Skip to main content

Table 2 Recommended Australian FASD diagnostic categories and criteria

From: Recommendations from a consensus development workshop on the diagnosis of fetal alcohol spectrum disorders in Australia

Diagnostic criteria#     Diagnostic category  
  Fetal Alcohol Syndrome (FAS) Partial Fetal Alcohol Syndrome (PFAS) Neurodevelopmental Disorder-Alcohol Exposed (ND-AE)
Requirements for diagnosis Requires all 4 of the following criteria to be met: Requires confirmed prenatal alcohol exposure, the presence of 2 of the 3 characteristic FAS facial anomalies at any age, and CNS criteria to be met: Requires confirmed prenatal alcohol exposure and CNS criteria to be met:
Prenatal alcohol exposure Confirmed or unknown Confirmed Confirmed
Facial anomalies Simultaneous presentation of all 3 of the following facial anomalies at any age: Simultaneous presentation of any 2 of the following facial anomalies¤ at any age: No anomalies required*
  i. short palpebral fissure length (2 or more standard deviations below the mean) i. short palpebral fissure length (2 or more standard deviations below the mean)  
  ii. smooth philtrum (Rank 4 or 5 on the UW Lip-Philtrum Guide) ii. smooth philtrum (Rank 4 or 5 on the UW Lip-Philtrum Guide)  
  iii. thin upper lip (Rank 4 or 5 on the UW Lip-Philtrum Guide) iii. thin upper lip (Rank 4 or 5 on the UW Lip-Philtrum Guide)  
Growth deficit Prenatal or postnatal growth deficit indicated by birth length or weight ≤ 10th percentile adjusted for gestational age, or postnatal height or weight ≤ 10th percentile No deficit required* No deficit required*
Central Nervous System (CNS) abnormality At least 1 of the following:
i. clinically significant structural abnormality (e.g. OFC ≤ 3rd percentile, abnormal brain structure), or neurological abnormality (seizure disorder or hard neurological signs); and/or
  ii. severe dysfunction (impairment in 3 or more domains of function, 2 or more standard deviations below the mean)
  1. OFC-occipital-frontal circumference. University of Washington Lip-Philtrum Guides: http://depts.washington.edu/fasdpn/htmls/lip-philtrum-guides.htm. *Not required for diagnosis but may be present. #Appropriate reference charts should be used, and other causes of growth deficit and CNS abnormality excluded. Assessment of dysfunction based on evidence from standard validated assessment instruments interpreted by qualified professionals.
  2. ¤Based on the presence of 2 of the 3 characteristic FAS facial features, the observed impairments cannot be causally linked to prenatal alcohol exposure.