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TABLE 1

Criteria for Diagnosis of FASD and Related Disorders

TerminologyDiagnostic 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 
TerminologyDiagnostic 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.

a

Confirming PAE is not necessary if the first 3 features are present.17 

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