Fetal Alcohol Spectrum Disorders

Different FASD diagnoses are based on particular symptoms and include:

Fetal alcohol syndrome (FAS): FAS represents the most involved end of the FASD spectrum. People with FAS have central nervous system (CNS) problems, minor facial features, and growth problems. People with FAS can have problems with learning, memory, attention span, communication, vision, or hearing. They might have a mix of these problems. People with FAS often have a hard time in school and trouble getting along with others.

Partial fetal alcohol syndrome (pFAS): When a person does not meet the full diagnostic criteria for FAS but has a history of prenatal alcohol exposure and some of the facial features, as well as a growth problem or CNS abnormalities, the person is considered to have pFAS.

Alcohol-related neurodevelopmental disorder (ARND): People with ARND might have intellectual disabilities and problems with behavior and learning. They might do poorly in school and have difficulties with math, memory, attention, judgment, and poor impulse control.

Alcohol-related birth defects (ARBD): People with ARBD might have problems with the heart, kidneys, or bones or with hearing. They might have a mix of these.

Neurobehavioral disorder associated with prenatal alcohol exposure (ND-PAE): A child or youth with ND-PAE will have problems in three areas: (1) thinking and memory, where the child may have trouble planning or may forget material he or she has already learned, (2) behavior problems, such as severe tantrums, mood issues (for example, irritability), and difficulty shifting attention from one task to another, and (3) trouble with day-to-day living, which can include problems with bathing, dressing for the weather, and playing with other children. In addition, to be diagnosed with ND-PAE, the mother of the child must have consumed more than minimal levels of alcohol before the child’s birth (defined as more than 13 alcoholic drinks per month of pregnancy or more than 2 alcoholic drinks in one sitting). ND-PAE was introduced into the Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (DSM-5) in 2013 as a condition for further study and a specifier for intellectual disability.

Areas evaluated for FASD diagnoses

The term FASDs is not meant for use as a clinical diagnosis. If your child is diagnosed with an FASD, the diagnosis will be for a specific condition under the umbrella of FASDs, as listed above.

Diagnosing FASDs can be hard because there is no medical test, like a blood test, for these conditions. And other disorders, such as ADHD (attention-deficit/hyperactivity disorder) and Williams syndrome, have some symptoms like FAS.

To diagnose FASDs, healthcare providers look for:

• Prenatal alcohol exposure, although confirmation is not required for diagnosis
• Central nervous system problems (e.g., small head size, problems with attention and hyperactivity, poor coordination)
• Lower-than-average height, weight, or both
• Abnormal facial features (e.g., smooth ridge between nose and upper lip)