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I am disturbed that Dr Abel would so completely misconstrue my editorial comments on the article by Stoler and Holmes,1Stoler JM Holmes LB Under-recognition of prenatal alcohol effects in infants of known alcohol abusing women.J Pediatr. 1999; 135: 430-436Abstract Full Text Full Text PDF PubMed Scopus (77) Google Scholar and I appreciate the opportunity to reply. My remarks in that editorial were intended to emphasize the importance of early recognition of the prenatal effects of alcohol as perhaps the most important way to prevent some of the secondary disabilities associated with FAS. Streissguth et al2Streissguth AP, et al. Understanding the occurrence of secondary disabilities in clients with fetal alcohol syndrome (FAS) and fetal alcohol effects (FAE). Atlanta: Centers for Disease Control and Prevention.Google Scholar have recently published a report sponsored by the Centers for Disease Control and Prevention indicating that a number of highly significant secondary disabilities including mental health problems, disrupted school experience, inappropriate sexual behavior, confinement, and trouble with the law occur in 50% or more of individuals with FAS or fetal alcohol effects. Within the category, "trouble with the law" crimes against persons including theft, shoplifting, burglary, assault, and murder occurred most frequently. Importantly, early diagnosis was a strong protective factor for all secondary disabilities. In the analysis by Streissguth et al,2Streissguth AP, et al. Understanding the occurrence of secondary disabilities in clients with fetal alcohol syndrome (FAS) and fetal alcohol effects (FAE). Atlanta: Centers for Disease Control and Prevention.Google Scholar the early recognition of FAS or fetal alcohol effects led to eligibility for services from the state of Washington's Division of Developmental Disabilities, which provides case managers, job placement and coaching, and shelter. Access to these services was the most effective factor protecting against "trouble with the law." My purpose in bringing up the case of Robert Alton Harris was not to re-open a discussion of the merits of his death penalty conviction but rather to illustrate the most extreme secondary disability that can occur when an individual with FAS is not recognized at an early age and therefore is not given the opportunity to benefit from available intervention programs. To suggest that all children with FAS are destined to commit murder, as Dr Abel states that I did, is obviously ridiculous and is a misrepresentation of my editorial comments. Finally, I would like to comment on Dr Abel's concern about stigmatizing people with FAS. There are clearly a number of very serious social and behavioral problems associated with FAS. To deny that the potential for these secondary disabilities exists under the "misguided hope of avoiding stigmatization" would be doing a great disservice to affected individuals and their caretakers who are already keenly aware of the anguish this disorder can cause for themselves and for the society in which they live.