exposure and only CDC guidelines label developmental delays as such, so criteria (and FASD diagnoses) vary somewhat across diagnostic systems. The four diagnostic systems list various CNS domains that can qualify for functional impairment that can determine an FASD diagnosis: Evidence of a complex pattern of behavior or cognitive abnormalities inconsistent with developmental level in the following CNS domains – Sufficient for a pFAS or ARND diagnosis using IOM guidelines Learning disabilities, academic achievement, impulse control, social perception, communication, abstraction, math skills, memory, attention, judgment Performance at two or more standard deviations on standardized testing in three or more of the following CNS domains – Sufficient for an FAS, pFAS or static encephalopathy diagnosis using 4-Digit Diagnostic Code Executive functioning, memory, cognition, social/adaptive skills, academic achievement, language, motor skills, attention, activity level General cognitive deficits (e.g., IQ) at or below the 3rd percentile on standardized testing – Sufficient for an FAS diagnosis using CDC guidelines Performance at or below the 16th percentile on standardized testing in three or more of the following CNS domains – Sufficient for an FAS diagnosis using CDC guidelines Cognition, executive functioning, motor functioning, attention and hyperactive problems, social skills, sensory processing disorder, social communication, memory, difficulties responding to common parenting practices Performance at two or more standard deviations on standardized testing in three or more of the following CNS domains – Sufficient for an FAS diagnosis using Canadian guidelines Cognition, communication, academic achievement, memory, executive functioning, adaptive behavior, motor skills, social skills, social communication Related signs Other conditions may commonly co-occur with FAS, stemming from prenatal alcohol exposure. However, these conditions are considered alcohol-related birth defects and not diagnostic criteria for FAS. Heart: A heart murmur that frequently disappears by one year of age. Ventricular septal defect, atrial septal defect, tetralogy of Fallot, coarctation of the aorta, and/or cardiac rhythm dysfunction. Bones: Joint anomalies including abnormal position and function, altered palmar crease patterns, small distal phalanges, and small fifth fingernails. Kidneys: Horseshoe, aplastic, dysplastic, or hypoplastic kidneys. Eyes: Strabismus, optic nerve hypoplasia (which may cause light sensitivity, decreased visual acuity, or involuntary eye movements). Occasional problems: ptosis of the eyelid, microphthalmia, cleft lip with or without a cleft palate, webbed neck, short neck, spina bifida, and hydrocephalus. Cause Fetal alcohol spectrum disorder is caused by a woman consuming alcohol while pregnant. Alcohol crosses through the placenta to the unborn child and can interfere with normal