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[quote=Anonymous][quote=Anonymous][quote=Anonymous]No, PP.  Sorry, but I have worked in this area and the misinformation is bothering me.

From the CDC's guidelines for diagnosis/diagnostic criteria:

Based on these scientific findings and the extensive clinical experience of the SWG, the following facial dysmorphic features were determined to meet the dysmorphia criteria essential for FAS (based on racial norms):
••
Smooth philtrum (measured as 4 or 5 on Lip-Philtrum Guide*)
••
Thin vermillion border (measured as 4 or 5 on Lip-Philtrum Guide) (i.e., upper lip)
••
Small palpebral fissures (measured as ?10th percentile according to age and racial norms)
The individual must exhibit all three characteristic facial features; however, additional features also can be present. For example, maxillary hypoplasia is often noted for individuals with FAS as well as those associated features described previously. [b]Cross-sectional and longitudinal studies indicate that many features can change with age or development. After puberty, the characteristic facial features associated with FAS can become more difficult to detect (62). However, recent findings indicate that these three key features remain for the majority of individuals with FAS (47,50).[/b]

[b]CRITERIA FOR FAS DIAGNOSIS
A diagnosis of FAS requires the presence of all three of the following findings:
1.
Documentation of all three facial abnormalities (smooth philtrum, thin vermillion border, and small palpebral fissures);
2.
Documentation of growth deficits; and
3.
Documentation of CNS abnormalities (structural, neurological or functional, or combination thereof ).[/b]

Also --

Changes in presentation of criteria across development. As would be expected for any congenital syndrome, presentation of the diagnostic features can change over development. [b]With regards to facial features (small palpebral fissures, smooth philtrum, and thin vermillion border), it has generally been accepted that these features are most evident during infancy and the early preschool years.[/b]

[PDF]  
Fetal Alcohol Syndrome: Guidelines for Referral and Diagnosiswww.cdc.gov/ncbddd/fasd/documents/fas_guidelines_accessible.pdf[/quote]

yes, you should be sorry because you clearly can only cut and paste words but not actually understand them.

Given there are three criteria, it is not possible to judge solely by facial features/

Further, the guide states "Individual dysmorphic features are not unique to any particular syndrome. Even rare defects or certain clusters of dysmorphic features can appear in a variety of syndromes." which means that the facial features can present for other reasons and be closely matched to those with FAS. This would be why the other two criteria are involved.  The guide further says that "THESE GUIDELINES STRONGLY RECOMMEND THAT FUNCTIONAL DOMAINS BE ASSESSED USING NORM-REFERENCED STANDARDIZED MEASURES. DOMAINS SHOULD BE ASSESSED BY APPROPRIATE PROFESSIONALS USING RELIABLE AND VALIDATED INSTRUMENTS."  
[b]
Diagnosising FASD in a very young child when the information on maternal health is unknown is not an exact science and given that many of the "standardized measures" would not be used until a child is preschool or school age, a definitve diagnosis is not possible in the very early  years.  I am sure that some doctors would speculate and provide the diagnosis on a cautionary basis with the caveat that as a child develops the diagnosis may need re-visited.[/b][/quote]

PP, I think you missed the boat by a long shot. My point, and the point of the CDC paper posted above, which I well understand and have applied clincially, thank you, was that FASD is [b]NOT[/b] FAS. It is not diagnosed in the same way. FAS is diagnosed using the method I pasted because it is a RECOGNIZED SYNDROME AND THERE ARE REQUIREMENTS THAT HAVE TO BE MET FOR DIAGNOSIS, namely, the three bolded ones listed above.  As I pointed out originally, a professional needs to document the facial features, growth deficits, and neurological issues, as well as exposure. My point was that is is possible for professionals to diagnosis FAS, which is a differential diagnosis, meaning other possibilities are ruled out, at a young age.  FASD is more difficult to diagnosis, and may indeed present later. What exactly are you taking issue with???? [/quote]

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