Clinical Toolkit
FASD Clinical Assessment Checklist
A structured checklist for FASD assessment, following SIGN 156.
FASD Compass · fasdcompass.co.uk/clinical-assessment-checklist/
A checklist for paediatricians, nurses and allied health professionals preparing for or carrying out an FASD assessment. It follows the structure of
SIGN 156 and does not replace it. Tick boxes on screen are for your own use and are not saved.
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An educational resource, not a diagnostic tool
These resources support clinical reasoning. They do not score, diagnose or rule out FASD, and they do not decide who should be referred. Diagnosis needs a multidisciplinary assessment using the SIGN 156 criteria.
Reason for referral and the main concerns, in the family’s words Informed consent, including for facial photographs, explained in plain language Interpreter or communication support arranged, if needed Reports gathered: health visitor, school, nursery, speech and language, occupational therapy, psychology, CAMHS The family knows they can bring a support person Pregnancy: antenatal care, illness, medicines and complications Birth: gestation, birth weight, length and head circumference Neonatal period: special care, feeding, withdrawal symptoms Developmental milestones, and any loss of skills Medical history: hearing, vision, seizures, sleep, feeding, illnesses and operations Current medicines Family history, ideally a three-generation family tree, including learning and neurodevelopmental conditions and consanguinity Social history: who the child lives with, any changes of carer or placement, and adverse experiences Education: settings attended, attendance, and consistent access to teaching Source of the information, and whether it is reliable and free from conflict of interest Type of drink, amount, pattern, frequency and timing in the index pregnancy Recorded clearly as confirmed, confirmed absent, or unknown Records checked: maternity notes, GP records, adoption or care medical reports, alcohol treatment records Other exposures recorded: tobacco, other drugs, and prescribed medicines such as anticonvulsants Not inferred from lifestyle, other drug use, care history or exposure in a previous pregnancy alone Height, weight and head circumference (OFC) plotted on UK-WHO growth charts, with earlier measurements from the Red Book. Microcephaly is OFC below the 3rd centile. Parental head circumference, where possible Palpebral fissure length measured Upper lip and philtrum ranked using the University of Washington Lip-Philtrum Guide Facial photographs taken with consent, using a standard method Associated features recorded (these do not confirm or rule out FASD) Heart, eyes, ears, palate, palmar creases, digits and joints examined Neurological examination, and skin checked for neurocutaneous signs Hearing and vision status known
Related Resources
The
Clinicians page sets out the SIGN 156 criteria and the 10 areas of assessment in detail.
Editable Word templates for referral, assessment, summaries, family feedback and management plans are in the
Clinical Toolkit .
Sources: SIGN 156: https://www.sign.ac.uk/media/1092/sign156.pdf · NICE QS204: https://www.nice.org.uk/guidance/qs204/chapter/Quality-statements
Last reviewed: November 2026 by Dr Inyang Takon, Consultant Neurodevelopmental Paediatrician. For professional education only. Clinical decisions remain with the treating clinician. Follow SIGN 156, NICE QS204 and your local pathways.