Alberta FASD clinics spark national dialogue on diagnostic guidelines

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In May 2025, the Lakeland Centre for FASD Rajani FASD Diagnostic Training and Support Services held its annual meeting for all the FASD diagnostic clinics in Alberta. This was an opportunity to network, share, learn and discuss common topics.     

CanFASD’s Audrey McFarlane (Director of Strategic Partnerships and Initiatives) was in attendance to give a brief talk on the work of CanFASD. One of the sessions this year was about the 2016 Canadian FASD Diagnostic Guidelines, particularly what assessment challenges did the clinics have. This discussion was particularly timely. CanFASD has been advocating for a review and update of the 2016 guidelines and has been actively seeking funding to support this important work.  

Key issues raised by Alberta clinics  

During the meeting, clinicians engaged in group discussions to identify specific challenges they face when using the current guidelines. Among the issues raised were:  

  • Trauma: 
    • What is the role of pre and postnatal trauma?  
    • How do we capture trauma as adults prior to assessment?   
  • Follow up and re-assessment:  
    • How do we address the needs of teens that receive an at-risk designation, and as they get older are not doing well?  
    • Managing a re-assessment and removing the FASD diagnosis given new information.   
  • Comorbidities:  
    • How to categorize ADHD – whether under attention or executive functioning – and concerns about “double-counting” domains for diagnosis. 
    • Should we even be using ADHD given the high prevalence?   
    • What is the rate of Autism/FASD overlap?  
  • Brain domains and diagnostic criteria:  
    • Is the alcohol intake identified in the guidelines to be considered a threshold or a guideline?   
    • Why are sensory issues not a clinical criteria yet? 
    • Are all the domains weighted the same?  Are some potentially more important than others?  
    • Should language and communication be treated as separate diagnostic domains, given their unique contributions to developmental challenges?  

The clinics had a great discussion about all of these and more. We have enough clinical experience with the 2016 guidelines, combined with the data from the National FASD Database to review and update the FASD diagnostic guidelines. The recent CAHS FASD Assessment report also highlighted that Canada is ready for updated guidelines.    

What’s next?  

CanFASD  is actively seeking the funds needed to do this important work. We will continue to advocate for the need for updated guidelines and write proposals to fund this initiative. We very much appreciate the Alberta clinics launching the discussion and look forward to engaging our communities more about the diagnostic process.     

If you’re interested in learning more, don’t miss the Canada FASD Conference, where the Lakeland Centre for FASD will be delivering several key presentations, including:  

These sessions offer practical tools and updated insights for clinicians and professionals involved in FASD assessment and care. Register now to be part of these important conversations and advance your knowledge in FASD diagnostics. 

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