Physical Effects
Weight and/or length growth deficiency (pre or post natal)
Abnormal brain structures, especially small cranium, corpus callosum

Dysmorphic facial features:

  • Short palpebral fissures
  • Smooth philtrum
  • Thin vermillion border

The physical assessment of the child includes many aspects that are already part of the regular health supervision visit. When one is examining the ear, for example, pay special attention to the external pinna for signs of PAE (see supplementary materials). 
The routine cardiac exam is sufficient.  Other aspects, such as checking for pronation of the elbows and formation of the digits are very quick and can easily be added. Clinics that have stopped doing head circumference measurements should add it back in.