (Dr Clarren), Child Development/Mental Retardation Center and the Alcoholism and Drug Abuse Institute of the University of Washington Medical School, Seattle; and the Department of Pediatrics, University of Vancouver, British Columbia (Dr Smith). Dr Aase is in private practice in Albuquerque, NM.

Footnotes
Reprint requests to Department of Psychiatry and Behaviorial Sciences, GG-20, University of Washington School of Medicine, 2707 NE Blakeley, Seattle, WA 98195(Dr Streissguth).

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