# FASD screening and diagnostic pathway in children under 7

Canonical: https://pinnacleblooms.org/ask/what-is-the-recommended-screening-and-diagnostic-pathway-for-fetal-alcohol-spectrum-disorder-in-children-under-7
Publisher: Pinnacle Blooms Network / Bharath Healthcare Laboratories Private Limited

FASD in children under 7 follows a staged pathway: non-judgemental prenatal alcohol risk screening, then multidisciplinary diagnostic assessment of the three sentinel facial features, pre/postnatal growth, CNS involvement across functional domains, and documented or probable exposure. There is no single test — diagnosis is a clinical synthesis, and developmental surveillance continues regardless of facial findings.

*The child in front of you may carry a prenatal exposure no one has named yet — a structured pathway is what brings it to light.*

## In short
For children under 7, FASD (ICD-11 LD2F.00) is identified through a staged pathway: **risk screening** (prenatal alcohol history, growth, antenatal records), followed by **multidisciplinary diagnostic assessment** examining the three sentinel facial features, growth, structural/functional CNS involvement and documented or probable prenatal alcohol exposure. There is no single test — diagnosis is a clinical synthesis against recognised criteria, and developmental surveillance should continue regardless of facial findings.

## The pathway, briefly
**1. Screen.** Take a non-judgemental maternal alcohol history; flag growth restriction, microcephaly, and any developmental concern. A positive screen routes to formal assessment — do not wait for facial dysmorphology, which is absent in most of the spectrum.

**2. Confirm exposure and dysmorphology.** Assess the three sentinel features (short palpebral fissures, smooth philtrum, thin upper lip) using a validated lip–philtrum guide, plus pre/postnatal growth and head circumference.

**3. Evaluate CNS across domains.** A multidisciplinary team profiles cognition, language, motor, attention/executive function, memory, adaptive behaviour and sensory regulation. Under 7, several domains are still emerging — document baseline now and re-evaluate, as some functional deficits clarify with age.

**4. Differential and comorbidity.** Exclude or note co-occurring genetic, sensory and attachment factors. Refer promptly to genetics or paediatric neurology where indicated.

## The Pinnacle way
A clinical **AbilityScore®** and any diagnosis are formed only at a Pinnacle Blooms Network centre, under qualified clinician care — never from an online form. Our clinician-administered structured assessment maps the functional domains above so co-management is precise. Explore [Fetal Alcohol Spectrum Disorder](/fetal-alcohol-spectrum-disorder), our [developmental assessment pathway](/developmental-assessment) and [how the AbilityScore® is calculated](/ask/what-is-the-abilityscore-and-how-is-it-calculated).

## Trusted sources
WHO ICD-11 (LD2F.00); CDC guidance on FASD diagnosis and the sentinel facial features; AAP recommendations on developmental surveillance and referral.

**Next step —** Refer a child with suspected prenatal alcohol exposure for a structured multidisciplinary assessment at a Pinnacle Blooms Network centre.

This is general information, not a diagnosis — individual assessment and diagnosis require an appropriately qualified healthcare professional.

## Sources
- WHO ICD-11 — Fetal Alcohol Spectrum Disorder (LD2F.00): https://icd.who.int/browse11/l-m/en
- CDC — Diagnosis of FASDs: https://www.cdc.gov/fasd/diagnosis/index.html
- American Academy of Pediatrics — developmental surveillance and referral: https://www.aap.org/

## Connected topics and perspectives
- Conditions: https://pinnacleblooms.org/ask/conditions
- Doctor: https://pinnacleblooms.org/ask/lens/stakeholder/doctor
- Context: https://pinnacleblooms.org/ask/lens/domain/context
- Assessment: https://pinnacleblooms.org/ask/lens/intent/assessment
- Measure: https://pinnacleblooms.org/ask/lens/lifecycle/measure
- Special Education: https://pinnacleblooms.org/ask/lens/route/special-education
- Early Clarity: https://pinnacleblooms.org/ask/lens/empowerment/early_clarity

## Related question paths

### Understand the subject
- Fetal Alcohol Spectrum Disorder: ICD-11 Definition & Early Features: https://pinnacleblooms.org/ask/what-is-fetal-alcohol-spectrum-disorder-and-what-are-its-icd-11-features-in-early-childhood
- ICD-11 Classification for Fetal Alcohol Spectrum Disorder: https://pinnacleblooms.org/ask/what-is-the-icd-11-classification-for-fetal-alcohol-spectrum-disorder
- What is the SNOMED CT concept for Fetal Alcohol Spectrum Disorder?: https://pinnacleblooms.org/ask/what-is-the-snomed-ct-concept-for-fetal-alcohol-spectrum-disorder
- How FASD Affects a Child's Daily Life: https://pinnacleblooms.org/ask/how-does-fetal-alcohol-spectrum-disorder-affect-a-child-s-daily-life
- Is Fetal Alcohol Spectrum Disorder considered a disability?: https://pinnacleblooms.org/ask/is-fetal-alcohol-spectrum-disorder-considered-a-disability
- Is FASD Genetic or Hereditary?: https://pinnacleblooms.org/ask/is-fetal-alcohol-spectrum-disorder-genetic-or-hereditary
- Common Myths About Fetal Alcohol Spectrum Disorder: https://pinnacleblooms.org/ask/what-are-common-myths-about-fetal-alcohol-spectrum-disorder
- What are the types or levels of Fetal Alcohol Spectrum Disorder?: https://pinnacleblooms.org/ask/what-are-the-types-or-levels-of-fetal-alcohol-spectrum-disorder
- What causes Fetal Alcohol Spectrum Disorder in children?: https://pinnacleblooms.org/ask/what-causes-fetal-alcohol-spectrum-disorder-in-children
- Early intervention outcomes for FASD in children under 7: https://pinnacleblooms.org/ask/what-does-current-research-show-about-early-intervention-outcomes-for-fetal-alcohol-spectrum-disorder-in-children-under-7
- What is Fetal Alcohol Spectrum Disorder?: https://pinnacleblooms.org/ask/what-is-fetal-alcohol-spectrum-disorder
- What is Fetal Alcohol Spectrum Disorder, and what does it look like in early childhood?: https://pinnacleblooms.org/ask/what-is-fetal-alcohol-spectrum-disorder-and-what-does-it-look-like-in-early-childhood

### Recognise signs & concerns
- Early Indicators of Fetal Alcohol Spectrum Disorder: https://pinnacleblooms.org/ask/what-early-indicators-of-fetal-alcohol-spectrum-disorder-should-a-paediatrician-watch-for
- FASD Red Flags for Referral in Young Children: https://pinnacleblooms.org/ask/what-clinical-red-flags-for-fetal-alcohol-spectrum-disorder-warrant-referral-in-a-young-child
- Spotting FASD Early: A Frontline Worker Guide: https://pinnacleblooms.org/ask/how-can-a-frontline-health-worker-spot-a-child-with-possible-fetal-alcohol-spectrum-disorder-early
- When to refer suspected FASD for developmental therapy: https://pinnacleblooms.org/ask/when-should-a-doctor-refer-a-child-with-suspected-fetal-alcohol-spectrum-disorder-for-developmental-therapy
- Can Fetal Alcohol Spectrum Disorder be cured?: https://pinnacleblooms.org/ask/can-fetal-alcohol-spectrum-disorder-be-cured
- Can Fetal Alcohol Spectrum Disorder be prevented?: https://pinnacleblooms.org/ask/can-fetal-alcohol-spectrum-disorder-be-prevented
- Do boys show Fetal Alcohol Spectrum Disorder differently?: https://pinnacleblooms.org/ask/do-boys-show-fetal-alcohol-spectrum-disorder-differently
- Do girls show FASD differently?: https://pinnacleblooms.org/ask/do-girls-show-fetal-alcohol-spectrum-disorder-differently
- Should I be worried my child might have FASD?: https://pinnacleblooms.org/ask/should-i-be-worried-my-child-might-have-fetal-alcohol-spectrum-disorder
- Early Signs of Fetal Alcohol Spectrum Disorder: https://pinnacleblooms.org/ask/what-are-the-early-signs-of-fetal-alcohol-spectrum-disorder
- Early Signs of FASD in a 1-Year-Old Boy: https://pinnacleblooms.org/ask/what-are-the-early-signs-of-fetal-alcohol-spectrum-disorder-in-a-1-year-old-boy
- Early Signs of FASD in a 1-Year-Old Girl: https://pinnacleblooms.org/ask/what-are-the-early-signs-of-fetal-alcohol-spectrum-disorder-in-a-1-year-old-girl

### Explore causes & influences
- What are the known contributing factors for FASD in early childhood?: https://pinnacleblooms.org/ask/what-are-the-known-contributing-factors-for-fetal-alcohol-spectrum-disorder-in-early-childhood
- Are boys more likely to have Fetal Alcohol Spectrum Disorder?: https://pinnacleblooms.org/ask/are-boys-more-likely-to-have-fetal-alcohol-spectrum-disorder
- Are girls more likely to have FASD?: https://pinnacleblooms.org/ask/are-girls-more-likely-to-have-fetal-alcohol-spectrum-disorder
- Early intervention for FASD: advancing UNCRPD and the SDGs: https://pinnacleblooms.org/ask/how-does-early-intervention-for-fetal-alcohol-spectrum-disorder-advance-un-child-rights-uncrpd-and-the-sdgs
- What Causes Fetal Alcohol Spectrum Disorder in Young Children?: https://pinnacleblooms.org/ask/what-causes-fetal-alcohol-spectrum-disorder-in-young-children
- Cost-Effectiveness of Early Therapy for FASD: https://pinnacleblooms.org/ask/what-is-the-cost-effectiveness-of-early-therapy-for-fetal-alcohol-spectrum-disorder-in-young-children
- FASD prevalence and public-health burden in India: https://pinnacleblooms.org/ask/what-is-the-prevalence-and-public-health-burden-of-fetal-alcohol-spectrum-disorder-among-young-children-in-india

### Understand assessment
- How Fetal Alcohol Spectrum Disorder Is Assessed in Children Under 7: https://pinnacleblooms.org/ask/how-is-fetal-alcohol-spectrum-disorder-assessed-in-children-under-7
- How Fetal Alcohol Spectrum Disorder Is Assessed in a Young Child: https://pinnacleblooms.org/ask/how-is-fetal-alcohol-spectrum-disorder-assessed-in-a-young-child
- How AbilityScore tracks FASD progress: https://pinnacleblooms.org/ask/how-does-abilityscore-track-progress-in-a-child-with-fetal-alcohol-spectrum-disorder
- What does an AbilityScore of 0–100 mean for a child with FASD?: https://pinnacleblooms.org/ask/what-does-an-abilityscore-of-0-100-mean-for-a-child-with-fetal-alcohol-spectrum-disorder
- What an AbilityScore® of 100–200 Means for a Child with FASD: https://pinnacleblooms.org/ask/what-does-an-abilityscore-of-100-200-mean-for-a-child-with-fetal-alcohol-spectrum-disorder
- AbilityScore 200–300 in Fetal Alcohol Spectrum Disorder: https://pinnacleblooms.org/ask/what-does-an-abilityscore-of-200-300-mean-for-a-child-with-fetal-alcohol-spectrum-disorder
- What an AbilityScore of 300–400 Means for a Child with FASD: https://pinnacleblooms.org/ask/what-does-an-abilityscore-of-300-400-mean-for-a-child-with-fetal-alcohol-spectrum-disorder
- What an AbilityScore® of 400–500 Means for a Child with FASD: https://pinnacleblooms.org/ask/what-does-an-abilityscore-of-400-500-mean-for-a-child-with-fetal-alcohol-spectrum-disorder
- What does an AbilityScore of 500-600 mean for a child with FASD?: https://pinnacleblooms.org/ask/what-does-an-abilityscore-of-500-600-mean-for-a-child-with-fetal-alcohol-spectrum-disorder
- AbilityScore 600–700 in Fetal Alcohol Spectrum Disorder: https://pinnacleblooms.org/ask/what-does-an-abilityscore-of-600-700-mean-for-a-child-with-fetal-alcohol-spectrum-disorder
- What does an AbilityScore of 700–800 mean for a child with FASD?: https://pinnacleblooms.org/ask/what-does-an-abilityscore-of-700-800-mean-for-a-child-with-fetal-alcohol-spectrum-disorder
- What an AbilityScore of 800–900 means for a child with FASD: https://pinnacleblooms.org/ask/what-does-an-abilityscore-of-800-900-mean-for-a-child-with-fetal-alcohol-spectrum-disorder

### Explore therapy & support
- How to Support a Child with FASD Day to Day: https://pinnacleblooms.org/ask/as-a-grandparent-or-caregiver-how-can-i-support-a-child-with-fetal-alcohol-spectrum-disorder-day-to-day
- Can a child with FASD attend a mainstream school?: https://pinnacleblooms.org/ask/can-a-child-with-fetal-alcohol-spectrum-disorder-attend-a-mainstream-school
- Can a Child with Fetal Alcohol Spectrum Disorder Attend a Regular School?: https://pinnacleblooms.org/ask/can-a-child-with-fetal-alcohol-spectrum-disorder-attend-a-regular-school
- Can a Child With Fetal Alcohol Spectrum Disorder Live Independently?: https://pinnacleblooms.org/ask/can-a-child-with-fetal-alcohol-spectrum-disorder-grow-up-to-live-independently
- How a Teacher Can Help a Child with FASD Learn: https://pinnacleblooms.org/ask/how-can-a-classroom-teacher-help-a-child-with-fetal-alcohol-spectrum-disorder-take-part-and-learn
- District early intervention for children under 7 with FASD: https://pinnacleblooms.org/ask/how-can-a-district-early-intervention-programme-identify-and-support-children-under-7-with-fetal-alcohol-spectrum-disorder
- How a teacher can include a child with FASD in a mainstream classroom: https://pinnacleblooms.org/ask/how-can-a-teacher-include-and-support-a-young-child-with-fetal-alcohol-spectrum-disorder-in-a-mainstream-classroom
- How therapy helps a child with FASD make progress: https://pinnacleblooms.org/ask/how-does-therapy-help-a-child-with-fetal-alcohol-spectrum-disorder-make-progress
- How Is FASD Diagnosed in a Child?: https://pinnacleblooms.org/ask/how-is-fetal-alcohol-spectrum-disorder-diagnosed-in-a-child
- How Fetal Alcohol Spectrum Disorder Is Supported Through Therapy: https://pinnacleblooms.org/ask/how-is-fetal-alcohol-spectrum-disorder-supported-through-therapy
- FASD and an AbilityScore of 0–100: your next steps: https://pinnacleblooms.org/ask/my-child-with-fetal-alcohol-spectrum-disorder-has-an-abilityscore-of-0-100-what-should-we-do-next
- AbilityScore 100–200 with FASD: your next step: https://pinnacleblooms.org/ask/my-child-with-fetal-alcohol-spectrum-disorder-has-an-abilityscore-of-100-200-what-should-we-do-next

### At home & in everyday life
- How can I support my child with Fetal Alcohol Spectrum Disorder at home?: https://pinnacleblooms.org/ask/how-can-i-support-my-child-with-fetal-alcohol-spectrum-disorder-at-home