FASD evaluations and diagnosis. The standardized approach is referred to as the Ten Brain Domains and encompasses aspects of all four diagnostic systems' recommendations for assessing CNS damage due to prenatal alcohol exposure. The framework provides clear definitions of brain dysfunction, specifies empirical data needed for accurate diagnosis, and defines intervention considerations that address the complex nature of FASD with the intention to avoid common secondary disabilities. The proposed Ten Brain Domains include: Achievement Adaptive behavior Attention Cognition Executive functioning Language Memory Motor skills Multisensory integration or soft neurological problems Social communication The Fetal Alcohol Diagnostic Program (FADP) uses unpublished Minnesota state criteria of performance at 1.5 or more standard deviations on standardized testing in three or more of the Ten Brain Domains to determine CNS damage. However, the Ten Brain Domains are easily incorporated into any of the four diagnostic systems' CNS damage criteria, as the framework only proposes the domains, rather than the cut-off criteria for FASD. Differential diagnosis The CDC reviewed nine syndromes that have overlapping features with FAS; however, none of these syndromes include all three FAS facial features, and none are the result of prenatal alcohol exposure: Aarskog syndrome Williams syndrome Noonan syndrome Dubowitz syndrome Brachman-DeLange syndrome Toluene syndrome Fetal hydantoin syndrome Fetal valproate syndrome Maternal PKU fetal effects Other disorders that have overlapping behavioral symptoms and/or that might be comorbid to fetal alcohol spectrum disorder might include: Attention deficit hyperactive disorder Autism spectrum disorder Reactive attachment disorder Oppositional defiant disorder Sensory integration dysfunction Bipolar disorder Depression Most people with an FASD have most often been misdiagnosed with ADHD due to the large overlap between their behavioral deficits. Prevention The only certain way to prevent FAS is to avoid drinking alcohol during pregnancy. In the United States, the Surgeon General recommended in 1981, and again in 2005, that women abstain from alcohol use while pregnant or while planning a pregnancy, the latter to avoid damage even in the earliest stages (even weeks) of a pregnancy, as the woman may not be aware that she has conceived. The Centers for Disease Control and the American College of Obstetricians and Gynecologists also recommend no alcohol during pregnancy. In the United States, federal legislation has required that warning labels be placed on all alcoholic beverage containers since 1988 under the Alcoholic Beverage Labeling Act. There is some controversy surrounding the "zero-tolerance" approach taken by many countries when it