Diagnosis

Diagnosis of fetal alcohol syndrome is usually based on a combination of
the mother’s drinking history (if known) and a physical examination of
the child. The Institute of Medicine (IOM) has established the following
guidelines for diagnosing fetal alcohol syndrome:
  • Facial features that include a smooth upper lip (lacking the normal
    indentation between the nose and the mouth); a thin red border
    along the upper lip; and an abnormally short distance between the
    inner and outer corners of the eye. Other facial features may
    include flattening of the middle part of the face, drooping of the
    eyelids, and unusually small eyes. Although these facial features
    do not look like major deformities to most people, they tell the
    doctor that the child’s brain has not developed normally.
  • Evidence of slow growth either before or after birth. The child is
    below the tenth percentile in weight or height for his or her age.
  • Evidence of abnormalities in the central nervous system. These may
    include an abnormally small head, developmental delays, learning
    difficulties, seizures or epilepsy, mental retardation, hyperactivity,
    irritability in infancy, and poor judgment or impulse control in later
    childhood. Many children with fetal alcohol syndrome do not learn
    to communicate normally with others. They may also have problems
    with memory and with paying attention. Some have difficulties
    with writing or other skills involving hand-to-eye coordination.
  • Confirmed or suspected drinking by the mother.
Children with FAS may have one or more of the following physical
features or characteristics even though these are not used to diagnose the
syndrome:
  • Cleft palate
  • Heart defects
  • Nearsightedness or other eye disorders
  • Hearing loss
  • Abnormal curvature of the spine
  • Unusual creases on the palms of the hands that resemble hockey
    sticks
  • Joints that are easily dislocated

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