This book addresses a critical public health problem in America - the leading preventable cause of birth defects, neurodevelopmental disorders and intellectual disability: prenatal alcohol exposure. Dr. Rich provides insight into the prevalence of neurodevelopmental disorder associated with prenatal alcohol exposure (ND-PAE) among juveniles accused of violent crimes, in neighborhoods where America's "least valued" citizens reside, and even in upper middle class communities. The problem develops as early as the first three weeks of pregnancy, when many women are unaware that they are pregnant. With appropriate diagnosis and treatment, affected individuals can avoid a lifetime of lost potential from substance use disorders, incarceration, unemployment, and homelessness. From her broad psychiatric, forensic, and public health experience, Dr. Rich has crafted a reasoned, passionate argument for communities and professionals to unite in ending an epidemic that currently affects one in twenty American children.