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For health professionals

Detailed information on referral, screening, assessment and formulating a diagnosis can be found in the Australian Guide to the diagnosis of FASD. The Guide was produced to assist clinicians in the diagnosis, referral and management of Fetal Alcohol Spectrum Disorder (FASD). It contains the Australian FASD Diagnostic Instrument and information about how to use the instrument. It provides clinicians with diagnostic criteria for FASD, which were agreed following a review of existing guidelines and consultation with clinical experts. These are similar to criteria in the Canadian guideline for diagnosis of  fetal alcohol spectrum disorders across the lifespan (Cook et al 2016) and use clinical aids developed at the University of Washington to assess facial dysmorphology Diagnostic Guide for FASD The 4-Digit Diagnostic Code (Astley 2004).

Diagnostic categories and criteria for FASD

A diagnosis of FASD requires evidence of prenatal alcohol exposure and severe impairments in three or more domains of central nervous system structure or function.

FASD is a diagnostic term with two diagnositc sub-categories:

  • FASD with three sentinel facial features
  • FASD with less than 3 sentinel facial features

Read more in the diagnosis criteria and the diagnostic algorithm for FASD which are included in the Australian Guide to the diagnosis of FASD.

Screening and referral guidelines

Appendix A9 Referral and screening guidelines for FASD in the Australian Guide to the diagnosis of FASD includes:

  1. Referral guidelines
  2. Screening tools for FASD
  3. Primary developmental surveillance

Diagnostic assessment

To assess an individual with prenatal alcohol exposure and/or suspected FASD, the following essential criteria must be considered:

Alternative diagnoses that might explain neurodevelopmental impairment must be excluded, including genetic diagnoses, exposure to other teratogens and both physical and psychosocial postnatal exposures such as early life trauma. FASD may, however, coexist with other conditions.

Ideally, the diagnostic assessment for FASD is conducted by a multidisciplinary team to enable accurate assessment of the range of outcomes that may be associated with prenatal alcohol exposure. Health professionals participating in a diagnostic assessment for a young person may include:

  • Paediatrician
  • Psychologist
  • Speech pathologist
  • Occupational therapist

For an adult, the health professionals involved in the diagnostic process are most likely to include one or two of the following:

  • Psychiatrist or physician
  • Neuro or clinical psychologist
  • Mental health worker

Accompanying the Australian Guide to the diagnosis of FASD are e-learning modules designed to assist clinicians with:

  • an introduction to FASD, including characteristics and manifestations
  • an understanding of the risks and effects of alcohol use in pregnancy and how to assess alcohol use in pregnancy
  • information needed to conduct a diagnostic assessment using the diagnostic criteria
  • general principles for discussing diagnosis, developing a management plan and supporting families and individuals after a FASD diagnosis
  • an understanding of referral and screening criteria for FASD

To register for the e-learning modules. 

Diagnosing FASD

Join health professionals from around Australia who assess and diagnose Fetal Alcohol Spectrum Disorder (FASD) using the 'Australian Guide to the diagnosis of FASD'.

A Doctor's Story

Gold Coast paediatrician Dr Doug Shelton shares his journey moving from ignorance to knowledge about Fetal Alcohol Spectrum Disorder (FASD). Dr Shelton now heads up one the leading FASD assessment clinics in Australia.