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Simple test may detect fetal alcohol syndrome: study

Canadian researchers say a simple test that tracks eye movements may offer a new tool to accurately diagnose fetal alcohol syndrome, a developmental disorder that affects about one in every 100 Canadian children.

Currently, diagnosing fetal alcohol syndrome (FAS) - caused by a woman drinking alcohol during pregnancy - is a hit-and-miss affair, based on physical characteristics, IQ and behavioural and learning difficulties.

Children with FAS often, but not always, have distinctive facial features, such as small eye openings, a webbing of skin between the eyes and the base of nose, droopy eyelids, a thin upper lip and low-set or poorly formed ears.

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Brain damage caused by exposure to alcohol while in the womb may lead to behavioural disturbances, including poor impulse control, lying, stealing, tantrums and aggression.

But because learning difficulties and emotional problems can be caused by a variety of conditions, kids with FAS are often misdiagnosed; many are told they have attention deficit hyperactivity disorder (ADHD), said James Reynolds, a professor of pharmacology and toxicology at Queen's University in Kingston, Ont.

Being misdiagnosed can have serious lifelong effects because children miss out on specialized therapy that can facilitate their ability to learn and to modify thinking patterns and behaviour, said Mr. Reynolds.

"When they're not identified and they're thrown into school systems where they cannot cope, they fail," Mr. Reynolds said Friday. "They drop out, they don't get a proper education, they often end up on the street, they end up in trouble with the law."

In a study of 22 children - 10 diagnosed with FAS and 12 without - Mr. Reynolds's research team used a simple eye-tracking test that detects brain damage. They discovered that kids with FAS have a distinct pattern of visual movement, linked to specific areas of the brain.

While eye-tracking has long been used by doctors around the world to evaluate neurological damage, it had "never been tested or tried in children with fetal alcohol syndrome before we started this study," he said.

The test involves having the child stare at a light in the centre of a screen. A second light is then played across the screen, like a bird flying across the sky. The child is instructed to avoid looking at the moving light and to stay focused on the central lit-up area.

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Kids and adults without brain damage can concentrate enough to keep their eyes from reflexively following the moving light, Reynolds said. "That requires a lot of extra brain power, a lot of extra processing because you have to suppress all of the brain structures involved in triggering the reflex.

"Children with developmental disabilities like fetal alcohol disorder and attention deficit hyperactivity disorder, they have great difficulty in suppressing that reflexive movement," he said. But "there are some very unique deficits emerging in our FAS group that are not present in the ADHD population."

The Queen's researchers hope further study will prove the eye-tracking test is indeed a conclusive means of picking up children with fetal alcohol syndrome.

So far, "it's looking pretty good," said Mr. Reynolds, who will present his findings at a meeting of the International Society for Neuroscience in Washington on Wednesday.

The next step in the research will be to take the test on the road - travelling with the eye-tracking equipment to remote communities in Ontario and eventually other provinces. Mobile testing should begin early next year.

Among aboriginal peoples, the prevalence of FAS is much higher than the national average - as high as 10 per cent in some communities where alcohol abuse is widespread.

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Basil Ziv, executive director of the Association for the Neurologically Disabled of Canada, said that if the test can provide an early diagnosis of fetal alcohol syndrome, it would be a great boon for the children and the adults that they will become.

"If you can identify this problem at an early age and you start therapy," said Mr. Ziv, "then you can give these children a better chance at life."

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