2.1. Maternal Interview

Fetal Alcohol Syndrome (FAS) can be diagnosed without information on prenatal alcohol exposure [25]. However, the information on maternal alcohol history during pregnancy is absolutely required for the diagnosis of partial FAS and Alcohol-related Neurodevelopmental Disorder (ARND) among individuals with behavioral and cognitive difficulties who do not present the specific facial dysmorphologic characteristics of FAS [25]. Therefore, an interview with the biological mother was requested for (1) children who demonstrated deficits (defined as two standard deviations below the mean on a subtest) in a minimum of two domains assessed during the neurodevelopmental assessment and (2) typically developing children (control group). This threshold was set to increase the likelihood that all potential cases were identified, as impairment in a minimum of three domains is necessary for a FASD-specific diagnosis [25]. The 30-min semi-structured interviews were conducted via telephone. During the interview, data were collected on demographics and living environment, pregnancy history, alcohol use (during the past 30 days, lifetime drinking behavior and drinking behavior prior to and following recognition of the pregnancy involving the child in the study), nutrition during pregnancy, and tobacco and other drug use prior to and following pregnancy recognition. The definition of a standard drink was provided to each mother to calibrate the amounts consumed, and drink conversion was done whenever necessary using the standard drink conversion chart. A standard drink is equal to a 341 mL (12 oz) bottle of 5% alcohol beer, cider or cooler; a 142 mL (5 oz) glass of 12% wine; an 85 mL glass of fortified wine (16%–18% alcohol; e.g., sherry, port or vermouth); or a 43 mL (1.5 oz) shot of 40% hard liquor (vodka, rum, rye, whisky or gin).

Interviewers were fully trained on the sensitive nature of the topic of alcohol use during pregnancy and its effects on the family. In addition, the interviewers were blinded as to which mothers of children were selected as controls and which mothers were selected because their children met FASD diagnostic criteria. A minimum of three attempts to contact the biological mother were made.