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Fetal Alcohol Spectrum Disorder Assessment & Diagnostic Clinic Client: ___Date: ___A. REFERRAL INFORMATION 1. Referral Agency: 2. Contact Name:Phone: Email:1. Individual Aware of Referral:Year #:B.
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How to fill out fetal alcohol syndrome disorder

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Obtain a thorough medical and family history
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Perform physical exams and screenings to check for physical abnormalities
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Conduct developmental assessments to evaluate cognitive and behavioral functions
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Consider specialized tests like MRI or genetic testing if necessary
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Consult with a team of healthcare professionals including pediatricians, psychologists, and specialists

Who needs fetal alcohol syndrome disorder?

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Individuals who suspect they may have been exposed to alcohol during pregnancy
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Children displaying symptoms of developmental delays or cognitive impairments
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Fetal alcohol syndrome disorder is a condition that occurs in children who have been exposed to alcohol in the womb, resulting in a range of physical, mental, behavioral, and learning difficulties.
Healthcare professionals, particularly those involved in prenatal care and child development, are required to diagnose and report cases of fetal alcohol syndrome disorder.
Healthcare professionals must document the necessary information such as maternal alcohol consumption during pregnancy, physical and behavioral symptoms in the child, and any relevant medical history.
The purpose of reporting fetal alcohol syndrome disorder is to track and monitor cases, provide appropriate interventions and support services, and raise awareness about the risks of alcohol consumption during pregnancy.
Information to be reported includes maternal alcohol consumption patterns, prenatal care history, child's physical and behavioral symptoms, developmental milestones, and any interventions or services provided.
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