FASD: Diagnostic Dilemmas and Challenges for a Modern Transgenerational Management Approach

For approximately 40 years, Fetal Alcohol Spectrum Disorders (FASD) has been defined consistently in terms of three diagnostic features in the presence of prenatal alcohol exposure: two physical criteria (i.e., dysmorphic face and growth deficits) and central nervous system dysfunction (structural, neurological, and/or functional). Despite this relatively long and intact diagnostic history, identifying FASD has been difficult historically due to the complexity of presenting symptoms, varied handling by different diagnostic schemes, need for multidisciplinary assessment, and the masking of neurodevelopmental symptoms behind psychiatric diagnoses (“co-occurring disorders”). The objectives of this chapter are threefold: (1) to summarize diagnostic schema and characteristics of children and adults with FASD; (2) to increase awareness of some of the diagnostic challenges that currently exist in FASD assessment, particularly in terms of co-occurring disorders; and (3) to recommend a model standard of multidisciplinary assessment and multimodal treatment that may be useful to professionals in the clinical setting.