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. Author manuscript; available in PMC: 2022 Feb 1.
Published in final edited form as: Alcohol Clin Exp Res. 2021 Jan 6;45(2):386–394. doi: 10.1111/acer.14525

Table 1.

Fetal Alcohol Spectrum Disorder Diagnostic Classification1

Fetal Alcohol Syndrome A classification of fetal alcohol syndrome requires all features specified in points 1 through 4

  1. A characteristic pattern of minor facial anomalies, including 2 or more of the following: short palpebral fissures (≤10th percentile), thin vermilion border of the upper lip (rank 4 or 5 on lip-philtrum guide), or smooth philtrum (rank 4 or 5 on lip-philtrum guide)

  2. Growth deficiency: Height, weight, or both at or below than the 10th percentile

  3. Deficient brain growth: head circumference at or below the 10th percentile

  4. Neurobehavioral impairment as defined by a, b, or both
    1. with cognitive deficit in at least 1 neurobehavioral domain of 1.5 or more SD below the mean (executive functioning, memory impairment, or visual-spatial impairment)
    2. Evidence of behavioral deficit in at least 1 domain 1.5 SD or more below the mean in impairments of self-regulation (mood or behavioral regulation impairment, attention deficit, or impulse control)
Partial Fetal Alcohol Syndrome For children with documented prenatal alcohol exposure, a classification of partial fetal alcohol syndrome requires features 1 and 2
  1. A characteristic pattern of minor facial anomalies, including 2 more of the following:
    1. Short palpebral fissures (≤10th percentile)
    2. Thin vermilion border of the upper lip (rank 4 or 5 on lip-philtrum guide)
    3. mooth philtrum (rank 4 or 5 on lip-philtrum guide)
  2. Neurobehavioral impairment
    1. Same criteria as fetal alcohol syndrome
For children without documented prenatal alcohol exposure, a classification of partial fetal alcohol syndrome requires all features, points 1 through 3
  1. A characteristic pattern of minor facial anomalies, including 2 or more of the following:
    1. Short palpebral fissures (≤10th percentile)
    2. Thin vermilion border of the upper lip (rank 4 or 5 on lip-philtrum guide)
    3. Smooth philtrum (rank 4 or 5 on lip-philtrum guide)
  2. Growth deficiency or deficient brain growth
    1. Height, weight or both at or below the 10th percentile, or
    2. Head circumference at or below the 10th percentile
  3. Neurobehavioral impairment
    1. Same criteria as fetal alcohol syndrome
Alcohol-Related Neurodevelopmental Disorder Requires features 1 and 2

  1. Documented prenatal alcohol exposure

  2. Neurobehavioral impairment (points a, b, or both)
    1. With cognitive impairment: Cognitive deficit in at least 2 neurobehavioral domains of more than 1.5 SDs below the mean in executive functioning, memory impairment or visual spatial impairment
    2. With behavioral impairment without cognitive impairment: evidence of behavioral deficit in at least 2 domains 1.5 or more SDs below the mean in impairments of self-regulation (mood or behavioral regulation impairment, attention deficit, or impulse control).
1

Adapted from Hoyme et al, 2016