FAS Facial Photographic Analysis Software    


The FAS Facial Photographic Analysis software was developed by Susan (Astley) Hemingway PhD in 2003 (and updated in 2012 and 2016) for use by health care and research professionals. It has been used to accurately measure the full continuum of expression of the FAS facial phenotype as defined by the FASD 4-Digit Code in thousands of individuals, birth to adult, evaluated in the FASD screening and diagnostic programs conducted by the Washington State FAS Diagnostic & Prevention Net (Astley & Clarren, 2001; Astley et al., 2002; Astley 2004). Analysis of over 3,000 patients has confirmed that the software provides more accurate measures of facial features than direct measurement by hand. The ability of the software to measure palpebral fissure lengths more accurately than can be achieved with a hand held ruler is summarized in a recent publication (Astley, 2015). Over 3,000 copies of the software have been distributed across 35 countries to date.


Brief Description of the Software

The software is designed to measure the magnitude of expression of the 3 key diagnostic facial features of FAS as defined by the FASD 4-Digit Code (short palpebral fissure lengths (PFL), smooth philtrum, and thin upper lip).

To use the software, the User:

  1. Opens three 2D digital facial photographs (frontal view, 3/4 view, and lateral view) into the software program.
  2. Enters name, birth date, photo date, gender, race.
  3. Measures the 3 facial features using special image analysis tools.
  4. Documents the presence of other facial anomalies.
  5. Documents the quality of the photos.

From this information, the software automatically computes the FASD 4-Digit Code Facial ABC-Score, and the 4-Digit Facial Rank.

  1. Rank 1, No FAS facial features present
  2. Rank 2, Mild FAS facial features (only 1 or 2 of the 3 features present)
  3. Rank 3, Moderate FAS facial features (2.5 of the 3 features present)
  4. Rank 4, Severe FAS facial features (all 3 of the features present)

The software stores all photo analysis information in a database that can be exported to Excel. The User can print a one-page FAS Facial Photographic Analysis Report. The report includes a summary of the facial analysis and a print of the three photos. A facial photographic analysis can be conducted in approximately 10 minutes.

What's New with Version 2.0 (released November 2012) (No longer distributed)

Version 1.0 was released in 2003. Version 2.0 was released in November 2012. Version 2.0 is downward compatible with Version 1.0, thus Version 1.0 is no longer distributed.

Version 2.0 provided the following new features:

  1. Two additional palpebral fissure length (PFL) normal growth charts are included: Canadian and Scandinavian. These new charts are considered more accurate growth charts for Caucasian PFLs than the Hall (1989) Caucasian PFL charts. Click here for more details on which PFL growth charts to use for Caucasians. Version 2 continued to provide the Hall Caucasian PFL growth charts for comparative purpose. Iosub's African American PFL growth charts should be used for African Americans.

  2. Version 1.0 required all photo analysis data to be stored in a single database named data.fas. This database could only be stored in the software's data directory. Version 2.0 allowed the User to assign any name to the database file and place it anywhere on their hard drive or server.

What's New with Version 2.1 (released September 2016) Most current version distributed.

Version 2.1 has the same features as Version 2.0, but now has the new Lip-Philtrum Guides with the frontal and 3/4 view images.

Video Introduction to the Software

Click here to view and listen to a video introduction to the software. The video is a large mp4 file, so it may take a moment to load before it will play.

Software Manual

The software comes with an electronic copy of the Manual. Click here to preview the software manual for:

  • Version 2.0 (no longer distributed)
  • Version 2.1 (latest version currently distributed)

Accuracy of the Software: Palpebral Fissure Length

The accuracy of the Software's measurement of the palpebral fissure length is illustrated in a brief report and comprehensive publication. The software is calibrated against the gold standard (a sliding digital caliper). The software computes the PFL from a 2D digital image of the face. The software utilizes an "adjustment factor" to accurately compute the PFL from a 2D photograph. The software computes the PFL within 0.2 mm accuracy relative to the gold standard of measurement (sliding digital caliper).

How to Take the Facial Photographs

Click here to obtain a brief 1-page instruction form. Click here to view video animations demonstrating how to take facial photographs and how to measure facial features accurately. Further instruction is provided in the FAS Facial Photographic Analysis Software Manual. Additional guidance is also provided in Astley & Clarren 2001.

Important Note: Digital cameras (including iPhones) are prone to taking distorted photos if the camera is held too close to the subject's face. It is imperative that the camera be held at least 4 feet from the subject's face to avoid distortion. The distortion will result in inaccurate facial measurements. Read this document to learn how to recognize and avoid taking distorted photos.

To Order the Software

Click here .

Software Installation Instructions

Click here.