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Screening and Modifications to Treatment
Screening and Modifications to Treatment (SMT) is an approach with encouraging practice-based evidence for identifying individuals with a possible FASD in residential
treatment programs for substance use disorders and modifying treatment approaches to improve outcomes. The percentage of individuals with an FASD in specialized systems
of care such as substance abuse treatment has not been accurately determined as many of these individuals are not recognized or diagnosed. However, one study reported that
the incidence of substance use disorders in individuals with an FASD was 35%.1 As many of these individuals repeatedly fail in, or drop out of, substance abuse treatment
due to their difficulty with typical approaches such as motivational interviewing, group therapy, and cognitive behavioral therapy, it is imperative to modify treatment
approaches if we hope to improve outcomes for these individuals and their families, as well as for the agencies and systems that provide services to them. For this to occur,
individuals should be correctly identified and the substance abuse treatment approach should be modified based on the understanding of how their brain processes information.
The Life History Screen that has been developed has been published in the International Journal of Alcohol and Drug Research in an article titled "Screening in Treatment
Programs for Fetal Alcohol Spectrum Disorders that Could Affect Therapeutic Progress."2 Further study needs to be completed to assess the psychometric utility of this screen.
The modifications to treatment have been described in the Journal of Addiction Medicine in an article titled "The impact of prenatal alcohol exposure on addiction treatment."3
This article also highlights what not to do in treatment for individuals with an FASD or other subtle cognitive impairments that affect brain functioning.
1. Streissguth, A.P., Barr, H.M., Kogan, J., & Bookstein, F. L. (1996). Understanding the Occurrence of Secondary Disabilities in Clients with Fetal Alcohol Syndrome (FAS) and Fetal
Alcohol Effects (FAE). Final Report to the Centers for Disease Control and Prevention (CDC), Seattle: University of Washington, Fetal Alcohol & Drug Unit, Tech. Rep. No. 96-06,
2. Grant, T., Novick Brown, N., Graham, J., Whitney, N., Dubovsky, D., & Nelson, L. (2013). Screening in treatment programs for Fetal Alcohol Spectrum Disorders that could affect
therapeutic progress. The International Journal of Alcohol and Drug Research, 2(3), 37-49.
3. Grant, T. M., Brown, N. N., Dubovsky, D., Sparrow, J., Ries, R. (2013). The impact of prenatal alcohol exposure on addiction treatment. Journal of Addiction Medicine, 7(2), 87-95.
All SMT programs were funded in 2012 and were unable to complete their programs due to funding cuts after the first year.