Jacquelyn Bertrand, PhD FAS Prevention Team. Fetal Alcohol Syndrome Screening and Diagnostic Guide.
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FAS Prevention Team
In April 2004, several federal agencies along with experts in the field were convened a summit by NOFAS to develop a consensus definition of FASD. The following definition was adopted:
Fetal Alcohol Spectrum Disorders (FASD) is an umbrella term describing the range of effects that can occur in an individual whose mother drank alcohol during pregnancy. These effects may include physical, mental, behavioral, and/or learning disabilities with possible lifelong implications. The term FASD is not intended for use as a clinical diagnosis.
Based on racial norms, person exhibits all three of the following facial features:
* Note: Measured as a 4 or 5 on the University of Washington lip-philtrum guide.
**Note: It is very difficult to measure palpebral fissure length (PFL) accurately.
percentile, which has been documented at any one
point in time.
Adjusted for :
3. Gestational age
Note: Examiner should make sure that the single point in time when the growth deficit was present does not correlate with a point in time when the child was nutritionally deprived.
1. Head circumference (OFC) < 10th percentile adjusted for age and sex.
2. Clinically significant brain abnormalities observable through imaging.
Neurological problems not due to a postnatal insult or fever, or other soft neurological signs outside normal limits.
Performance substantially below that expected for an individual’s age, schooling, or circumstances, as evidenced by:
1. Global cognitive or intellectual deficits representing multiple domains of deficit with performance below the 3rdpercentile (2 SD below the mean for standardized testing)
2. Functional deficits below the 16th percentile (1 SD below the mean for standardized testing) in at least three of the following domains:
a) cognitive or developmental deficits or discrepancies
b) executive functioning deficits
c) motor functioning delays
d) problems with attention or hyperactivity
e) social skills
f) other, e.g., sensory problems, pragmatic language problems, memory deficits, etc.
FAS diagnosis requires all three of the findings
Note: Confirmed prenatal alcohol use can strengthen the evidence for diagnosis, but is not necessary in the presence of all findings listed above.
To assist with differential diagnosis between FAS and environmental causes for CNS abnormalities it is important to obtain a complete and detailed history for the individual and his or her family.