Diagnosis in Fetal Alcohol Syndrome (FAS) still is insufficient an inadequate. Diagnostic criteria based on physical, particularly facial features like a small upper lip or small palpebral fissures fall far short to identify the FAS. Symptoms in FAS are predominantly not somatic but behavioural and emotional.
A questionnaire including 38 items presenting social, behavioural and emotional problems of children and adolescents was administered to parents of children and adolescents with FAS. Additionally the questionnaire was answered by parents of children with mistakable diagnoses (ADHD, Autism, Attachment Deficits).
In the questionnaire, the total score of children and adolescents with FAS was remarkably higher than the total scores of children with other diagnoses (see below). In a disciminant analysis the questionnaire classified 92% of the patients correctly according to their diagnose.
The Fetal Alcohol Syndrome Questionnaire (FASQ) is a new additional tool not only for a professional differential diagnosis. The FASQ, moreover, allows to diagnose those three in four FAS patients who show no facial features at all.
This is the FASQ:
Score 0 if the child never shows the behavior decribed in the item. Score 1 if the child sometimes shows the behavior decribed in the item. Score 2 if the child often shows the behavior decribed in the item. Score 3 if the child always shows the behavior decribed in the item.
A total score of 45 or more is typical for children at age 2 - 5;11 with FAS.
A total score of 55 or more is typical for children at age 6 or older with FAS.
1. destructive (deliberately or accidentally)
2. poor understanding of rules
3. cannot give reasons for his or her actions
4. pedagogic measures (gratification, praise, reproach) do not affect the child
5. requires high level of constant supervision
6. difficulty to predict risks, does not recognize dangerous situations
7. always seems to be loosing things
8. gets into frequent quarrels, spats, fights with other children, argues a lot
9. difficulty in understanding „ownership“ or possessions of others
10. no sense of stranger danger, would go with anyone
11. easily influenced, easily talked into things, too trusting, naive
12. indiscriminate, everyone is equally important, is his or her „best friend“ at once
13. requires constant reminders for daily events (structure of the day)
14. unable to walk or bike safely on the street, careless
15. cannot clothe corresponding to weather
16. no concept of time
17. problems to understand the value of money
18. high or absent pain threshold, does not sense/feel injuries
19. cannot explain/illustrate his or her actions
20. lying, confabulation
22. plays with matches, setting fires
23. damages things
24. stealing behaviours at home
25. does not feel guilty /shows little remorse for actions
26. does not make connection between actions and consequences
27. does not learn from experience
28. Echolalia (repetition of what is said; multiple repetitions)
29. not able to play /entertain self (for some time)
30. loses interest in an activity soon or immediately
31. switches rapidly from one activity to another, without finishing any activity
32. not prone to play with toys
33. few ideas for play
34. no or rare imaginative, fanciful play
35. Concentration difficulties
36. easily distracted, highly suggestible
37. poor and slow learning
38. forgetful, learns a skill and quickly forgets it
We are preparing the evaluative study on the FASQ (based on more reiable sample sizes than shown here) for peer reviewed publication.
The FASQ is used in several research programs run by the Muenster FAS clinic and the study group of René Hoksbergen (Utrecht University, NL).
The FASQ is an additional instrument that may improve the diagnosis of FAS (focusing the behavioral and emotional symptoms). The diagnosis of FAS itself needs a professional setting and information about mother´s alcohol consumption during pregnancy or the unmistakable presence of tyypical physical features of FAS.