Criteria for Diagnosis of FASD and Related Disorders
| Terminology . | Diagnostic Features . |
|---|---|
| FAS | Explicit diagnostic criteria that include all of the following: |
| Three facial abnormalities (ie, smooth philtrum, thin vermillion border, and small palpebral fissures). Also may see midface hypoplasia, micrognathia, microcephaly, epicanthal folds | |
| Growth deficiency (height and/or wt ≤10th percentile at any age) | |
| Structural, neurologic, or functional CNS abnormalities | |
| Prenatal exposure to alcohola | |
| Partial FAS | Some but not all of the physical features of full FAS (above) |
| CNS damage (structural, neurologic, and/or functional impairment) | |
| Confirmed prenatal exposure to alcohol | |
| Alcohol-related birth defects | Classification for individuals who do not have the facial characteristics of full FAS |
| Significant birth defects affecting the heart, eyes, kidneys, and/or bones resulting from PAE | |
| Hearing may also be affected | |
| Usually do not meet criteria for CNS structural or functional abnormalities | |
| Confirmed prenatal exposure to alcohol | |
| Alcohol-related neurodevelopmental disorder | Cluster of symptoms that may include intellectual disabilities as well as challenges with behavior and learning resulting from PAE |
| May also have a CNS anomaly | |
| Often perform poorly in school and have difficulties with math, memory, attention, judgment, and impulse control | |
| Confirmed prenatal exposure to alcohol | |
| ND-PAE | Have impairment of neurocognition, self-regulation, and adaptive functioning |
| Combines deficits in these 3 areas in conjunction with evidence of PAE, childhood onset of symptoms, and significant distress or impairment in social, academic, occupational, or other important area of function | |
| Confirmed prenatal exposure to alcohol |
| Terminology . | Diagnostic Features . |
|---|---|
| FAS | Explicit diagnostic criteria that include all of the following: |
| Three facial abnormalities (ie, smooth philtrum, thin vermillion border, and small palpebral fissures). Also may see midface hypoplasia, micrognathia, microcephaly, epicanthal folds | |
| Growth deficiency (height and/or wt ≤10th percentile at any age) | |
| Structural, neurologic, or functional CNS abnormalities | |
| Prenatal exposure to alcohola | |
| Partial FAS | Some but not all of the physical features of full FAS (above) |
| CNS damage (structural, neurologic, and/or functional impairment) | |
| Confirmed prenatal exposure to alcohol | |
| Alcohol-related birth defects | Classification for individuals who do not have the facial characteristics of full FAS |
| Significant birth defects affecting the heart, eyes, kidneys, and/or bones resulting from PAE | |
| Hearing may also be affected | |
| Usually do not meet criteria for CNS structural or functional abnormalities | |
| Confirmed prenatal exposure to alcohol | |
| Alcohol-related neurodevelopmental disorder | Cluster of symptoms that may include intellectual disabilities as well as challenges with behavior and learning resulting from PAE |
| May also have a CNS anomaly | |
| Often perform poorly in school and have difficulties with math, memory, attention, judgment, and impulse control | |
| Confirmed prenatal exposure to alcohol | |
| ND-PAE | Have impairment of neurocognition, self-regulation, and adaptive functioning |
| Combines deficits in these 3 areas in conjunction with evidence of PAE, childhood onset of symptoms, and significant distress or impairment in social, academic, occupational, or other important area of function | |
| Confirmed prenatal exposure to alcohol |
CNS, central nervous system. Adapted from Hoyme HE, Kalberg WO, Elliott AJ, et al. Updated clinical guidelines for diagnosing fetal alcohol spectrum disorders. Pediatrics. 2016;138(2):e20154256 and Fetal Alcohol Spectrum Disorders Expert Panel. Flow Diagram for Medical Home Evaluation of Fetal Alcohol Spectrum Disorders. Elk Grove Village, IL: American Academy of Pediatrics; 2013. Available at: www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/fetal-alcohol-spectrum-disorders-toolkit/Pages/Algorithm-for-Evaluation.aspx. Accessed December 18, 2017.
Confirming PAE is not necessary if the first 3 features are present.17