Fig. 1

a FASD 4-Digit Diagnostic Code grid. FASD is defined by growth deficiency, specific FAS facial features, evidence of CNS damage and prenatal alcohol exposure. The 4-Digit Code ranks each of these areas on four-point, case-defined, Likert scales. The 4-Digit Code (3444) inserted in the grid is one of 12 codes that meet the diagnostic criteria for FAS. b FASD 4-Digit Code FAS facial phenotype. The rank 4 FAS facial phenotype as defined by the 4-Digit Diagnostic Code requires the presence of all three of the following anomalies: (1) palpebral fissure lengths 2 or more standard deviations below the norm mean; (2) a smooth philtrum (rank 4 or 5 on the Lip–Philtrum Guide), and (3) a thin upper lip (rank 4 or 5 on the Lip–Philtrum Guide). Examples of the rank 4 FAS facial phenotype for Caucasian, Native American, African American, and Asian American children are shown. © 2009 University of Washington. Reproduced with permission from Susan Astley, Ph.D.