Fetal alcohol spectrum disorder: Canadian guidelines for diagnosis

TLDR

Diagnosing FASD is complex, necessitating clear guidelines. This paper reviews and clarifies current diagnostic systems, offering recommendations for diagnosing FASD-related disabilities across all ages. A Public Health Agency of Canada subcommittee reviewed and integrated existing diagnostic approaches, consulting experts nationwide to develop standardized Canadian guidelines. The guidelines comprise seven categories—screening, physical examination, neurobehavioural assessment, treatment, maternal history, diagnostic criteria, and harmonization of existing codes—and emphasize a comprehensive, multidisciplinary assessment for FASD diagnosis.

Abstract

THE DIAGNOSIS OF FETAL ALCOHOL SPECTRUM DISORDER (FASD) is complex and guidelines are warranted. A subcommittee of the Public Health Agency of Canada9s National Advisory Committee on Fetal Alcohol Spectrum Disorder reviewed, analysed and integrated current approaches to diagnosis to reach agreement on a standard in Canada. The purpose of this paper is to review and clarify the use of current diagnostic systems and make recommendations on their application for diagnosis of FASD-related disabilities in people of all ages. The guidelines are based on widespread consultation of expert practitioners and partners in the field. The guidelines have been organized into 7 categories: screening and referral; the physical examination and differential diagnosis; the neurobehavioural assessment; and treatment and follow-up; maternal alcohol history in pregnancy; diagnostic criteria for fetal alcohol syndrome (FAS), partial FAS and alcohol-related neurodevelopmental disorder; and harmonization of Institute of Medicine and 4-Digit Diagnostic Code approaches. The diagnosis requires a comprehensive history and physical and neurobehavioural assessments; a multidisciplinary approach is necessary. These are the first Canadian guidelines for the diagnosis of FAS and its related disabilities, developed by broad-based consultation among experts in diagnosis.