Adult FASD Identification Tool

Russell Family Fetal Alcohol Disorders Association

This is an informal non-medical identification tool for adults with FASD based on my experience as a mother with two biological children with FASD and my research into the condition over the last 12 years. There is a difference between medical information and personal medical advice. The material in this form offers information only. For professional medical advice take this document to your doctor and discuss. Only your doctor can give you medical advice and / or a diagnosis. The problems outlined below can vary in intensity and can affect those with the disorder throughout their lives. Some people may have just one or two problems; others may have many. The types of problems young people with FASD have can also change as they get older. A positive response to all these questions still may not mean FASD as there are other conditions which also have these same signs, symptoms and history. This form should be completed by a third party asking these questions of the individual with suspected FASD so that they can explain anything the individual does not understand.

Personal History

Did you ‘get into trouble’ a lot when you were young? / Choose an item
Was it for your behaviour or because you had problems understanding what people wanted of you? / Choose an item
If it was for your behaviour were you diagnosed with a learning disability, behaviour disorder or developmental delay when you were young? / Choose an item
Are you living on your own at the moment? / Choose an item
If you are living on your own, do you pay the rent and bills, buy food and clean the house/unit on your own? / Choose an item
If you are not living on your own – who are you living with? / Choose an item
Have you ever been evicted or kicked out of a house/unit/flat or other residence? / Choose an item
After being evicted, how long were you without a place to live? / Choose an item
Why did it take that long for you to find a place to live? / Choose an item.
Did you ever see either of your parents use alcohol or drugs at any time during your childhood? / Choose an item
Have you ever been in trouble with the police, been in prison, on probation or parole or had to undertake community service? / Choose an item
Academic / School History
Did you have ‘trouble’ at school with teachers, students, homework or schoolwork? / Choose an item
Were you placed in a ‘special’ class for children with behavioural or learning problems? / Choose an item
What made it special - were there only a few children? / Choose an item / Were there more teachers than usual? / Choose an item
Did you have particular trouble with mathematics? / Choose an item
Were you bullied at school or did you do the bullying or both? / Choose an item

Drug and Alcohol Use / Mental Health

Have you had a drug and / or alcohol addiction? / Choose an item
If you have or have had drug and / or alcohol problems were you ever ‘kicked’ out of home because of it? / Choose an item
Did you ever go to rehab for your drug and / or alcohol use? / Choose an item
Were you ever able to get clean and sober? / Choose an item
If yes, how long have you been clean and sober? / Choose an item.
Have you ever been confined in a mental health facility? / Choose an item
If yes, for how long? / Choose an item.
Have you ever thought that suicide was an option for you? / Choose an item
Have you ever seriously attempted suicide? / Choose an item

Employment History

Have you had many jobs in your life? / Choose an item
What kind of jobs have you done?
What was the main reason you lost your jobs? / Choose an item.
Did you lose jobs without understanding why? / Choose an item
When you are at work, could you remember what you were supposed to do one day but forget it the next day? / Choose an item
Did you want to run your own business so you didn’t have to worry about bosses and other workers? / Choose an item

Medical History

Were you sick a lot when you were a child / Choose an item
Did you parents take you to the doctor a lot? / Choose an item
What sort of things did you go to the doctor’s for? / Choose an item
Have you been diagnosed with any of the following – heart, kidney or skeletal problems such as a concave chest? / Choose an item
Have you ever been treated for hearing or vision problems? / Choose an item
Have you ever been treated for a mental health problem eg depression, anxiety, personality disorder, bipolar etc? / Choose an item
Were you prescribed medication? / Choose an item
How long did you take the medication? / Choose an item.
When you stopped taking medication was it because…….. / Choose an item.
Now that you know a little bit about FASD do you think you have it? / Choose an item

If there are more ‘yes’ than ‘no’ responses you should speak to a doctor about FASD. You may need to go to several medical professionals before you will find someone who can help you. For more information on Fetal Alcohol Spectrum Disorder visit http://rffada.org or email Anne Russell at .