FASD | Diagnostic criteria |
Fetal alcohol syndrome | - At least 2 characteristic facial features
- Growth retardation
- Clear evidence of brain involvement
- Neurobehavioral impairment
- With or without documented prenatal alcohol exposure
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Partial fetal alcohol syndrome | With documented prenatal alcohol exposure: - At least 2 characteristic facial features
- Neurobehavioral impairment
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Without documented prenatal alcohol exposure: - At least 2 characteristic facial features
- Growth retardation or clear evidence of brain involvement
- Neurobehavioral impairment
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Alcohol-related neurodevelopmental disorder | - Documented prenatal alcohol exposure
- Neurobehavioral impairment
- (This diagnosis cannot be definitively diagnosed in children <3 years of age)
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Alcohol-related birth defects (ARBD) | - Documented prenatal alcohol exposure
- At least 1 specific major malformation associated with prenatal alcohol exposure
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Neurobehavioral disorder associated with prenatal alcohol exposure¶ | - Documented prenatal alcohol exposure
- Neurobehavioral impairment and onset in childhood
- Facial features, growth retardation, and clear evidence of brain involvement not necessary (but may be present)
- Not better explained by other teratogens, genetic or medical conditions, or environmental neglect
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Definition of clinical features |
Characteristic facial features | - Short palpebral fissuresΔ
- Thin vermillion border (University of Washington Lip-Philtrum rank 4 or 5)
- Smooth philtrum (University of Washington Lip-Philtrum rank 4 or 5)
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Growth retardation | - Height and/or weight (adjusted for gestational age) ≤10th percentile for age, sex, race/ethnicity at any point of time (eg, prenatal or postnatal)
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CNS involvement | Clear evidence of brain involvement | For FAS and pFAS | For ND-PAE |
- Structural or neurologic involvement (1 of the following):
- Head circumference ≤10th percentile for age and sex, or, if weight and height are <10th percentile, head circumference ≤3rd percentile
- Significant structural abnormalities on neuroimaging
- Hard neurologic signs◊
- Recurrent seizures that are not due to postnatal insult or fever
| NA |
Neurobehavioral impairment | - Functional abnormalities (1 of the following):
- Significant global cognitive or intellectual deficits
- Significant developmental delay§
- Functional deficits¥ in at least 3 of the following domains:
- Cognitive or developmental deficits or discrepancies
- Executive functioning deficits
- Motor functioning delays
- Problems with attention or hyperactivity
- Social skills
- Other, such as sensory problems, pragmatic language problems, memory deficits, etc
- Evidence of significant impairment of self-regulation in at least 1 of the following domains:
- Mood or behavioral regulation impairment
- Attention deficit
- Impulse control
| - Functional impairments/deficits in each of the following domains:
- Neurocognitive (at least 1):
- Intellectual disability
- Executive functioning
- Learning
- Memory
- Visual-spatial reasoning
- Self-regulation (at least 1):
- Mood or behavioral regulation
- Attention
- Impulse control
- Adaptive function (at least 2):
- Communication
- Social communication and interaction
- Daily living skills
- Motor skills
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