A pediatrician and two psychologists specializing in diagnosing and treating FASD were in Yellowknife this week training health care workers on the new Canadian diagnosis guidelines released late last year.

"It really addresses a lot of the previous gaps and inconsistencies," said pediatrician Dr. Hasu Rajani, who is part of a travelling FASD diagnostic team based in Alberta.

Updated from 2005, the latest guidelines include new FASD symptoms and new screening questions for women who are pregnant.

"It's not to tell women of childbearing age what to do. It's just being aware and being educated that alcohol can significantly impact, during pregnancy, the fetus," said Rajani.

The new guidelines also narrow the disorders on the Fetal Alcohol Spectrum from three to two.

If a patient has all three facial features related to FASD — small eyes and eyelids, flattening of the area between the nose and upper lip, and a thin upper lip — then health professionals can diagnose them with the disorder, if there is evidence of severe and pervasive brain dysfunction as demonstrated through a comprehensive assessment.

Infants born with microcephaly (a very small head size) and the three facial features can also be diagnosed, pending a full assessment at a later age.

Lack of growth has also been removed as a key part of the diagnostic guidelines. New research has shown that growth is not always affected in people with FASD.

"Years ago there used to be this thought that kids who were exposed to alcohol prenatally were always really tiny," said psychologist Dr. Monty Nelson. "Now it's not so much the case."

The new guidelines also add a new "at risk" diagnosis for patients who don't necessarily show other symptoms.

"There may be situations when we're assessing individuals who are on medications or have significant issues related with mental health or with substance use and we cannot complete an assessment but we know that they may have a neuro-developmental disorder related to fetal alcohol exposure," said Rajani.

"We hope this will allow teams to provide information and supports for the mom and the child while they are at risk."

The guidelines were updated by a group of 14 psychologists, researchers, pediatricians, social workers, geneticists and parents of children with FASD.


  • An earlier version of this story incorrectly stated the number of disorders on the fetal alcohol spectrum. Other changes have also been made to more accurately reflect the changes to the guidelines.
    Feb 19, 2016 4:23 PM CT