Evidence-Based
Fetal Alcohol Spectrum Disorder
Understand. Recognise. Support.
FASD is the leading preventable cause of neurodevelopmental disability. Early recognition and the right strategies make a lifelong difference.
What is FASD?
🧠Definition
FASD is a lifelong neurodevelopmental condition caused by prenatal alcohol exposure. It affects brain structure and function, leading to challenges across cognition, behaviour, communication, and daily living. FASD is categorised into two presentations based on the presence or absence of sentinel facial features — both are equally significant diagnoses.
FASD with Sentinel Facial Features FASD without Sentinel Facial Features

Both presentations are equally valid diagnoses of FASD. The absence of facial features does not mean a milder condition — neurodevelopmental impairment can be equally significant in both.

Key Facts
📊Prevalence (UK)
SIGN 156 estimates that approximately 3.2% of babies born in the UK are affected by FASD — three to four times the rate of autism. In Scotland alone, up to 172,000 people may be affected. FASD remains significantly underdiagnosed.
⚠️No Safe Amount
There is no known safe level, safe type, or safe time during pregnancy to drink alcohol. This is the advice of the UK Chief Medical Officers and is the basis of NICE QS204 Statement 1.
✅100% Preventable
FASD is entirely preventable. Not drinking alcohol during pregnancy eliminates the risk entirely.
📋NICE QS204 — 5 Quality Statements
QS1 — Pregnant women are advised throughout pregnancy not to drink alcohol.

QS2 — Alcohol use is asked about and recorded throughout pregnancy.

QS3 — Children with probable PAE and significant difficulties are referred for assessment.

QS4 — Children with confirmed PAE or all 3 facial features have a neurodevelopmental assessment if there are clinical concerns.

QS5 — Children with a diagnosis of FASD have an individualised management plan.
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Diagnostic Classifications
📚 SIGN 156 (Scottish Intercollegiate Guidelines Network, 2019) — adopted by NICE QS204 (2022) for England & Wales. SNOMED CT codes implemented 2024.
FASD with Sentinel Facial Features
▼

SNOMED CT: 1894471000000108

Per SIGN 156: All three sentinel facial features must be present. These are highly specific to prenatal alcohol exposure and, when all three are present, confirmation of alcohol exposure through other means is not required.

The Three Sentinel Facial Features:

  • Smooth philtrum — ranked 4 or 5 on the University of Washington Lip-Philtrum Guide
  • Thin vermillion border (upper lip) — ranked 4 or 5 on the Lip-Philtrum Guide
  • Short palpebral fissures — at or below the 3rd centile (≤3rd percentile for age)

Plus:

  • Prenatal alcohol exposure (confirmed, probable, or unknown — all three SFF alone may be sufficient)
  • Evidence of pervasive brain dysfunction (≥3 neurodevelopmental domains severely impaired) — or microcephaly in infants

Note: Features such as flat midface, low nasal bridge, or short nose are associated features, not sentinel features. Only the three above are sentinel.

FASD without Sentinel Facial Features
▼

SNOMED CT: 1894461000000101

Per SIGN 156: This accounts for the majority of FASD presentations (approximately 90% of cases). Facial features are absent or fewer than three sentinel features are present.

Diagnostic Criteria (both required):

  • Confirmed or probable prenatal alcohol exposure — reliable evidence of maternal alcohol use during pregnancy is essential where facial features are absent (SIGN 156, NICE QS204)
  • Pervasive brain dysfunction — severe impairment in 3 or more of the 10 SIGN 156 neurodevelopmental domains (see below)

There is no 'mild' FASD — neurodevelopmental impairment in this presentation can be equally or more severe than in the facial-features presentation.

The 10 SIGN 156 Neurodevelopmental Domains
▼

Per SIGN 156: Severe impairment in 3 or more of these domains = pervasive brain dysfunction. Each domain must be assessed by a qualified professional using standardised tools.

  • Brain structure / Neuroanatomy / Neurophysiology
  • Motor skills (fine and gross motor, coordination)
  • Cognition (intellectual ability, processing)
  • Language (receptive and expressive)
  • Academic achievement
  • Memory (especially working memory and short-term recall)
  • Attention (including hyperactivity)
  • Executive function (including impulse control, planning, flexibility)
  • Affect regulation (emotional dysregulation)
  • Adaptive behaviour, social skills, and social communication
At Increased Risk of FASD
▼

SNOMED CT: 2078801000000102

SIGN 156 and NICE QS204 recognise a third category for children who do not yet meet full diagnostic criteria but remain at increased risk:

  • Confirmed or probable PAE but insufficient evidence of neurodevelopmental impairment at this time (e.g. infant or young child where full assessment not yet possible)
  • Three sentinel facial features present but full neurodevelopmental assessment not yet completed
  • Should receive monitoring, support, and re-assessment as the child develops

NICE QS204 states: support should not wait for a formal diagnosis — children at increased risk should receive early intervention.

Brain & Neurodevelopmental Signs
▼
  • Memory difficulties (especially short-term and working memory)
  • Poor cause-and-effect reasoning
  • Difficulty with abstract concepts
  • Impulse control challenges
  • Attention and concentration difficulties
  • Language delays or processing difficulties
  • Inconsistent performance — 'good days and bad days'
Behavioural Signs
▼
  • Difficulty understanding consequences
  • Emotional dysregulation / meltdowns
  • Confabulation (apparent lying — neurological, not intentional)
  • Difficulty with transitions and change
  • Social naivety / over-friendliness with strangers
  • Sleep disturbances
Physical Signs
▼
  • Growth restriction (height, weight, or head circumference)
  • Microcephaly (OFC ≤ 3rd centile) — particularly significant in infants
  • Sensory processing differences (over or under-responsive)
  • Poor fine and gross motor coordination
  • Feeding difficulties in infancy
  • Hearing or vision problems
For Parents & Carers
You're Not Alone — and It's Not Your Fault
Understanding your child's FASD brain helps you advocate, adapt, and build on their strengths every day.
Understanding Your Child
🧩The FASD Brain
Children with FASD have a neurological difference — not a behavioural choice. Their brains process information differently. Behaviours that look like defiance are often genuine neurological challenges with memory, impulse control, and cause-and-effect thinking.
💡
Key Mindset Shift
"Can't, not won't" — Many FASD behaviours reflect neurological inability, not deliberate non-compliance. Consequences-based discipline alone rarely works.
Strategies for Home
📚 Streissguth & Kanter (1997); Blackburn et al. (2010); FASD Network Guidelines
1
Create Predictable Routines
Use consistent daily schedules with visual timetables. Give warnings before transitions: "5 more minutes, then bath time."
2
Use Visual Supports
Pair verbal instructions with pictures or written steps. A picture checklist for the morning routine reduces cognitive load significantly.
3
Keep Instructions Simple
Give one instruction at a time. Use short, concrete language. Ask your child to repeat back what they heard.
4
Regulation Before Reasoning
When dysregulated, their thinking brain is offline. Help them calm first before reasoning or discussing consequences.
5
Celebrate Strengths
Many children with FASD are highly creative, caring, and artistic. Build on what they can do.
6
Seek Your Own Support
Caring for a child with FASD is demanding. Connect with FASD support groups and ensure your own wellbeing is supported.
If You Are Concerned: What to Do
📚 Based on SIGN 156 Section 2.1.4 (Referral) and NICE QS204 Statement 3
1
Talk to Your GP or Health Visitor First
Share your concerns clearly. Mention any known or suspected prenatal alcohol exposure, developmental delays, or behavioural challenges that worry you. You don't need a confirmed history of alcohol use in pregnancy to ask for an assessment — probable or suspected PAE with significant difficulties is enough to trigger a referral (NICE QS204 Statement 3).
2
Ask for a Referral to a Paediatrician
Your GP should refer your child to a community paediatrician or neurodevelopmental service. SIGN 156 is clear: referral should be made sensitively when there is evidence of significant physical, developmental or behavioural concerns and probable PAE. You should not have to prove the alcohol exposure before being referred.
3
Request an FASD-Informed Assessment
Ask specifically that prenatal alcohol exposure is considered as a possible cause of your child's difficulties. SIGN 156 notes that PAE is frequently not considered, particularly in children already labelled with ADHD or ASD. A full FASD assessment involves a multidisciplinary team (paediatrician, psychologist, speech and language therapist, occupational therapist).
4
Don't Wait for a Diagnosis to Ask for Support
NICE QS204 is explicit: support should not wait for a formal diagnosis. While waiting for assessment, ask the school to put interim strategies in place, request an Early Help Assessment, or contact your local FASD support group for peer support and practical guidance.
5
After Diagnosis: Your Child's Management Plan
Per NICE QS5, every child diagnosed with FASD must have an individualised management plan. This should be developed with you and cover: therapy needs, school support, community resources, and regular review. Ask your paediatrician to share it with the school, health visitor, and any other professionals involved in your child's care.
📞
Who Else Can Help?
• National FASD helpline and resources: nationalfasd.org.uk
• FASD Scotland: fasdscotland.com
• Your child's school — ask for a SENCO (Special Educational Needs Coordinator) referral
• Social care and Early Help services if support at home is needed
For Teachers & Schools
Every Child Can Learn — With the Right Environment
Children with FASD require adapted teaching approaches to thrive in the classroom.
Classroom Strategies
📚 Pei et al. (2016); Blackburn & Whitehurst (2010)
Environment & Seating
▼
  • Seat near the teacher and away from distractions
  • Reduce visual clutter in the workspace
  • Allow fidget tools and movement breaks
  • Provide a calm-down space they can access independently
Instructions & Communication
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  • Give one instruction at a time and check for understanding
  • Use concrete, literal language — avoid sarcasm and idioms
  • Pair verbal with visual cues
  • Allow extra processing time before expecting a response
Routines & Transitions
▼
  • Use a consistent visual daily timetable on the desk
  • Give advance warnings before transitions
  • Prepare for changes in routine the day before
  • Use a "now and next" board for anxious learners
Assessment & Workload
▼
  • Break tasks into small, manageable chunks
  • Allow oral responses instead of written where possible
  • Extra time for tests and assessments
  • Avoid copying from the board — provide pre-printed notes
Behaviour & Regulation
▼
  • Avoid punitive approaches — focus on scaffolding
  • Identify triggers and create a regulation plan with the family
  • Use a calm-down space, not exclusion as punishment
  • Confabulation (making up stories) is neurological, not lying
If You Are Concerned: Steps for Schools
📚 Based on SIGN 156 Section 2.1.4, NICE QS204 Statements 3–4, and GIRFEC principles
1
Speak to the Child's Parent or Carer First
If you have concerns about a child's learning, behaviour, or development that might be linked to prenatal alcohol exposure, approach the family sensitively. Ask open questions about the child's history, health, and any known concerns. Do not make assumptions — many children with FASD are adopted or in foster care and birth history may not be known.
2
Involve the SENCO
Refer to your school's Special Educational Needs Coordinator (SENCO) as a first step. The SENCO can coordinate support, initiate an Education, Health and Care Plan (EHCP) or statutory assessment, liaise with external specialists, and ensure interim strategies are documented and reviewed.
3
Make a Referral to Children's Services / Health
Where there are significant physical, developmental, or behavioural concerns alongside probable or known prenatal alcohol exposure, NICE QS204 Statement 3 requires referral for assessment. As a teacher, you can refer to the school nurse, health visitor, or raise concerns via the school's safeguarding lead to ensure a health referral is made. Do not wait for a diagnosis before putting support in place.
4
Contribute to the MDT Assessment
Teachers and educational psychologists are valued members of the FASD assessment team (SIGN 156 Section 3.7). School reports, observations of the child's performance and behaviour across contexts, and information about learning progress are essential to the assessment process. Provide written information when requested and attend multi-agency meetings where possible.
5
Implement the Management Plan
After diagnosis, every child with FASD must have an individualised management plan (NICE QS5). Schools should be active participants in developing and implementing this. Ensure strategies are reviewed regularly, especially at key transitions (new class, new school, secondary transfer). SIGN 156 emphasises reassessment at all transition stages throughout the young person's life.
💡
Remember: Inconsistency is Neurological
SIGN 156 describes the FASD learner profile as one of pervasive and long-standing brain dysfunction. A child performing well one day and struggling the next is not being manipulative — this variability is a hallmark of FASD. Assessment must reflect the child's typical performance, not their best day.
Clinicians, GPs & Nurses
Diagnosis Changes Lives — Don't Miss It
FASD remains significantly underdiagnosed in the UK. SIGN 156 and NICE QS204 provide the current national framework for assessment, diagnosis, and care.
NICE QS204 — Your Obligations
📚 NICE Quality Standard QS204 (March 2022) applies in England & Wales. SIGN 156 (2019, revalidated 2022) applies in Scotland. Both use the same two-category diagnostic framework.
1
QS1 — Advise Against Drinking in Pregnancy
All pregnant women should be advised at every antenatal contact that there is no safe level of alcohol in pregnancy. This should be verbal and written, based on UK CMO low-risk drinking guidelines.
2
QS2 — Ask About and Record Alcohol Use
Alcohol use must be asked about and documented throughout pregnancy. Use validated tools (e.g. AUDIT-C). Record all responses — including nil consumption — in the patient record.
3
QS3 — Refer for Assessment
Children and young people with probable prenatal alcohol exposure and significant physical, developmental, or behavioural difficulties should be referred for FASD assessment. Do not wait for confirmed exposure before referring.
4
QS4 — Neurodevelopmental Assessment
Children with confirmed PAE, or all three sentinel facial features, must have a neurodevelopmental assessment if there are clinical concerns. Assessment should cover all 10 SIGN 156 domains.
5
QS5 — Management Plan
Every child diagnosed with FASD must have an individualised management plan that addresses immediate and long-term needs, signposts to services, and is shared with the family, school, and relevant professionals.
SIGN 156 Diagnostic Framework
📚 SIGN 156 (2019). Adopted by NICE QS204 as the underpinning diagnostic guideline for the UK.
🔬FASD with Sentinel Facial Features
SNOMED CT: 1894471000000108

Requires all three sentinel facial features:
• Smooth philtrum — rank 4–5, University of Washington Lip-Philtrum Guide
• Thin vermillion border — rank 4–5, Lip-Philtrum Guide
• Short palpebral fissures — ≤3rd centile for age

Plus: Evidence of PAE (or unknown — all 3 SFF may suffice as proxy for PAE) and pervasive brain dysfunction (≥3 SIGN 156 domains severely impaired). In infants, microcephaly (OFC ≤3rd centile) may substitute for neurodevelopmental domain criteria.
🔬FASD without Sentinel Facial Features
SNOMED CT: 1894461000000101

Previously termed: pFAS, ARND, ARBD, ND-PAE — all now superseded under SIGN 156/NICE QS204.

Requires:
• Confirmed or probable PAE — reliable evidence is essential where facial features are absent (self-report, clinical records, alcohol treatment history, collateral history)
• Pervasive brain dysfunction — severe impairment in ≥3 of the 10 SIGN 156 neurodevelopmental domains

Fewer than 3 sentinel facial features are present. This is not a milder diagnosis.
⚠️At Increased Risk of FASD
SNOMED CT: 2078801000000102

For children who do not yet meet full criteria — e.g. confirmed PAE but child too young for full neurodevelopmental assessment, or 3 SFF present but assessment not yet complete. Should receive early support and regular re-assessment. Per NICE QS204: support must not wait for a formal diagnosis.
SIGN 156 — 10 Areas of Assessment
📚 Extracted directly from SIGN 156 Section 3.4. Severe impairment = global score or major subdomain score ≥2 SDs below the mean on a standardised measure. Impairment in ≥3 areas = pervasive brain dysfunction. "Domain" is used in SIGN 156 as an area of assessment.
1. Brain Structure / Neuroanatomy / Neurophysiology
▼

Impairment is present when:

  • Occipitofrontal head circumference (OFC) is <3rd centile (microcephaly)
  • A seizure disorder has been diagnosed not due to known postnatal influences
  • Brain imaging shows convincing evidence of structural abnormalities associated with PAE (e.g. partial/complete agenesis of the corpus callosum, cerebellar hypoplasia) after other aetiologies excluded

MRI is not required as standard. In infants and young children, microcephaly alone may be sufficient for diagnosis without full neurodevelopmental assessment.

2. Motor Skills
▼

Impairment is present when a composite score below clinical cut-off is obtained on:

  • Fine motor skills
  • Gross motor skills
  • Graphomotor skills (writing, drawing)
  • Visual-motor integration

Tone, reflexes, balance, coordination, strength, and other neurological examination findings may be considered in combination with formal assessment.

3. Cognition
▼

Impairment is present when standardised tests show:

  • Composite IQ or cognitive score below clinical cut-off
  • A major subdomain score (verbal, nonverbal, or fluid reasoning) below cut-off
  • A large and unusual discrepancy among major subdomain scores (base rate ≤3% of population, with the lower score ≥1 SD below the mean)

Children with FASD commonly have a spiky cognitive profile — strong in some areas, significantly impaired in others. Uneven profiles are characteristic and should not be dismissed.

4. Language
▼

Impairment is present when:

  • Composite score on core language, receptive language, or expressive language is below clinical cut-off
  • Multiple subtest scores on higher-level language skills are below cut-off (e.g. narrative comprehension, complex language)
  • Large discrepancy between receptive and expressive language composites (base rate <3%, lower score ≥1 SD below mean)

Children may appear to understand but not follow through — this often reflects a gap between receptive and executive processing, not non-compliance.

5. Academic Achievement
▼

Impairment is present when standardised scores in reading, mathematics, or written expression are below clinical cut-off, or when there is a significant discrepancy between cognitive ability and achievement (base rate <3%, achievement score ≥1 SD below mean).

The clinical team must confirm the child has had consistent access to academic instruction before recording a deficit in this area.

6. Memory
▼

Impairment is present when:

  • Composite score on overall memory, verbal memory, or visual memory is below clinical cut-off
  • Large discrepancy between verbal and non-verbal memory (base rate <3%, lower score ≥1 SD below mean)

Working memory deficits are assessed under Executive Function, not Memory. Children may appear to have learned a rule or skill and then "forgotten" it — this is characteristic of FASD memory impairment.

7. Attention
▼

In SIGN 156, attention is defined as sustained or selective attention and resistance to distractions. Inhibition, impulse control, and hyperactivity are assessed under Executive Function.

Direct assessment: Multiple subtest scores below cut-off on continuous processing tests or neuropsychological attention measures.

Indirect assessment: Converging evidence from clinical interview, questionnaire, file review, and direct clinical observation during testing.

FASD is frequently misdiagnosed as ADHD alone. Many children receive ADHD diagnoses and medication without recognition of the underlying PAE. Both conditions can coexist.

8. Executive Function (incl. Impulse Control & Hyperactivity)
▼

Executive function covers higher-level skills for organising and controlling thoughts and behaviours toward long-term goals. In SIGN 156 this includes:

  • Working memory
  • Inhibition and impulse control
  • Hyperactivity
  • Planning and problem solving
  • Shifting and cognitive flexibility

Direct: Multiple neuropsychological subtest scores below cut-off. Indirect: Converging evidence from rating scales, clinical interview, file review, and direct observation.

9. Affect Regulation
▼

Impairment is manifested by high levels of emotional expression causing significant clinical impairment, in the form of:

  • Anxiety disorders (panic, phobic, separation anxiety, generalised anxiety)
  • Depressive disorders
  • Oppositional defiant disorder or conduct disorder (frequent loss of temper, negativistic or vindictive behaviours)

Important SIGN 156 qualifier:

Affect dysregulation should only be attributed to PAE if it is long-standing. It should NOT be attributed to PAE if it is clearly a response to adverse life events (e.g. multiple foster placements) or is situationally specific.

10. Adaptive Behaviour, Social Skills & Social Communication
▼

Impairment assessed by:

  • Direct (social communication): Score below cut-off on composite measure of social language, pragmatic language, or social communication skills
  • Indirect (adaptive behaviour/social skills): Score below cut-off on global composite or major subdomain of a standardised caregiver rating scale or informant interview

For children and most adolescents, standardised caregiver ratings should be used. Observations and ratings should be gathered across environments — parents report on home behaviour; teachers on school behaviour.

For adults without a consistent caregiver in the last 2 years, historical records and alternative interview methods may be used as a proxy.

SIGN 156 Screening Triggers
!
Consider FASD Assessment When:
• Child in foster, kinship, or adoptive care with unknown birth history
• Known or probable prenatal alcohol exposure at any level
• ADHD or ASD diagnosis not fully explaining the clinical picture, or not responding as expected
• Multiple failed placements, school exclusions, or placement breakdowns
• Unexplained learning difficulties with inconsistency in performance
• Three sentinel facial features identified on examination
• Comorbid mental health, conduct, or attachment disorder presentations
• Social services involvement in early life
SIGN 156 Assessment Pathway
📚 SIGN 156 Sections 3.1–3.7. The diagnostic algorithm (Annex 2, SIGN 156) should be followed for all cases.
1
Gather PAE History
Confirmation of PAE requires documentation that the biological mother consumed alcohol during the index pregnancy based on: reliable clinical observation, self-report, reports by a reliable source, medical records of positive blood alcohol concentrations, or alcohol treatment / social / legal / medical problems related to drinking during the pregnancy. Unsubstantiated information, lifestyle alone, or history in previous pregnancies cannot in isolation confirm PAE in the index pregnancy.
2
Medical Examination
Assess all three sentinel facial features using the University of Washington Lip-Philtrum Guides. Measure palpebral fissure length (≥2 SDs below the mean per SIGN 156). Plot OFC, height, and weight on UK-WHO growth charts (available from SIGN website). Take a full family, social, and medical history. Obtain a three-generation family tree where possible to identify inheritable disorders. Genetic causes must be considered and excluded before arriving at an FASD diagnosis.
3
Note Associated Features (Not Diagnostic)
The following should be recorded but do not contribute to confirming or refuting an FASD diagnosis (per Canadian Rec. 3.2 adopted by SIGN 156): mid-face hypoplasia, micrognathia, abnormal ear position/formation, high arched palate, epicanthal folds, limb abnormalities, palmar crease abnormalities, short upturned nose. Growth impairment and congenital anomalies should also be documented if present.
4
Neurodevelopmental Assessment (MDT)
SIGN 156 MDT must include: neonatologist / paediatrician / physician with FASD competency; child development specialist with skill set for physical and functional assessments (e.g. speech and language therapist, occupational therapist, clinical or educational psychologist). Additional input may include clinical geneticist, physiotherapist, neuropsychologist, CAMHS, nurses, social workers, and family therapists. Assess across all 10 areas of assessment. Direct standardised measures should be used whenever possible.
5
Apply the Diagnostic Algorithm
Use the SIGN 156 Annex 2 diagnostic algorithm. For infants <6 years: if all 3 SFF + microcephaly → FASD with SFF; if all 3 SFF without microcephaly → refer to clinical geneticist + 'At Risk' designation; if PAE confirmed but criteria not met → 'At Risk'. For older children: apply the full 10-domain assessment. Record SNOMED CT codes. Note: the diagnostic/descriptive criteria for FASD are the same for adults as for younger individuals (SIGN 156 Rec. 8.1).
6
Communicate and Develop Management Plan
Per NICE QS5 and SIGN 156 Section 4: Present findings to the family in writing and verbally. Use plain language appropriate to the child's age. The individualised management plan must address: basic and immediate needs, therapy services (SLT, OT, psychology), school adjustments, family support and psychoeducation, signposting to resources, and scheduled review. Reassessment at all transition points throughout the child's life.
🔗Comorbidities — Over 400 Associated Conditions
FASD is associated with over 400 co-occurring conditions across 18 ICD-10 chapters. Common comorbidities explicitly listed in SIGN 156 include ADHD, ASD features, and mood disorders. Also frequently seen: anxiety disorders, conduct disorder, attachment disorders, sleep disorders, substance misuse in adolescence/adulthood, and involvement in the judicial system. Treat the whole child and coordinate care across agencies.
📊Screening Tools for PAE in Pregnancy
Per SIGN 156 Recommendations 2.3 and 2.4: use validated tools — T-ACE, TWEAK, or AUDIT-C — to screen all pregnant women for alcohol consumption. Consider associated biomarkers (CDT, PEth) alongside questionnaires. Document dose, pattern, and frequency of alcohol use. PAE information (confirmed / confirmed absent / unknown) must remain accessible in the child's health records throughout childhood.
🌟
You Are Amazing!
Your brain works in its own special way. That's not bad — it just means you learn differently. And that's okay!
🧠
About Your Brain
Before you were born, something called alcohol made it a little harder for some parts of your brain to grow the usual way. It wasn't your fault. It wasn't your mum's fault either.
Things You Might Find Hard
😤It's Okay to Find Things Tricky
Lots of kids with FASD find some things harder than others. You might find it hard to remember things, concentrate, or stay calm when things feel overwhelming. That's not your fault!
When Things Feel Too Much
▼
  • Find a quiet spot and take slow, deep breaths
  • Squeeze something soft (a stress ball or cushion)
  • Tell a trusted adult how you're feeling
  • Listen to calming music with headphones
  • Draw or colour how you feel
Your Superpowers 🦸
💛
You Care About People
Many kids with FASD are very kind, loving, and loyal friends. That's a real superpower!
🎨
You're Creative
Lots of children with FASD are brilliant at art, music, drama, or building things. Your imagination is special.
⚡
You're Full of Energy
Your energy and enthusiasm make you exciting to be around! Learning how to use that energy well is part of your journey.
FASD Compass Podcast
Expert Conversations That Matter
Clinicians, researchers, families, and advocates sharing what they know about FASD.
Latest Episodes
🧠
EP. 12 · Neurodevelopment
Why FASD Is Still Being Missed in 2024
Dr. Sarah Munro — Paediatric Neurologist
38 min
We explore the diagnostic gap, why FASD is so frequently misdiagnosed as ADHD or conduct disorder, and what clinicians can do differently in the consult room.
DiagnosisCliniciansEarly ID
0:0038:24
🏫
EP. 11 · Education
Building FASD-Informed Schools: A Teacher's Guide
Bronwyn Clarke — Special Education Lead
44 min
Practical classroom strategies that work, how to talk to parents about FASD, and why traditional discipline frameworks fail these children.
EducationTeachersStrategies
0:0044:10
👨‍👩‍👧
EP. 10 · Family Stories
Raising a Child with FASD: One Family's Journey
Mark & Lisa Adeyemi — Foster Carers
52 min
A moving and honest conversation with foster carers who have raised three children with FASD. What they wish they'd known earlier, and how their family found its rhythm.
FamilyFoster CareLived Experience
0:0052:05
🔬
EP. 09 · Research
The Latest in FASD Research: What's Changing?
Prof. James Osei — CanFASD Research Network
41 min
An in-depth discussion on emerging neuroimaging findings, biomarkers for prenatal alcohol exposure, and what future diagnostic criteria might look like.
ResearchNeuroscienceFuture
0:0041:30
FASD Screening Tool
Early Detection Questionnaire
A brief evidence-informed checklist to help identify children who may benefit from further FASD assessment.
Question 1 of 10
QUESTION 1 OF 10
🤖
FASD Compass AI
SIGN 156 · NICE QS204 · Works offline
🤖
Hi! I'm the FASD Compass AI, here to answer your questions about Fetal Alcohol Spectrum Disorder. I can help parents, teachers, clinicians, or anyone wanting to learn more. What would you like to know?
Now
⚕️ This assistant provides general educational information based on SIGN 156 and NICE QS204. Always consult a qualified healthcare professional for decisions about individual children.
What is FASD?
Signs in toddlers
School strategies
How is FASD diagnosed?
Helping meltdowns
References & Resources
Evidence-Based Sources
All content in FASD Compass is based on peer-reviewed literature and current diagnostic guidelines.
Key Guidelines
📄Primary UK Guidelines
• SIGN 156 — Scottish Intercollegiate Guidelines Network. Children and Young People Exposed Prenatally to Alcohol. Edinburgh: SIGN; 2019 (revalidated 2022). SIGN publication no. 156. ISBN 978-1-909103-67-2.

• NICE QS204 — National Institute for Health and Care Excellence. Fetal Alcohol Spectrum Disorder. Quality Standard QS204. Published March 2022. Applies in England & Wales.

• SNOMED CT codes (implemented 2024): FASD with SFF (1894471000000108), FASD without SFF (1894461000000101), At increased risk (2078801000000102).

• DHSC Health Needs Assessment for FASD in England. September 2021.
📚Educational & Behavioural
• Pei, J. et al. (2016). Supporting students with FASD. Canadian Journal of Special Education.

• Blackburn, C. & Whitehurst, T. (2010). FASD: Emerging issues in awareness, prevention and intervention.

• Streissguth, A.P. & Kanter, J. (1997). The challenge of FASD in the 21st century.
🌐Organisations
• FASD Support Network (UK)
• Canada FASD Research Network (CanFASD)
• National FASD
• FASD Hub Australia
• FASD Network of Southern Africa
🔬 This app is for educational purposes only. Always seek professional clinical assessment for individual children.