FASD Diagnostic Tools    
Listed below are the following FASD Diagnostic Tools:
  • FASD 4-Digit Diagnostic Code TM
  • Lip-Philtrum Guides 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 (2004)
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, laminated, pictorial guides used by the 4-Digit Code to accurately measure philtrum smoothness and upper lip thinness.
Guide 1 (Caucasian)
Guide 2 (African American)

Click here to view free digital Lip-Philtrum Guides for use on smartphones and computer tablets/pads.



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.



FAS Facial Photographic Analysis Software
Version 2.1 (2016)

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 digital facial photographs. Click here to learn more.



Diagnostic Forms (2004)
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.



Growth Charts

Click here for CDC Growth Charts , for free Epi Info software from CDC that calculates growth percentiles electronically, for Parent Specific Adjustments for Evaluation of Length and Stature, or for a link to growth charts from around the world. Clinicians should select growth charts that are most accurate and valid for the patient's race/ethnicity.


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 for Caucasians. Click here for animations demonstrating how to measure the PFL accurately. The most accurate method for measuring the PFL is from a 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 FAS DPN currently uses the Scandinavian PFL charts for Caucasians and the Iosub PFL charts for African Americans.