uration of use to be made. In general, clinicians and researchers rely on the mother's self-report of alcohol use. Self-reports may be inaccurate, however, because social pressures, fear of being labeled, and anxiety about losing custody of her child may lead a woman to underreport her alcohol consumption during pregnancy. Problems recalling the frequency and quantity of alcohol consumed also can lead to erroneous estimates. In the absence of an accurate report, clinicians and caretakers, such as foster and adoptive parents, will not know whether or to what extent the child was exposed to alcohol during gestation. Therefore, both clinicians and researchers must establish trust and rapport with all pregnant women to enable them to report their alcohol use both honestly and accurately.
Because of the difficulty in reliably ascertaining fetal alcohol exposure, a committee convened by the Institute of Medicine to study FAS recently reviewed the diagnostic criteria currently in use and recommended revisions. The committee members
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