Children with FASD-Evolving Patterns of Developmental Problems and Intervention Costs in Ages 0 through 16 in Finland

Area of Science:

• Pediatrics
• Neurodevelopmental Disorders
• Public Health

Background:

• Fetal alcohol spectrum disorder (FASD) is a leading preventable cause of neurodevelopmental disabilities.
• Early identification and intervention are crucial for improving outcomes in children with FASD.
• Longitudinal data on the spectrum of problems and associated costs in FASD are essential for effective healthcare planning.

Purpose of the Study:

• To identify typical problems and interventions for individuals with FASD from birth to age 16.
• To estimate the healthcare and associated costs during different developmental periods.
• To inform early identification and intervention strategies for children with FASD.

Main Methods:

• Retrospective chart review of 55 individuals diagnosed with FASD.
• Analysis of problems, interventions, and costs across different age groups (0-1, 1-6, 7-12, 13-16 years).
• Estimation of cumulative mean extra costs, including those related to out-of-home placement.

Main Results:

• High rates of neonatal intensive care, physiotherapy, and congenital malformations in the first year.
• Prevalence of occupational therapy, speech therapy, and strabismus between ages 1-6.
• Increased diagnosis of ADHD, need for special education, learning disorders, and psychiatric care with age.
• Significant rates of psychiatric unit treatment and intellectual disability by adolescence.
• 80% of individuals were placed out of home, accounting for 78.5% of estimated cumulative costs.

Conclusions:

• FASD is associated with a wide range of medical, developmental, and behavioral problems that evolve with age.
• Out-of-home placement represents a major cost driver for individuals with FASD.
• Understanding typical problem trajectories can aid in early identification, assessment, and intervention planning for children with FASD.