Foetal alcohol spectrum disorder

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Target exams

Red flags

• Confirmed or highly probable prenatal alcohol exposure with developmental, behavioural or learning impairment — do not wait for classic face before multidisciplinary assessment
• Adolescent or adult with FASD phenotype and new suicidal ideation, self-harm or severe mood instability — psychiatric morbidity is high; assess risk directly
• Child protection concerns: ongoing parental alcohol use disorder, neglect, domestic violence, or unsafe caregiving — escalate under local safeguarding statute
• Forensic interview of a person with FASD without adapted communication — high suggestibility and poor consequence awareness create false confession and fitness risks
• Assuming absence of facial dysmorphology excludes FASD — most psychiatry-relevant cases lack the full sentinel triad
• Pregnancy in a woman with active alcohol use disorder — dual crisis of maternal and fetal risk; treat alcohol use and offer contraception/pregnancy planning without delay