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The long road to a diagnosis

Hey there, time traveller!
This article was published 25/3/2011 (2310 days ago), so information in it may no longer be current.

If doctors could diagnose FASD with a simple blood test, life would be so much easier. But it takes a small army of brain experts, everyone from speech therapists to psychologists, to cobble together a diagnosis using a lot of standardized tests and a little professional judgment. Here's how it works:



Anyone can refer a kid to the clinic -- teachers, parents, social workers.



Confirmation the birth mother drank during pregnancy is the critical next step, which means talking to family members or the birth mother, going through a child's birth, medical and child welfare records. Staff also gather up any assessment tests done by schools or social workers. If staff can confirm prenatal alcohol exposure, a get-to-know-you meeting is set up with the family and the testing begins.



These are the most "school-like" tests. They include games that gauge how well a child uses words or pictures to reason as well as memory games. For example, clinic psychologist Leanne Mak might ask a child to remember a series of number and then put the numbers in order. There are also basic spelling and math tests and an IQ test.



Brenda Fjeldsted looks at how a child copes with the world -- everything from sensory trouble to dexterity. Is a toddler walking on time? Can older kids throw a ball at a target, put little coins in a slot or use scissors? Fjeldsted also asks parents and teachers to fill out long questionnaires -- is the child sensitive to sounds such as the flush of a toilet? Does he notice when people come in the room? Does he splash in the bathtub? All the tests are used to rate the child's development.



The clinic's speech and language pathologist, Shelley Proven, has a battery of fun tests, some using picture books, that gauge how well a child understands language, expresses himself, uses grammar and starts and ends a conversation. Can a child repeat back a long sentence? Can he understand and follow two parts of a sentence: "get your boots and give them to mom." Can a teen look at a list of words and put them in order to form a sentence?


Pediatricians and geneticists measure everything from a child's head size to their muscle tone to their reflexes. And they check whether a child has any of the classic FASD facial features.



Once all the tests are done, all the experts hash out their findings. Sometimes they disagree. If they come to a consensus on a diagnosis, they make a to-do list for parents, teachers, social workers and anyone else involved with the child.



Outreach and follow-up co-ordinator Dorothy Schwab meets with the family, goes over the diagnosis in plain language and explains what's next. She co-ordinates a range of services, such as respite, referrals, even the disability tax credit and often goes out to a child's school to meet with teachers, school councillors and any other staff to come up with a special education plan.


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