Substance abuse treatment outcomes in women with Fetal Alcohol Spectrum Disorder
Bibliographic record
Abstract
Grant, T., Novick Brown, N., Graham, J., & Ernst, C. (2014). Substance abuse treatment outcomes in women with Fetal Alcohol Spectrum Disorder.The International Journal Of Alcohol And Drug Research, 3(1), 43-49. doi:10.7895/ijadr.v3i1.112Aims: There is little literature describing substance use treatment participation or completion rates for adults with neurocognitive impairments, including Fetal Alcohol Spectrum Disorders (FASD). This paper examines inpatient and outpatient substance abuse treatment outcomes among women with diagnosed or suspected FASD compared to women without prenatal alcohol exposure (PAE).Design: Three-group observational study.Setting: A three-year case management intervention program in Washington State for high-risk women who abuse alcohol and/or drugs during pregnancy.Participants: Group 1: No PAE (N = 463); Group 2: Diagnosed with FASD (FAS, ARND, fetal alcohol effects, or static encephalopathy) by a qualified physician (N = 25; 14 included in hypothesis testing); Group 3: Suspected FASD (all reported PAE and displayed behaviors consistent with a clinical diagnosis of FASD) (N = 61).Measures: Addiction Severity Index and biannual assessment of substance abuse treatment received and alcohol and drug use.Findings: Women with diagnosed/suspected FASD were less likely than those without PAE to attend and complete inpatient and outpatient treatment. Women with diagnosed/suspected FASD who completed treatment were twice as likely to do so within a structured residential setting compared to a less structured outpatient setting.Conclusions: Program structure in substance abuse treatment is important for people with FASD because of brain-based impairments. Outpatient treatment participation requires intact executive function skills (e.g., planning, organizing, sequencing), while structured inpatient treatment is not as challenging because it requires less independent decision-making. We suggest routine intake screening, referral protocols for follow-up diagnostic assessment, maximizing program structure to the extent possible, and modified therapeutic approaches to accommodate disabilities.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".