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Module 6: Diagnosis and Treatment of FASD

Diagnostic Procedures

FASD is not a medical diagnosis but is a descriptive term for various disorders. FAS is a medical diagnosis included in the International Classification of Diseases, Ninth Edition, Clinical Modification (ICD-9-CM). The code is 760.71, "noxious influences affecting fetus via placenta or breast milk, specifically alcohol; includes fetal alcohol syndrome."

Many variables are considered in the diagnosis of FASD. Only specialists trained in dysmorphology and neurodevelopmental assessment and who understand the effects of prenatal alcohol exposure are qualified to diagnose FAS. They will also be able to recognize alternative syndromes and neurodevelopmental conditions.

Because FAS is a medical diagnosis, a trained physician must diagnose it. The medical examination includes evaluation of the prenatal and birth history and previous medical history, general physical examination, evaluation of early and current growth patterns, and measurement of facial features. Ideally, input and testing by specialists will be obtained to enhance the diagnosis1. These include:

  • Speech pathologists, who can assess abilities to understand and communicate
  • Occupational therapists and physical therapists, who can assess motor functions and adaptive abilities
  • Psychologists, who can conduct developmental tests to determine abilities and deficits
  • Neuropsychologists, who can describe cognitive impairments and explain their causes and evaluate behavioral impairments resulting from brain injury
  • Psychiatrists, who can assess signs and symptoms of mental health disorders and suggest medication as appropriate
  • Nurses and social workers, who can assess family dynamics and other related issues
  • Teacher and student
  • Parents who are familiar with this disorder and work with other parents either in training or parent support groups and can help with family support and advocacy

It is also useful to get input from teachers, parents, and caregivers for an accurate diagnosis and understanding of the person's specific pattern of effects and needs. Often, people who interact with the individual on a regular basis can detect problems that specialists might miss. For example, some children with an FASD are affectionate and can be happy, social, and gregarious. These are seen as positive qualities. Behavior not appropriate to their developmental stage is more often detected in school where teachers can compare the behaviors with other children. Others may do well in school but have much more difficulty at home or in social and peer situations.

Differences Between FASD and FAS

Fetal Alcohol Spectrum Disorders

Fetal Alcohol Syndrome

Umbrella term, not a diagnosis

Clinical diagnosis (ICD-9-CM code 760.71)

No formal diagnostic criteria

Diagnostic criteria (see CDC guidelines)

No specific facial anomalies

Specific facial anomalies (smooth philtrum, thin upper lip, small eye openings)

Cannot be confirmed without maternal alcohol history

Can be confirmed without maternal alcohol history

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