When you were preparing to adopt or foster your child, you diligently educated yourself about the impacts of prenatal substance exposure. However, now that this child is living with you and attending school, real life is an entirely different experience than you expected! Isn’t that true of most parenting challenges? So now what do you do when you observe their challenging behaviors or lagging abilities, and you suspect that the child has Fetal Alcohol Spectrum Disorder (FASD)?

If You Only Have a Minute:

1. Start the conversation with your child’s pediatrician.
2. Loop in the teachers, counselors, and other educational team members.
3. Schedule consultations with educational and medical practitioners.

Three Steps to Get an FASD Diagnosis

Unlike prenatal substance exposure to drugs, which often can be diagnosed at birth, FASD is typically not diagnosed until the school-age years. This is because a typically developing brain transitions from concrete, explicit thought to abstract thought around this age. A child with FASD has delayed development of those thinking skills. Those delays appear in their schoolwork (right around 3rd or 4th grade). When you are battling homework every night, struggling with behavior issues, and troubled by your child’s challenges, it’s easy to feel overwhelmed, with no idea what to do first.

According to the CDC, one significant protective factor to help minimize the effects of prenatal substance exposure is diagnosis before the age of 6. This offers expanded opportunities for children to receive the most appropriate and effective educational and social supports. So, the earlier the better in many cases.

If you are wondering whether your child may have FASD, there are a few steps you should take to get the diagnosis underway.

1. Talk with your child’s pediatrician.

Though your general pediatrician likely cannot assess and diagnose FASD, you can ask them for recommendations of specialists and resources in your community that can perform the necessary evaluations. FASDUnited.org also maintains a state-by-state resource directory of FASD diagnostic clinics and service providers.

Share with the pediatrician what you know about your child’s prenatal experience, photos of the child as a baby or toddler, growth charts, medical records, and the biological family’s health history (if you have it). Be prepared to give specific examples of challenges or delayed skills your child faces daily, especially at school.

Your pediatrician might recommend (or perform) assessments before recommending you to a developmental pediatrician, geneticist, or neurologist. Diagnosis often includes a neuro-psychological exam and an adaptive functioning assessment.

Navigating Challenging Behaviors – a free download!

It’s common for a child with FASD to have other diagnoses, such as ADHD, ODD, ASD, or PTSD. Although it’s possible to have co-occurring diagnoses, the more diagnoses an individual has, the more likely the underlying cause is prenatal alcohol exposure. Don’t be afraid to ask questions and dig deeper if your pediatrician’s initial assessment doesn’t make sense.

2. Talk with your child’s teachers and counselors.

Hopefully, you’ve already opened a clear line of communication between home and school about your child and their academic experience. If you have not, email your child’s primary teacher and request a meeting to discuss their observations, your struggles with schoolwork at home, and how your child adapts to the classroom environment. Discuss your expectations for your child, and listen to what they report about strengths and weaknesses in the classroom.

If your child is struggling academically, you can request a psychoeducational evaluation. Again, make this request via email for documentation. Most states have time frames that school districts must observe when a parent requests academic support or services. Ask them to include assessments of your child’s adaptive and executive function skills. The special education team will use the results of that evaluation to create a support plan that targets areas of need and goals to support those needs.

You can learn more about IEPs, 504s, and OHIs (Other Health Issues) in this podcast.

3. Schedule consultations with the specialists.

Use your pediatrician’s recommendation or referral to schedule assessments and evaluations with specialists who are experts in prenatal substance exposure. If you have FASD clinics or specialists in your area, that’s fantastic. Many families travel for the sometimes-extensive evaluations and care from specialty clinics nationwide. However, you can also work with geneticists, psychologists, or developmental pediatricians and achieve excellent results.

Try to be patient – many of these specialists have extensive waiting lists. Ask whether they need any additional information you can gather while you wait.

If you want additional direction and guidance, consider the FASD Family Navigator program from FASDUnited.org.*

Additional Resources

These resources and organizations can be very helpful in getting the right diagnosis and educating yourself about your student’s rights and next steps.

If you haven’t yet participated in the CreatingaFamily.org Prenatal Substance Exposure Workshop for Foster, Adoptive, and Kinship Parents, register for one of the series of 3 sessions today! Throughout 2026, we are thrilled to have generous support from The Jockey Being Family Foundation® that allows us to offer them for FREE.

*CreatingaFamily.org is pleased to be an FASD United Affiliate. This membership enhances and deepens our knowledge of fetal alcohol spectrum disorder, increases our access to resources, and strengthens our ability to support families raising children affected by prenatal alcohol exposure.

Image Credits: Wavebreak Media: https://app.envato.com/photos/396a2032-8232-494d-9da8-a98c0c6efd77; Pavel Danilyuk: https://www.pexels.com/photo/a-doctor-in-a-consultation-with-a-mother-and-her-daughter-7653094/; Katerina Holmes: https://www.pexels.com/photo/thoughtful-black-boy-with-copybook-5905877/