Fetal Alcohol Spectrum Disorders (FASD) Screening
Reviewed
Also called: Fetal Alcohol Syndrome Screening, Fetal Alcohol 4-Digit Diagnostic Code
A screening to find out if a child has a fetal alcohol spectrum disorder (FASD) due to prenatal alcohol exposure. It involves a physical exam, developmental and behavioral assessment, and review of alcohol exposure history. There is no single lab test.
Specimen: Not applicable
Why this test may be ordered
- To check for FASD if the mother drank alcohol during pregnancy
- To evaluate symptoms such as abnormal facial features, small head size, low height/weight, poor coordination, vision/hearing problems, intellectual disability, delayed development, hyperactivity, or poor social skills
Preparation and collection
No special preparations are needed.
The provider performs a physical exam, checks growth measurements, assesses intellectual and developmental delays, observes behavior, and may use the 4-digit code method to rate features on a scale of 1 to 4.
There are no risks to having an FASD screening.
Understanding results
The screening does not produce a single lab result. Instead, the provider combines findings from the physical exam, growth measurements, developmental assessment, and alcohol exposure history to assign a rating using the 4-digit code. The total score helps determine the likelihood of an FASD. Results are interpreted by your healthcare professional.
- Screen-positive / Higher-likelihood: The child shows a combination of lower height/weight, FAS facial features, behavior/learning difficulties, and confirmed prenatal alcohol exposure. This suggests a higher likelihood of an FASD. Limitation: This is a screening result, not a confirmed diagnosis. Other conditions can cause similar features. Next step: Your provider may recommend a team of specialists including a special education teacher, speech therapist, physical/occupational therapists, and mental health professionals to support development and quality of life.
- Screen-negative / Lower-likelihood: The child does not show enough features or exposure history to suggest a high likelihood of an FASD at this time. Limitation: Some symptoms may appear later as the child grows. A negative screen does not rule out all possible effects of prenatal alcohol exposure. Next step: Continue routine developmental monitoring. If concerns arise later, follow up with your healthcare provider.
- There is no single test for FASDs; the screening combines multiple assessments.
- Symptoms can range from mild to severe and vary by age, making detection challenging.
- A screen-negative result does not guarantee absence of all alcohol-related effects.
- The screening relies on accurate reporting of prenatal alcohol exposure, which may not always be available.
What to do next
If the screening suggests a higher likelihood of FASD, your provider may recommend working with a team of specialists (special education teacher, speech therapist, physical/occupational therapists, mental health professionals), special school services, behavior modification therapy, mental health therapy, social skill training, vocational/life skill therapy, and medicines to help with some symptoms. There is no cure, but early treatment may improve development and quality of life.
- Did you drink any alcohol during your pregnancy?
- Has your child had any developmental delays or learning difficulties?
- Have you noticed any unusual facial features or growth problems in your child?
- Does your child have trouble with coordination, vision, or hearing?
- Have there been any behavioral concerns such as hyperactivity or poor impulse control?
Evidence source
U.S. National Library of Medicine: Fetal Alcohol Spectrum Disorders (FASD) Screening