FASD Diagnostic Tools    

Listed below are the following FASD Diagnostic Tools:

All are available free of charge.

Click here for the Order Form

  • FASD 4-Digit Diagnostic Code TM
  • Lip-Philtrum Guides 1 & 2 TM
  • Palpebral Fissure Length Ruler
  • FAS Facial Photographic Analysis Software
  • 4-Digit Code Diagnostic Forms
  • Growth Charts
  • PFL Z-Score Calculator

Diagnostic Guide for Fetal Alcohol Spectrum Disorders: The 4-Digit Diagnostic Code TM (2024) Download a free copy as a pdf.

A comprehensive, fully validated method for diagnosing the full spectrum of outcomes observed in individuals of all ages with prenatal alcohol exposure.



Lip-Philtrum Guides TM (2014)
5-point, pictorial guides used by the 4-Digit Code to accurately measure philtrum smoothness and upper lip thinness.
Guide 1 (Caucasian and all races with thinner lips similar to Caucasians)
Guide 2 (African American and all races with thicker lips similar to African Americans)

Click here to view the 4-Digit Code Face Tables printed on the backside of each Guide.

The digital versions of these Lip-Philtrum Guides are available free of charge for use on a mobile phone. Submit our Order Form form to request the Lip-Philtrum Guides.



Palpebral Fissure Length Ruler
15 cm clear plastic ruler for measuring palpebral fissure length. Use of a handheld rule rarely results in accurate measures. More accurate measures of PFL can be obtained using the FAS Facial Photographic Analysis Software. If a ruler is used, please view the video animations demonstrating how to measure the PFL with a ruler. Starting in 2023 we are no longer distributing the ruler due to its limited accuracy.



FAS Facial Photographic Analysis Software
Version 2.1 (2016)

Video Demonstration of Software

The software was developed by Susan (Astley) Hemingway PhD for healthcare and research professionals. It is used to measure the magnitude of expression of the key diagnostic facial features of FAS from 2D digital facial photographs. Click here to learn more. To obtain a free copy of the software, submit our Order Form.



Diagnostic Forms
PDF versions of the
FASD Diagnostic Form, FASD 4-Digit Short Form, and New Patient Information Form
used by the 4-Digit Code are available free of charge by clicking on the link above.



Growth Charts

Click here for CDC Growth Charts, WHO Growth Charts, Parent Specific Adjustments for Evaluation of Length and Stature, or for a link to growth charts from around the world. Clinicians should select the most current growth charts that are most accurate and valid for the patient's age, sex, race/ethnicity, and country of origin.


Palpebral Fissure Length Z-Score Calculator

Click here to access the PFL Z-score Calculator. Click here for a brief overview on which PFL normal growth charts to use. Click here for animations demonstrating how to measure the PFL accurately. The most accurate method for measuring the PFL is from a 2D digital facial photo using the FAS Facial Photographic Analysis Software (2016). Click here to view a brief demonstration of the software's PFL measurement accuracy. Click here to view a published study demonstrating the software's PFL measurement accuracy (Astley, 2015). The WA State FASDPN clinic currently uses the Iosub PFL charts for African Americans and the Stromland Scandinavian PFL charts all other races.