Introduction: The consequences for children born with birth defects and developmental disabilities encompassed by fetal alcohol spectrum disorder (FASD) are profound, affecting all areas of social, behavioural and cognitive functioning. The current project aimed to develop a diagnosis process for young children (aged 3-7 years).

Approach: A protocol for the assessment of the 10 brain domains required under the Australian Diagnostic Guidelines was used to assess children referred to a designated FASD clinic. All children were required to have confirmed prenatal alcohol exposure.

Results: Data on the first 90 children will be presented. The majority met diagnosis for FASD, either with three sentinel facial features (13; 14%) or FASD with <three sentinel facial features (46; 50%). Eighteen (20%) were considered at risk of FASD and 13 (14%) received no diagnosis. High rates of comorbidity were found; impairment on multiple domains of functioning were observed (45% had impairment on four or more domains). Most children were not living with biological parents and two-thirds had current or previous contact with child protection.

Discussions and Conclusions: Young children with confirmed prenatal alcohol exposure demonstrate multiple impairments across 10 domains, highlighting the importance of ensuring early diagnosis and support is provided. The clinical utility of this diagnostic process will be considered with reference to: (i) the value held in communicating among practitioners, families and teachers; (ii) the ease of use and time required; and (iii) its usefulness in selecting interventions and making recommendations. Issues with potential diagnostic problems will be discussed.