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. 2012 May 3;2(3):e000968. doi: 10.1136/bmjopen-2012-000968

Table 1.

Diagnostic criteria based on the Canadian guidelines for the diagnosis of fetal alcohol spectrum disorders42

Diagnostic category Fetal alcohol syndrome Partial fetal alcohol syndrome Neurodevelopmental disorder–alcohol exposed
Diagnostic criteria Requires all four criteria below to be met Requires confirmed prenatal alcohol exposure, the presence of two of the three characteristic facial anomalies at any age and CNS criteria to be met Requires confirmed prenatal alcohol exposure and CNS criteria to be met
Prenatal alcohol exposure Confirmed or unknown Confirmed Confirmed
Facial anomalies Presence of all three of the following facial anomalies at any age:

  • Short palpebral fissure length (≤2 SDs below the mean using the Hall charts43)

  • Smooth philtrum (rank 4 or 5 on the UW Lip-Philtrum Guide*)

  • Thin upper lip (rank 4 or 5 on the UW Lip-Philtrum Guide)

 Presence of any two of the following facial anomalies at any age:

  • Short palpebral fissure length (≤2 SDs below the mean)

  • Smooth philtrum (rank 4 or 5 on the UW Lip-Philtrum Guide)

  • Thin upper lip (rank 4 or 5 on the UW Lip-Philtrum Guide)

 No anomalies required
Growth deficit Prenatal or postnatal growth deficit indicated by birth length or weight ≤10th percentile adjusted for gestational age or postnatal height or weight ≤10th percentile No deficit required No deficit required
Central nervous system (CNS) abnormality Significant CNS dysfunction (evidence of impairment in three or more of the following CNS domains):

  • Hard and soft neurological signs; seizure disorder; gross and fine motor functioning; articulation, phonology and motor speech

  • Cognition (IQ or uneven cognitive profile)

  • Memory

  • Executive functioning and abstract reasoning

  • Communication (expressive and receptive language)

  • Attention deficit/hyperactivity +/− other behavioural problems; abnormal sensory processing

  • Visual motor integration

  • Adaptive behaviour/social skills/social communication

  • Academic achievement

  • CNS structure (including head circumference ≤3rd percentile or other structural CNS abnormality)
*

The University of Washington (UW) Lip-Philtrum Guide is a 5-point Likert scale with representative photographs of lip and philtrum combinations with ranks 1–3 within normal limits and ranks 4 and 5 outside normal limits.