Hoyme et reported various criteria for evaluating a pediatric patient for features of the Fetal Alcohol Spectrum Disorders. These included criteria for the Fetal Alcohol Syndrome (FAS). The authors are from multiple institutions in the United States and South Africa.
Patient selection: child being evaluated for a fetal alcohol spectrum disorder (FASD)
The presence or absence of a documented history of prenatal alcohol exposure does not influence the criteria for FAS.
Criteria for Fetal Alcohol Syndrome (FAS) - all of the following:
(1) a characteristic pattern of minor facial anomalies including at least 2 of the following - short palpebral fissures, smooth philtrum, thin vermilion border of the upper lip
(2) prenatal and/or postnatal growth deficiency with height and/or weight <= 10th percentile for age, gender and race
(3) abnormalities of the central nervous system, with at least one of the following - head circumference <= 10th percentile, structural brain anomalies, recurrent nonfebrile seizures not explained by other causes
(4) neurobehavioral impairment
Neurobehavioral impairment involves one of the following:
(1) age < 3 years and developmental delay >= 1.5 SD below the mean
(2) age >= 3 years, cognitive impairment, global impairment >= 1.5 SD below mean (general conceptual ability, performance IQ, verbal IQ, spatial IQ)
(3) age >= 3 years, cognitive impairment, cognitive deficit in 1 or more neurobehavioral domains (executive functioning, specific-learning, memory, visual-spatial)
(4) age >= 3 years, behavioral deficit >= 1.5 SD below mean affecting self-regulation (mood or behavioral regulation, attention deficit, impulse control)
