The Silent Epidemic addresses a critical public health problem in America – the leading preventable cause of birth defects, neurodevelopmental disorders, and intellectual disability: prenatal alcohol exposure. From her work in community health, forensic psychiatry, and private practice, 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.