The most current version of the FASD 4-Digit Diagnostic Code and Lip-Philtrum Guides were printed in 2004. All clinicians are encouraged to upgrade to this lastest version. See below for more details.

In 1997, the Washington State FAS Diagnostic and Prevention Network developed a new, comprehensive, reproducible method for diagnosing the full spectrum of outcomes of patients with prenatal alcohol exposure. This new diagnostic method, called the 4-Digit Diagnostic Code, provides more accurate and reproducible diagnoses than the gestalt method of diagnosis due to its use of quantitative, objective measurement scales and specific case-definitions. The four digits in the Code reflect the magnitude of expression of the four key diagnostic features of FAS in the following order: (1) growth deficiency, (2) the FAS facial features, (3) central nervous system (CNS) damage/dysfunction, and (4) prenatal alcohol exposure. The magnitude of expression of each feature is ranked independently on a 4-point Likert scale with 1 reflecting complete absence of the FAS feature and 4 reflecting a strong "classic" presence of the FAS feature. The 4-Digit Diagnostic Code has been used to diagnose over 2000 patients in the FAS DPN clinics to date. A patient's 4-Digit Diagnostic Code is derived after a thorough evaluation by an interdisciplinary team of professionals. The team typically includes a physician, psychologist, occupational therapist, speech-language pathologist, social worker, and family advocate.

What's New in the (2004) 4-Digit Code

The FASD 4-Digit Diagnostic Code is described in full in the Diagnostic Guide for Fetal Alcohol Spectrum Disorders: the 4-Digit Diagnostic Code (2004). The Guide provides a comprehensive and objective method for diagnosing the full spectrum of outcomes observed in individuals with prenatal alcohol exposure. It is used in all Washington State FAS Diagnostic & Prevention Network clinics. It is intended for use by medical professionals.

The use of the 4-Digit Diagnostic Code is demonstrated in the FAS Tutor™ CD-ROM. The clinical and public health performance of the 4-Digit Code is described in Astley & Clarren, 2000; Astley & Clarren, 2001; Astley et al., 2002; and Astley, 2004. A detailed description of the interdisciplinary approach to diagnosis used by the Washington State FAS DPN can be found Clarren et. al., 2000. Click here to view what's new in the (2004) 4-Digit Code using Adobe Acrobat Reader. If you do not already have the Acrobat Reader, you may download it for free from Adobe. To order the Diagnostic Guide, click here.

Free PDF of 2004 Guide. You are also welcome to print a single copy of the Diagnostic Guide for your use. Please do not distribute the PDF file or hard copies of the Diagnostic Guide. You are welcome to distribute our website address to others who may like to download a copy of the Guide. Click here to get the complete Diagnostic Guide for Fetal Alcohol Spectrum Disorders: the 4-Digit Diagnostic Code. As this is a very large file (4 MB), this may take some time to download. You may want to download the file to your hard drive before viewing or printing by right-mouse clicking on the 'click here' link above, and choosing Save Target As.