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Training & Education

Improvements in FASD prevention, identification and care can be enhanced through systematic efforts to educate healthcare professionals. Such efforts will contribute toward the goals of better alcohol screening and intervention for women at risk for an alcohol-exposed pregnancy and identification and treatment for individuals living with FASDs.

Parents, caregivers, school staff, and others who are with children with FASDs every day can benefit from learning more about FASDs, how they affect the child, strategies for working with the child to best enable him or her to meet his or her full potential, and how to locate appropriate services for the affected child and his or her family.

CDC is committed to improving practice, education, and awareness of those who care for women at risk for an alcohol-exposed pregnancy and those who work with individuals living with FASDs. CDC supports the following activities:

Collaborative for Alcohol-Free Pregnancy:
Partnering for Practice Change

CDC works with FASD Practice and Implementation Centers (PICs) and National Partners, to prevent FASDs by improving healthcare practice, education, and awareness among healthcare professionals. CDC recognizes the following strategies as essential among healthcare professionals working to preventing FASDs:

  • Use of evidence-based practices, such as alcohol screening and brief intervention (SBI), to prevent alcohol-exposed pregnancy and risky alcohol use
  • Care for women at risk of an alcohol-exposed
  • Work with people living with FASDs

In 2014, CDC funded FASD Practice and Implementation Centers (PICs) to expand previous efforts from FASD training programs and shift the perspective from individual training for medical and allied health care professionals to impacting healthcare practice at the systems level and focusing on prevention opportunities. Grantees include:

  • Baylor College of Medicine
  • University of Alaska Anchorage
  • University of California, San Diego
  • University of Missouri
  • University of Nevada, Reno
  • University of Wisconsin

In 2014, CDC funded national partners to strengthen strategic partnerships with key national medical societies, professional organizations, and constituent groups. The two main components include: (1) supporting strategies to improve the delivery of care related to FASDs through promotion of training opportunities; creating change around Maintenance of Certification and other continuing educational requirements for provider groups; developing, integrating, and disseminating FASD-related content and messaging; and fostering collaboration among medical organizations and CDC-funded Practice and Implementation Centers to create complementary products, messages, and approaches; (2) ensuring messages are scientifically accurate and consistent with the perspectives of families and individuals living with FASDs; and increasing the availability and reach of community-level FASD resources and materials. Grantees are:

  • American Academy of Pediatrics
  • American College of Obstetricians and Gynecologists
  • University of Pittsburgh, School of Nursing
  • University of Texas at Austin, School of Social Work
  • National Organization on Fetal Alcohol Syndrome

Collaboration with the Administration for Children and Families

Photo of baby boy in a yellow shirt
CDC and the Administration for Children and Families (ACF) Children’s Bureau are working together to improve the identification and care of children who were exposed to alcohol and other drugs during pregnancy.  The focus of this work is the Prenatal Alcohol and Other Drug Exposures in Child Welfare project.

There are approximately 3.4 million children in the U.S. child welfare system, with 415,000 of these children in foster care. ACF estimates that 6 out of 10 children in foster care come from homes where alcohol and/or other drugs are misused.

Exposure to alcohol and other drugs during pregnancy can cause significant problems for newborns, children, and adolescents. Alcohol can cause life-long birth defects and developmental disabilities such as fetal alcohol spectrum disorders (FASDs). Children with FASDs can have difficulty with learning, controlling impulses, and behaving in appropriate ways. ACF research found that developmental issues can make parenting difficult and frustrating, often leading to periods of abuse or neglect.

The goal of the Prenatal Alcohol and Other Drug Exposures in Child Welfare project is to improve the health and developmental outcomes of children in the welfare system who were exposed to alcohol and other drugs during pregnancy. Over the course of this multi-year project, activities will include the following:

  • Exploring current knowledge, attitudes, policies, practices, and needs of child welfare agencies for identifying and caring for children who were exposed to alcohol and other drugs during pregnancy, as well as caring for their families
  • Developing resources based on the best available evidence of success for training professional staff, families, and foster families to promote identification, referral, and care of children who were exposed to alcohol and other drugs during pregnancy
  • Promoting the best ways to identify, refer, and care for children who were exposed to alcohol and other drugs during pregnancy, as well as care for their families
  • Establishing methods for national, state, and local monitoring of children who were exposed to alcohol and other drugs during pregnancy
For more information on children who were exposed to alcohol during pregnancy, visit

Educational Resources – National Organization on Fetal Alcohol Syndrome (NOFAS)

Doctor in scrubs

In 2010, the Centers for Disease Control and Prevention (CDC) awarded a 4-year cooperative agreement to the National Organization on Fetal Alcohol Syndrome (NOFAS) . The purpose of this project was to (1) increase the availability and coordination of fetal alcohol spectrum disorders (FASD)-related prevention, intervention, and support services at the national, state, and local levels, and (2) increase awareness regarding FASDs through the distribution and dissemination of accurate information through professional and public health networks and the media. The project, The NOFAS Clearinghouse and Media Outreach Center: A Model of Collaboration, Communication, and Capacity Building, included the following components:

  • A clearinghouse to:
    • Enhance and expand the National and State Resource Directory to link communities and professionals with community resources such as diagnosis, family support groups, treatment for women, and treatment for individuals living with an FASD.
    • Enhance and expand the NOFAS Information Clearinghouse and disseminate resources and materials.
  • Affiliate and stakeholder networks to:
    • Engage and grow the NOFAS Affiliate Network and build capacity among network members through technical assistance and through award of microgrants.
    • Engage and grow the Friends of NOFAS network.
  • Media outreach to:
    • Track current media coverage regarding alcohol use and pregnancy and FASDs.
    • Develop a process for responding to media portrayals of these issues in a timely manner using consistent messages.
    • Develop strategies to engage the media proactively to provide accurate coverage of the topics of alcohol use, pregnancy, and FASDs.

CDC previously collaborated with NOFAS to develop and disseminate FASD prevention and education resources for parents and family members, educators, students, professionals, and the public.

As part of this project, NOFAS developed a school-based K-12 FASD Education and Prevention Curriculum for teachers to implement with students in Kindergarten through grade 12. The curriculum provides age-appropriate information about the consequences that alcohol can have on human development while also encouraging youth to be tolerant and accepting of all individuals regardless of a person’s individual capabilities or disabilities.

NOFAS also developed an FASD Public Awareness Guide. The primary purpose of the guide is to enhance public awareness about the risk of prenatal alcohol consumption, FASDs, and the needs of the people and families living with the disorder. The guide offers practical suggestions and strategies to approach community members, service systems, the media, etc. with the FASD prevention and education message, as well as suggestions on how to advocate for services for individuals with FASDs.

Educating Families and Professionals

In 2001, CDC funded four nonprofit organizations to develop and evaluate educational curricula for various audiences about FASDs and how to access appropriate services for children with FASDs and their families. After being tested through multiple trainings and found to be effective, materials from three of these organizations are still available:

Curriculum: Triumph through the Challenges of Fetal Alcohol Syndrome

Double ARC developed and tested separate training curricula for parents and teachers. The parent curriculum describes the core deficits of children with FAS and related conditions, teaches effective parenting techniques addressing these deficits, and directs parents to service resources for children, including school programs. The curriculum for teachers describes FAS and related conditions, ways to recognize children who might have the condition, and approaches to enhancing school performance. Double ARC has also created a video on FAS available for use with the curriculum. Double ARC offers training for facilitators who will be teaching the parent classes. These materials were tested with more than 400 participants in sessions for parents and teachers.

Fetal Alcohol Syndrome Awareness Curriculum for Tribal Justice Systems Personnel

The Preparing a Healthy Path curriculum was designed to inform justice systems personnel about FASDs and to provide them with strategies for responding to persons with FASDs who are involved with the justice system. The curriculum was tested with more than 400 participants from tribes in California, Idaho, Oregon, and Washington.

Executive Summary: FASD Regional Training Centers

Regional Training Centers (RTCs)

Learn more about the FASD Competency-Based Curriculum Development Guide for Medical and Allied Health Education and Practice »

CDC funds FASD Regional Training Centers (RTCs). The purpose of these Centers is to develop, implement, and evaluate educational curricula regarding FASD prevention, identification, and care; and incorporate the curricula into the training programs at each grantee’s university or college, into other schools throughout their regions, and into the credentialing requirements of professional boards.

The competencies upon which the RTC trainings are based are:

  1. Demonstrate knowledge of the historical, biomedical, and clinical background of fetal alcohol syndrome (FAS) and other disorders related to prenatal alcohol exposure, known collectively as fetal alcohol spectrum disorders (FASDs).
  2. Provide services aimed at preventing alcohol-exposed pregnancies in women of childbearing age through screening and brief interventions for alcohol use.
  3. Apply concepts and models of addiction to women of childbearing age, including those who are pregnant, to provide appropriate prevention services, referral, and case management.
  4. Describe the effects of alcohol on the developing embryo and the developing fetus.
  5. Screen, diagnose, and assess infants, children, adolescents, and adults for FAS and other prenatal alcohol-related disorders.
  6. Provide long-term case management for persons with FASDs.
  7. Recognize ethical, legal, and policy issues related to FASDs.
Funded Projects from 2012 to 2014: Implementation of Alcohol Screening and Brief Intervention

In 2012, CDC funded three FASD Regional Training Centers to move from training on alcohol screening and brief intervention (SBI) to implementation of this practice as a routine part of primary care within a health system in their region. The RTCs are documenting the implementation process, identifying barriers and facilitators to implementation, developing ways to overcome barriers, and evaluating uptake of alcohol SBI in multiple settings:

Arctic FASD Regional Training Center

  • State of Alaska, Section of Public Health Nursing
    • Three Public Health Nursing Clinics (Fairbanks, Ketchikan, Mat-Su/Wasilla, AK)

Frontier FASD Regional Training Center

  • University Health System, University of Nevada School of Medicine
    • Women’s Health Care Center and Patient Care Center (Las Vegas, NV)
    • Family Medical Center, Student Health Center, Student Outreach Center (Reno, NV)

Southeastern FASD Regional Training Center

  • Meharry Medical College Family Medicine Primary Care System
    • Two Family Medicine Clinics (Nashville, TN)
Funded Projects from 2011 to 2014:

Arctic FASD Regional Training Center based at the University of Alaska Anchorage (Anchorage, Alaska)

Frontier FASD Regional Training Center – based at the University of Nevada Reno (Reno, Nevada)

Great Lakes FASD Regional Training Center – based at the University of Wisconsin (Madison, Wisconsin)

Midwestern FASD Regional Training Center – University of Missouri (Columbia, Missouri)

Recent RTC Articles (2012 – Present)*

The knowledge of rehabilitation professionals concerning fetal alcohol spectrum disorders
Occupational Therapy in Health Care 2015; DOI: 10.3109/07380577.2015.1053163
Birch SM, Carpenter HA, Marsh AM, McClung KA, Doll JD
[Read Summary]

Fetal alcohol spectrum disorders: Survey of healthcare providers after continuing education
Journal of Intellectual Disability – Diagnosis and Treatment 2014; 2(2):133-143
Evans SF, Tenkku LE, Kennedy T, Zoorob R, Rudeen PK

Fetal alcohol spectrum disorders: An overview for pediatric and adolescent care providers
Current Problems in Pediatric and Adolescent Health Care 2014; 44:74-81
Senturias Y
[Read Summary]

Fetal spectrum disorders: An overview of ethical and legal issues for healthcare providers
Current Problems in Pediatric and Adolescent Health Care 2014; 44:102-104
Senturias Y, Baldonado M
[Read Summary]

Screening and brief intervention for risky alcohol use
Current Problems in Pediatric and Adolescent Health Care 2014; 44:82-87
Zoorob R, Snell H, Kihlberg C, Senturias Y
[Read Summary]

Fetal alcohol spectrum disorders: Guidance for recognition, diagnosis, differential diagnosis and referral
Current Problems in Pediatric and Adolescent Health Care 2014; 44:88-95
Senturias Y, Asamoah A
[Read Summary]

Managing children and adolescents with fetal alcohol spectrum disorders in the medical home
Current Problems in Pediatric and Adolescent Health Care 2014; 44:96-101
Senturias Y, Burns B
[Read Summary]

*See Past Activities for Previous Articles

Enhancing the Health and Development of Infants and Children

Funded Project

American Academy of Pediatrics
In 2009, CDC funded the American Academy of Pediatrics to implement the Public Health Program to Enhance the Health and Development of Infants and Children (PEHDIC). The overarching goal of this program is to link the physician community at the national, state, and local levels with activities that support health promotion and disease prevention for newborns and infants, child development and health, hearing screening, early identification of children with developmental disabilities, prevention of secondary conditions among children with disabilities, health promotion for children with disabilities, and transition of children with disabilities to adult life. As part of the project, AAP is working with CDC to conduct a variety of activities, including:

  • Developing professional education materials to inform pediatricians about the prevention, identification, and treatment of FASDs. This includes:
    • A PediaLink online educational course, Fetal Alcohol Spectrum Disorders: Identification and Management, emphasizing the importance of the primary care provider in suspecting or identifying FASDs, making proper referrals, and facilitating appropriate health care, education, and community services.
    • An FASD Toolkit to raise awareness, promote surveillance and screening, and ensure that all children living with FASDs receive appropriate and timely intervention. The toolkit serves as the framework for the management of a child with an FASD in the medical home and includes a variety of resources and tools.
  • Disseminating information on FASDs to AAP membership through a variety of newsletters and communication channels, such as AAP OnCall, AAP SmartBriefs, and AAP News.
  • Disseminating a fact sheet encouraging pediatricians to consider FASDs when evaluating children with developmental problems, behavioral concerns, or school failure.