The initial contact occurs when the child presents at an office visit.  Triggers for investigation emerged from a history of growth and developmental problems, maternal alcohol use and the presence of  facial abnormalities associated with FAS.  At this evaluation specific data related to the four FAS criteria are obtained and if the FAS criteria are met, the individual is referred to a specialist, if it is not met the patient is  monitored over time for any additional changes. The FAS diagnosis can be confirmed using  more extensive dysmorphic and anthropometric assessment procedures along with neurodevelopmental of evaluation.  This can then lead to a  referral to a multidisciplinary team which can organize and provide   intervention services  including  case management, and community and educational resources.