Understanding How to Diagnose Preschoolers with Prenatal Alcohol Exposure

Fetal Alcohol Spectrum Disorder (FASD) is a lifelong disability impacting the brain and body of someone exposed to alcohol prenatally. FASD is one of the most common neurodevelopmental disabilities, impacting more Canadians than Autism, cerebral palsy, and Down syndrome combined.

Prenatal alcohol has impacts on sleep, arousal, attention, emotions, behaviour, and executive functioning. Often families caring for preschoolers impacted by prenatal alcohol exposure are having to manage these behaviours, without knowing why they are happening or how to best support their child.

Early diagnosis of FASD is critical as it will identify children at risk for behavioural and learning difficulties and connect them with the appropriate interventions and supports to enhance their development. Early diagnosis is also a protective factor against secondary outcomes like involvement with the law, substance use challenges, dropping out of school, and homelessness. However, FASD is rarely diagnosed in preschool-aged kids. Diagnostic clinics for FASD are few and far between in Canada, and there are very few clinics that even offer preschool assessment.

Diagnosing FASD in general is a complex process involving several assessments from a multidisciplinary team of professionals. Diagnosing young children comes with its own complications. Standardized tests are limited for this age group and clinicians are often concerned about attributing a child’s challenges solely to prenatal alcohol exposure. As a result, diagnosis is often delayed until later in life, meaning these children miss out on FASD-specific supports that can help set them up for success. Evidence-based interventions and special education geared towards their specific needs and learning style will help them reach their full potential.

Dr. Ana Hanlon-Dearman at the Canada FASD Research Network (CanFASD) is trying to address this gap in service. She recognizes the challenges with preschool diagnosis but emphasizes that more and more research is showing the importance of early identification and assessment. Working with within the Network of researchers at CanFASD, she’s using use research and data to better understand assessment and diagnosis in this age group. In this way, we can identify the challenges clinicians are experiencing and, in the future, improve diagnostic training and tools to diagnose FASD more confidently in children under five.

Our knowledge of FASD has grown exponentially over the last fifty years since it was first named. But the supports and services available still lag significantly behind that of other disabilities. It is due in part to researchers like Dr. Hanlon-Dearman who do this work, and to families and service providers that ask these questions, that our current patchwork of supports and services exist across Canada.

There is a Bill that is currently going through the Senate to improve Canada’s response to FASD. If passed, Bill S-253 will ensure the research that people like Dr. Hanlon-Dearman are doing will be effectively applied across the country. Our children deserve better. Families are asking the questions and researchers are finding the answers. We need decision-makers to step up to ensure these answers are applied. We need to ensure the knowledge developed reaches the people who need it to make effective policy decisions, provide the best supports, and make the healthiest choices possible.

For more information about Dr. Ana Hanlon-Dearman and the other innovative work happening at CanFASD, visit our website at www.canfasd.ca.


The Canada FASD Research Network (CanFASD) is a Member of Research Canada: An Alliance for Health Discovery and Sponsor of the Parliamentary Health Research Caucus Buffet Luncheon, Reinventing Children’s Health through Game-Changing Pediatric Research and Innovation. Visit rc-rc.ca to learn more.