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[quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous]
Well, sometimes, but just to be clear -- physical exam findings in FASD do not correlate with the level of impairment. Some of the people most strongly affected do not have any physical signs of the exposure [I]in utero[/I]. [/quote]

Yes, I agree.

My point is that if a kid has facial features that lead all the doctors and teachers to know he's FAS, then he should be told.  Because the situation where some people know you have something and you don't know it is terrible.

[b]But, given that FASD can't be conclusively diagnosed in someone who doesn't have physical features, and doesn't have a documented history about of prenatal exposure, it makes much less sense to speculate.[/b]  And since you can't know that someone in that case has FASD, or another disorder, because there is so much overlap, then it's probably safer to give them the diagnosis that carries less stigma, because stigma and low expectations for kids with FASD are a big problem.[/quote]

Just to clarify -- do you mean that

1. FASD can only be diagnosed in people who has specific physical features, OR 
2. that it can only be diagnosed in someone with a documented history of prenatal exposure, OR 
3. that the person has to have both specific physical features and a documented history of prenatal exposure, OR
4. that the diagnosis requires at least one or the other, but not both, and not either one specifically?[/quote]

My experience is doctors first look at physical features, then history, if known and then child's needs/concerns.[/quote]

Ah. It might be helpful to know what diagnosticians are doing, rather than what it may just look like they are doing.

The standardized criteria for diagnosis require either documented prenatal exposure (plus other elements) OR specific clinical exam findings (plus other elements), OR both.

But of note, those physical exam findings might be subtle enough to easily be missed by the untrained eye. Also, some people with no physical exam findings may have more serious sequelae of [I]in utero[/I] exposure to alcohol than people who are easily identified as having classic physical features for the disorder.

I think this might be helpful in understanding why people might be disagreeing with you here. Many people can be diagnosed with FASD but not be easily identified as such by laypeople, and some who virtually cannot be identified by eye may have severe problems from it.

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Updated Clinical Guidelines for Diagnosing Fetal Alcohol Spectrum Disorders
PEDIATRICS Volume 138, number 2, August 2016

(see next three posts)

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