The New Jersey Regional Diagnostic Centers use the diagnostic system developed at the University of Washington Fetal Alcohol Syndrome Prevention and Diagnostic Network (FASPDN), and the Centers thank the staff of the FASPDN for their innovation and commitment to refining the diagnostic criteria for FAS. The N.J. diagnostic system describes the severity of the expression of the effects of prenatal exposure to alcohol by examining deficits in growth, facial abnormalities, brain function, and confirmation of prenatal exposure to alcohol. Each of these features is described briefly below along with photographs provided by the University of Washington for demonstration purposes. Because FAS is considered a lifelong birth defect, it needs to be diagnosed by a medical physician. This usually is a developmental pediatrician, or a dysmorphologist. Other professionals who may participate in giving a thorough diagnosis include, but are not limited to, a psychologist, LDTC, speech-language
The diagnosis of FAS can only be made by a medical professional.
Fetal Alcohol Syndrome (FAS) is 100% preventable if a woman does not use alcohol while she is pregnant. Indeed, FAS is the most commonly known preventable birth defect that results in mental retardation.
How are FAS and FASD Related?
FAS is a cluster of permanent, non-curable birth defects. It is characterized by significant deficits in growth, facial anomalies, and brain dysfunction that result from the use of alcohol during pregnancy. FASD is the umbrella term for any confirmed prenatal alcohol exposure, including FAS. See for more information.
How Common is FAS in New Jersey?
It is difficult to provide specific estimates on how often FAS and FASD occur, but conservative estimates indicate that FAS occurs in 1 to 3 children per 1,000 live births, and FASD occurs in as many as 5 to 10 children per 1,000 live births. FAS occurs twice as often as Spina Bifida and five times more often than Down syndrome. Down syndrome and Spina Bifida, the two of the most commonly recognized birth defects, can be easily recognzied in newborns. In comparison, it can be extremely difficult to diagnose FAS and FASDs before 8 months of age.
of these babies who develop FAS/FASD is, of course, unknown. Over 5,000 children born in 2000, or 4.4% of total live births, entered New Jersey’s Birth Defects Registry (NJBDR) because they met NJBDR eligibility criteria. FAS is a reportable birth defect within New Jersey and health care providers are required by New Jersey State law to report FAS to the NJBDR prior to five (5) years of age.
Fetal Alcohol Syndrome (FAS) is a life-long birth defect caused by the maternal consumption of alcohol during pregnancy. Damage to the developing child can occur in varying degrees, with FAS being the most severe. Children born with FAS typically appear with clear evidence of anatomical abnormality, but for some, the diagnosis of FAS may not be possible before the eighth month. In addition to the major signs detailed below many children with FAS may be born with heart and kidney defects, problems with bones and joints, and other physical defects. See .The most common expressions of these abnormalities include:
Growth retardation: Children with FAS are typically very small at birth and usually remain so throughout life. See and for more information.
Facial abnormalities: Children with FAS typically present with 1) small, widely spaced eyes, 2) a smooth philtrum (that is, no groove between the nose and upper lip),and 3) a thin upper lip.
Central Nervous System Abnormalities: Children with FAS typically present with signs of intellectual disabilities or cognitive difficulties, developmental delays, hyperactivity, perceptual problems, poor coordination, and learning difficulties.
The “classical FAS” diagnosis represents only a portion of the larger number of children who have been prenatally-exposed to alcohol, with the larger portion identified by the terms Alcohol Related Birth Defects (ARBD), Alcohol Related Neurodevelopmental Disorder (ARND), and Fetal Alcohol Effects (FAE). The Seatle system uses terms such as static encephalopathy, sentinel physical findings and neurobehavioral disorder, as well. The generally accepted diagnostic label is FASD, and while there is no precise set of measurements for the diagnosis of FASD, the term,describes deficits that are less obvious, and less severe, than those of FAS. In April, 2004, the National Organization on Fetal Alcohol Syndrome (NOFAS) hosted a summit to discuss a consensus term for all disorders resulting from prenatal alcohol exposure. This summit resulted in the development of the term Fetal Alcohol Spectrum Disoders. The definition is as follows: Fetal Alcohol Spectrum Disorders (FASD) is an umbrella termdescribing the range of effects that can occur in an individual whose mother drank alcohol during pregnancy. These effects may include physical, mental, behavioral and/or learning disabilities with possible lifelong implications.
The child with FASD typically demonstrates a wide range of behavioral and learning difficulties, as well as varying degrees of developmental delays, but typically does not present with the craniofacial features described above for FAS and may not be classified with mental retardation. The subtlety of these behavioral and learning difficulties often result in the child being considered as disinterested and unmotivated to perform in school, and hence the necessary educational and behavioral supports needed to compensate for the difficulties are not provided. for a considerable list of informative sites and links related to potential developmental problems caused by the prenatal consumption of alcohol by women of childbearing age.
The term FASD is not intended for use as a clinical diagnosis. Depending on what diagnostic system is being used — IOM, CDC or the Seattle 4 Digit Code — you should use the diagnosis obtained after your multi-disciplinary assessment of the individual. You should include the term FASD when the diagnosis also includes the confirmation of alcohol exposure during pregnancy. The use of FASD currently has received support from many organizations, including the CDC, NOFAS, SAMHSA’s FASD Center of Excellence, March of Dimes, and the FASD Task Force of the New Jersey Governor’s Council on the Prevention of Mental Retardation and Developmental Disabilities.
What is New Jersey Doing About FAS?
New Jersey has pursued excellence in the identification and treatment of FAS since the early 1980′s, with some efforts continuing across the years and others running for shorter intervals. Before 1981, there was relatively little discussion of FAS across the state, with the first statewide conference on FAS held in 1982 for perinatal professionals. In 1983, the Governor’s Task Force on Alcoholism established the New Jersey Task Force on Fetal Alcohol Syndrome, and this task force then initiated a wide range of activities to promote prevention and education in both the public and private sectors. These outreach activities substantially increased public awareness of the dangers of consuming alcohol during pregnancy.
Despite the broadening of public awareness, there are relatively few direct services that have been made available to women who have used or are addicted to alcohol. The first major change in service delivery began in 1998 with the FAS Prevention Project. This project provides for an integrated statewide network of regionalized services intended to prevent FAS and FASD and to increase the likelihood of healthy children, and at that time, led to the requirement that each hospital have available a Risk Reduction Specialist. These specialists provide drug and alcohol assessment and screeening, education, and referrals for susbtance abuse treatment. Statewide efforts have included initiatives related to education and prevention, and each has met with varying degrees of success. A review of these programs noted that one missing component was the development of a statewide comprehensive system for the prevention, diagnosis, and treatment of FAS.
In early 2002, the New Jersey Department of Health and Senior Services established six regional centers for FAS and FASD. The Regional Centers:
The Regional Diagnostic Centers continue to operate throughout New Jersey. They are available for diagnostic assessments, as well as lectures and workshops on various related topics. Each Center also works with their regional Maternal Child Health Consortia’s Perinatal Addiction Specialists. Together, they offer information and workshops covering prenatal alcohol use and the lifelong effects.
NJ also is the first in the nation to offer a Perinatal Addictons Specialist Certification through the Certification Board of NJ. This specialty covers 30 hours training in this area, including 6 hours of training in the effects of prenatal exposure to alcohol, and now is a requirement for all new and renewing CADCs. For more information, please go to the website: .
We encourage you to visit the following websites to learn more about FASD:
Detailed information regarding the costs of FAS can be found at and , for the Tenth Special Report to Congress on the effects of alcohol abuse and prenatal exposure to alcohol.
Epidemiological information about FASD is available at
Information on the FASD Consensus state is available at and family issues at
Additional information on pregnancy and alcohol is available at , , and
Information on diagnostic criteria for FAS is available at ,
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Visit and for more information about FASD services in New Jersey and legislative mandates for reporting the diagnosis of FAS to the State.
For more information, please contact Dr. Susan Adubato at