For those living with fetal alcohol spectrum disorder (FASD), receiving a diagnosis can play a vital role in their everyday lives. Confirmation of FASD opens up many opportunities to individuals and their families, including improved access to supports and services, appropriate legal counsel, proper medication, additional funding and more. Additionally, knowing the root cause of one’s struggles can provide answers to individuals and their families and, hopefully, some closure.
What is FASD?
FASD itself is not a diagnosis. As outlined by the Canadian Medical Association Journal, FASD is an umbrella term outlining four diagnostic categories: fetal alcohol syndrome (FAS), partial fetal alcohol syndrome (pFAS), alcohol related neurodevelopmental disorder (ARND) and alcohol related birth defects (ARBD). Proposed guideline revisions by the Public Health Agency of Canada via the Canada Fetal Alcohol Spectrum Disorder Network (CanFASD) are pending that would replace the previous definitions outlined: fetal alcohol spectrum disorder with sentinel facial features and fetal alcohol spectrum disorder without sentinel facial features. Please visit our website’s glossary for full definitions of the listed diagnoses.
Where diagnosis comes from
Currently only certified medical doctors can give official diagnoses within the realm of FASD. However, diagnosis is reached through consultation with psychologists, psychiatrists and other health practitioners as part of “multidisciplinary assessment teams” that examine nine brain domains. If the revised diagnosis guidelines come into effect – which include adding a tenth domain called “affect regulation” – psychologists and psychiatrists will be able to determine an FASD diagnosis without the approval of a medical doctor.
The current nine neurobehavioural domains examined in determining diagnosis are:
- Hard or soft neurologic signs (sensory motor skills, seizures, etc.)
- Brain structure (head circumference, MRI)
- Cognition (Intelligence Quotient)
- Communication: receptive and expressive
- Academic achievement
- Executive function and abstract reasoning (managing ideas, planning for the day, etc.)
- Attention deficit/hyperactivity
- Adaptive behaviour, social skills and social communication
Physicians and psychiatrists also examine facial dysmorphology, growth, neurobehaviour and medical history of prenatal alcohol effects. Psychologists are only certified to measure domains three to nine.
We spoke to three prominent Saskatchewan-based doctors working within the field of FASD diagnosis: Dr. Gerald Block, psychologist; Dr. Mansfield Mela, psychiatrist; and Dr. Delores Logan, MD. Each specialist provided their insights into FASD diagnosis, why it’s an important field of work and areas that can be improved.
Please follow the links to each corresponding doctor and their diagnostic interpretations: