Children with FASDs may present with a range of characteristics or parental concerns. Parents or other members of the clinic team (MA, nurses) who have some knowledge of FASD may bring these issues to your attention.

• Developmental, cognitive, behavioral concerns
  • Hyperactivity
  • Won't follow directions
  • Doesn't pay attention
  • Not learning
  • Impulsive (does things he knows he shouldn't do)
• Specific dysmorphic facial characteristics
• Growth deficits
• History of maternal alcohol use reported by a parent or discovered by a foster/adoptive parent. Parents who bring this to your attention are often looking for reassurance, or searching for an explanation for their child’s problems.

FASDs should be considered in the differential diagnosis for all children with growth, developmental, or behavioral problems. Children known to have been exposed to alcohol should be assessed for FASD.

Other risk factors include:

• Other related exposures associated with alcohol use (e.g., tobacco, marujuana, cocaine, methamphetamine)
• Adoption, particularly from endemic regions (e.g., Russia/Eastern Europe, South Africa)
• History of foster care/children in child welfare

Referral for FASD assessment may come from adoption professionals, child welfare providers, and others for these reasons. There should be a low threshold for assessing children with these risk factors for FASD.

Sometimes, it’s just a matter of parental concern. This may occur as parents do their own research on their child’s problems and find information on FASD, or if a friend or relative suggests they ask the child’s doctor about FASD.