Project FAST (Fetal Alcohol Screening for Today) was funded by the Substance Abuse and Mental Health Services Administration/Fetal Alcohol Spectrum Disorders Center of Excellence to improve the prevention of Fetal Alcohol Spectrum Disorder (FASD) and to further the identification and treatment of children with FASD. The innovative, multi-disciplinary approach of Project FAST brought together obstetric, pediatric, pediatric behavioral health, Early Intervention, alcohol use disorder treatment, child welfare, mental health, and other public health professionals to enhance systems of care for families impacted by prenatal alcohol use.

FASD Prevention: Through Project FAST (2004 – 2007), a total of 1158 Pregnant Women were screened for alcohol, tobacco and other drugs, utilizing the 5 P’s + Q/F Screening/Engagement Tool. Based on the Relational Model, the 5 P’s asks about Parental, Peer, Partner, and Past Problem Use of Alcohol and Other Drugs, as well as Present Use (Pregnancy) and Tobacco Use. A high rate of 96% of pregnant women received a Brief Intervention that recommended them to abstain from alcohol during pregnancy. Alcohol screening occurred at two prenatal clinics in Lowell and Springfield. Additionally, partnering Early Intervention staff were trained on “Taking an Alcohol History.” A total of 291 Early Intervention and medical staff received screening, brief intervention and linkages to resources training and technical assistance.

FASD Identification and Treatment: This project provided the first opportunity for children with developmental delays to be routinely and universally screened for FASD Risk Factors in Massachusetts. Project FAST trained Early Intervention staff and Family Practitioners to screen children, birth-three for FASD risk factors. Project staff and medical advisors, under the leadership of Barbara A. Morse, Ph.D., a leading national FASD expert, designed Project FAST FASD Screening Tool. At least one indicator from each of the following two categories (physiological and behavioral) must be present to result in a positive screen for referral to a pediatrician, geneticist, or neurologist: Prenatal Alcohol Exposure, Small Head Circumference for Age and Gender, or Smooth Philtrum; AND: Poor Sleep Patterns, Difficult to Feed, or Hard to Soothe. A total of 1129 children were screened for FASD; 18 were referred for further assessment, and one child was diagnosed with Fetal Alcohol Syndrome. Further work in this area would result in an increase of FASD diagnoses.

FASD Health Education in Residential Substance Use Disorder Treatment programs for Pregnant/Postpartum Women. To prevent FASD in future pregnancies and to increase the identification of children of mothers in treatment, staff at two treatment programs were trained on FASD Health Education. A total of 73 women in treatment received strength-based FASD Health Education. Linkages between local resources such as Early Intervention, treatment programs and pediatric geneticists, have resulted in a fuller appreciation of the continuum of services available to women and their prenatally alcohol-exposed infants. This familiarity increases the possibilities for referrals to be made.