Diagnosing FAS and FASD

Four experts work as a team to diagnose a child with FAS. A psychologist, a medical professional, a speech pathologist and an occupational therapist examine the child in a process that can last from hours to months.

Diagnosing FAS is more complicated than simply looking for physical features caused by alcohol, although those can be key to a diagnosis. Children with FAS are smaller than their peers and have unique facial features, including small eyes, a thin upper lip and a smooth philtrum (the groove between the nose and upper lip).

“. . . Nothing except alcohol will cause these three features together,” said Marilyn Pierce-Bulger, a nurse practitioner and member of the Assets Inc. diagnostic team in Anchorage.

Diagnostic teams here use facial recognition software created by the University of Washington to help determine whether a child meets the criteria for Fetal Alcohol Syndrome.

Most children damaged by a pregnant mother’s drinking do not have full FAS. Some patients with a less visible Fetal Alcohol Spectrum Disorder may actually have more severe behavioral or learning disabilities than those with full FAS.

To learn more about the diagnostic process, go to www.depts.washington.edu/fasdpn


1. FASD and autism prevalence:

Substance Abuse and Mental Health Services Administration, Fetal Alcohol Spectrum Disorders Center for Excellence.

“Fetal Alcohol Syndrome Prevention in Washington State: Evidence of Success,” University of Washington.

2. Lifetime costs of FAS:

“Cost of Fetal Alcohol Spectrum Disorders,” American Journal of Medicine.

“Economic Costs of Alcohol & Drug Abuse in Alaska,” McDowell Group.

3. Cost of prevention versus treatment:

“Fetal Alcohol Syndrome (FAS) Primary Prevention Through FAS Diagnosis,” University of Washington.

4. FASD as percent of population; Alaska rates:

Dr. Philip May, professor of sociology and family community medicine, University of New Mexico.

Substance Abuse and Mental Health Services Administration, Fetal Alcohol Spectrum Disorders Center for Excellence.

Alaska Maternal and Child Health Data Book 2012, state Division of Public Health.

5. Women most likely to drink during pregnancy:

Alcohol Use and Binge Drinking Among Women of Childbearing Age, U.S., 2006-2010, Centers for Disease Control & Prevention.

6. State by state binge drinking rates:

“State-Specific Weighted Prevalence Estimates of Alcohol Use Among Women Aged 18-44 Years,” Behavioral Risk Factor Surveillance System, 2010.

7. Percentage of Alaska women who say they drank while pregnant:

Alaska Division of Public Health, Vital Statistics. Figures for 2005 to 2009, the most recent years for which data is available.

Originally published February 24, 2014 by KYLE HOPKINS in Anchorage Daily News.