Abstract :
Keywords Prenatal alcohol exposure; Fetal alcohol spectrum disorder; Neurobehavioral Screening Tool; Pregnancy; Alcohol Highlights * The Neurobehavioral Screening Tool is inadequate for screening high-risk children. * Further research is needed to establish a valid neurobehavioral tool. * Confirming prenatal alcohol exposure may be difficult in clinical practice. * A reliable indicator of fetal alcohol spectrum disorders is needed. Abstract Background Fetal alcohol spectrum disorders (FASD) describe various conditions resulting from prenatal alcohol exposure. The diagnosis of FASD can be challenging and complex. The Neurobehavioral Screening Tool (NST), derived from Achenbach's Child Behavior Checklist, has been suggested as a tool for identifying FASD. Aims To assess the external validity of the NST and to identify additional characteristics of FASD in a cohort of Israeli children and young adults referred to a neurology and child developmental clinic at a tertiary pediatric medical center in Israel. Study design An observational study based on medical records. Subjects 151 children and young adults, of whom 40 were diagnosed with FASD according to updated clinical guidelines. Outcome measures NST results, as well as demographic and neurobehavioral variables, were compared between those who were and were not diagnosed with FASD. Results The NST demonstrated 72 % to 73 % sensitivity, and 34 % to 36 % specificity, in identifying FASD. Items 4 and 5 ('Lies or cheats', 'Lacks guilt after misbehaving') were the most predictive items in the NST. Other variables that were characteristic of the FASD group included: emotional regulation difficulties (p value Conclusions Our findings regarding the screening capabilities of the NST were less promising than those of most previous studies. Further research is needed to establish a valid neurobehavioral tool with the possible focus on antisocial behaviors and emotional regulation problems. Author Affiliation: (a) Adelson School of Medicine, Ariel University, Ariel, Israel (b) Institute of Pediatric Neurology and Child Development, Schneider Children's Medical Center of Israel, Petach Tikva, Israel (c) Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel (d) Maccabitech, Maccabi Health Services, Tel Aviv, Israel * Corresponding author at: Institute of Pediatric Neurology and Child Development, Schneider Children's Medical Center of Israel, Petach Tikva, Israel. Article History: Received 22 January 2022; Revised 27 May 2022; Accepted 11 June 2022 (footnote)[white star] This work received no financial support. Byline: Dana Ronen (a), Yehuda Senecky (b), Gabriel Chodick (c,d), Esther Ganelin-Cohen [esterg2@clalit.org.il] (b,c,*)