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Competency 2: Identification of FASD and Diagnosis of FAS

Diagnosis

Because most people with an FASD have no visible signs of alcohol exposure, their problems may be wrongly blamed on poor parenting or on other disorders. Early diagnosis and intervention contribute to positive long-term outcomes.11 Accurate diagnosis can:

  • Help the person receive appropriate services and entitlements such as Supplemental Security Income (SSI)
  • Aid communication among clinicians, caregivers, educators, and families
  • Provide better self-awareness and understanding by family members

Anyone age 65 or older, or who is blind or disabled, and has limited income and resources, and who is a U.S. citizen, or who falls into one of the qualified categories of aliens, is eligible for SSI.12 Having FAS may qualify a person for SSI when FAS is considered a disability as shown in several legal cases.13 The Social Security Act that covers SSI does not specifically mention FAS as a disability. When the Secretary published the child-disability listings for comment in 1977, he described them as including only the “more common impairments’ affecting children14 and has said the child-disability listings "provide a means to efficiently and equitably evaluate the more common impairment").14 As yet, no specific listings exist for many well-known childhood impairments, including spina bifida, Down syndrome, muscular dystrophy, autism, AIDS, infant drug dependency, and fetal alcohol syndrome. The Secretary, however, has proposed new listings for "Down syndrome and other Hereditary, Congenital and Acquired Disorders." At the state level, the definition and qualifications for developmental disability vary state to state. Alaska is one of the few states that specifically addresses or includes FAS in its definition of developmental disability.15

According to Alaska state law, the term developmental disability (DD) means a severe, chronic disability that:

  • Is attributable to a mental or physical impairment or combination of mental and physical impairments
  • Is manifested before the individual attains age 22
  • Is likely to contribute indefinitely
  • Results in substantial functional limitations in three or more of the following areas of major life activity:
    • Self care
    • Receptive and expressive language
    • Learning
    • Mobility
    • Self direction
    • Capacity for independent living
    • Economic self sufficiency; and reflects the person’s need for a combination and sequence of special, interdisciplinary, or generic assistance, supports or other services that are of lifelong or extended duration and are individually planned and coordinated.

Examples of developmental disabilities are mental retardation, cerebral palsy, autism, and seizure disorder. Mental illness and Fetal Alcohol Syndrome may also be developmental disabilities. However, the disability must result in substantial functional limitations and meet the other criteria in the definition in order to qualify as a DD. One of those criteria is that it meet the disability severity qualifications for Supplemental Security Income.15

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