Recommended Assessment Tools for Children and Adults with confirmed or suspected FASD

© 2001 Teresa Kellerman, revised October 2005

 Thousands of children are born with Fetal Alcohol Spectrum Disorders (FASD), some with Fetal Alcohol Syndrome (FAS), many with Alcohol Related Neurodevelopmental Disorders (ARND), also called Fetal Alcohol Effects (FAE).  Only 11% of children with FASD receive a diagnosis by age 6 (Streissguth 1996).  Only 16% have an IQ below normal.  Most deficits are invisible and difficult to detect.

Assessments recommended for infants and young children:

Assessments recommended for school age children:

Examples of tests of executive function that help to differentiate children who may have FASD from non-affected children and those with other developmental disabilities [Connor PD, Sampson PD, Bookstein FL, Barr HM, Streissguth AP.  Direct and indirect effects of prenatal alcohol damage on executive function.  Dev Neuropsychol. 2000;18: 331-54] include the following: 

Assessments for adolescents and adults recommended by Robin LaDue:

Risk Assessment Questions:

When should a referral for an evaluation be made for diagnosis of FASD?  

The Centers for Disease Control and Prevention have recently published guidelines for identifying and referring persons with FAS. [MMWR 2005;54(No. RR-11) p. 6]  The guidelines state that the following circumstances should prompt a diagnostic referral, even when knowledge of prenatal alcohol exposure is unknown:

The guidelines further state that the possibility of FASD should be considered for individuals who have experienced at least one of the following social or family situations:

[Streissguth AP, Bookstein FL, Barr HM, Sampson PD, O’Malley K, Young JK. Risk factors for adverse life outcomes in fetal alcohol syndrome and fetal alcohol effects. Dev Beh Ped 2004;25:228–38.]


The guidelines also indicate that since only 25% of individuals with full FAS have below IQ, a measure of functional domains may reveal scores below normal.  For this reason, it is advised that a functional assessment be included in addition to an intelligence test.  Experts like Ann Streissguth and Ed Riley recommend the Vineland Adaptive Behavior Scales, preferably the parent version, for most accurate assessment of the individual’s functional abilities.


Functional Domains:  

Individuals with FASD are likely to have deficits in three or more of the above functional domains.  These deficits can be present in those with a normal IQ and are difficult to detect and may not show up on a standard intelligence assessment.  These deficits are more likely to be detected using the Vineland assessment tool.  In most individuals with FASD, the Vineland score will be much lower than the individual’s IQ.



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