Assessment & Diagnosis

Assessment & Diagnosis

What is involved in FASD Assessment and Diagnosis?

  • Fetal Alcohol Spectrum Disorder: Canadian Guidelines for Diagnosis are the Canadian standard for diagnosing FASD.  
  • The diagnosis of FASD requires a medical diagnosis in the context of a Multi-Disciplinary Assessment.
  • A Multi-Disciplinary Assessment means that a team of professionals (e.g., Physician, Psychologist or Neuropsychologist, Speech and Language Pathologist, Occupational Therapist, Social Worker) may be involved in providing the necessary assessments that are required for the Medical Professional to make a final diagnostic decision.

New Diagnostic Terms:

1) FASD with sentinel facial findings (short palpebral fissures, smooth philtrum and thin upper lip)

2) FASD with no sentinel facial findings

New designation for infants and young children. Infants and young children who do not meet the diagnostic criteria for FASD but have confirmed prenatal alcohol exposure and early signs of development concerns can be designated as: At risk for neurodevelopmental disorder and FASD, associated with prenatal alcohol exposure.

FASD diagnosis may involve:

  • a physical examination
  • a dysmorphology assessment
  • a Psychological or NeuroPsychological assessment
  • a Speech and Language Assessment
  • an Occupational Therapy Assessment
  • Confirmation of prenatal alcohol exposure (PAE) or the presence of 3 characteristic facial features

Why is diagnosis important?

  • FASD’s are often referred to as a hidden or invisible disability, as the damage to the brain due to Prenatal Alcohol Exposure is not readily observable and instead presents as behavioral challenges.  Without a diagnosis these behaviors are misunderstood and often blame is placed on the child and/or the parents.
  • When gestational exposure to alcohol is not considered, misdiagnosis based on the individual’s behavioral presentation frequently occurs (e.g., Attention Deficit Disorder, Conduct Disorder etc.) and intervention attempts may not be appropriate.
  • Proper multi-disciplinary assessment and diagnosis allows for links to be made between the individual’s behavioral presentation and brain functionality.  Increased understanding of the child’s strengths and needs by individuals, parents, caregivers, teachers, and professionals can then occur.
  • Diagnosis allows for behaviors to be reframed and their meaning better understood.  Understanding the underlying brain dysfunction allows for a shift in perception of the individual from someone who ‘won’t’ do what is being required of them to someone who possibly ‘can’t’ do what is being asked of them without appropriate accommodations because of their disability (Diane Malbin).
  • Early diagnosis has been found to correlate with better long-term outcomes for children and their families.
  • Early diagnosis and intervention in the form of appropriate accommodations, support and development of compensatory strategies helps to prevent the development of Secondary Symptoms (e.g., anxiety, frustration, isolation, aggression) and Tertiary Symptoms (e.g., criminal involvement, addictions, school failure, homelessness)