Criteria

A diagnosis of Fetal Alcohol Syndrome (FAS) is based on four separate criteria; prenatal alcohol exposure (whether confirmed or not), growth retardation, facial characteristics, and neurodevelopmental problems. These criteria are described below. Not all children adversely affected by maternal alcohol use meet all four of the criteria. These children may have an isolated physical abnormality and be classified as having an Alcohol-Related Birth Defect (ARBD). Other children may just have neurodevelopmental abnormalities, such as problems with communication skills, memory, learning ability, visual/spatial skills, intelligence, and motor skills. These children are classified as having an Alcohol-Related Neurodevelopmental Disorder (ARND).

Identification of FAS, ARBD and ARND

1. Fetal Alcohol Exposure - required for diagnosis (see below). 
2. Fetal Alcohol Syndrome (FAS) - Fetal Alcohol Exposure and Criteria I, II and III (see below). 
3. Alcohol-Related Neurodevelopmental Disorder (ARND) - Fetal Alcohol Exposure and Criteria III (see below). 
4. Alcohol-Related Birth Defects (ARBD) - Fetal Alcohol Exposure and Criteria IV (see below).

Maternal Alcohol Use (confirmed or unconfirmed)

• Abstainer (No alcohol or less than 1 drink per month)
• Low-risk drinker (3-6 drinks a week. None before driving, when pregnant, or on medication)
• At-risk drinker (7-21 drinks a week. Drink in high risk situations)
• Problem drinker (More that 21 drinks per week)
• Dependent drinker (Cannot stop drinking once started)

Criteria I: Growth Retardation

• Weight less than tenth percentile
• Length/height less than tenth percentile

Criteria II: Facial malformation

• Short palpebral fissures
• Thin upper lip
• Long, flat philtrum
• Hypoplastic midface

Criteria III: Neurodevelopmental Disorder

• Head circumference less than tenth percentile
• Sleep disturbances
• Attention deficits
• Decreased response to noise
• Decreased visual focus
• Increased activity
• Delayed speech development
• Altered motor skills
• Learning deficits
• Increased activity

Criteria IV: Other Physical Abnormalities

• Ophthalmologic (problems related to the eyes)
• Otologic (problems related to the ears)
• Cardiac (problems related to the heart)
• Limb

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