Diagnosis of Fetal Alcohol Spectrum Disorder in New Zealand is well known to be a difficult process unless there is documented prenatal alcohol exposure and the baby has the 'sentinel facial features' which can be associated with FASD and which make diagnosis relatively straightforward.

These features include small palpebral fissure length (the length of the eye opening), smooth philtrum (the groove between the nose and upper lip) and thin upper lip. They only occur if alcohol is consumed early in pregnancy (days 19-21) when the baby's face is forming. 

Sentinel facial features are present in less than 10% of people with FASD – the vast majority of people do not have any outward physical sign, making it truly a 'hidden' disability.

Diagnosis takes a team of multi-disciplinary specialists to work together over a period of time examining various brain domains which can be affected by prenatal alcohol exposure (there must be substantial impairment in at least three to get a diagnosis).

There are very long waitlists for the few free public services available around the motu / country. If you opt for a private diagnosis, the costs can be prohibitive (up to $9K). 

FASD-CAN has advocated for more training for professionals since the first FASD Action Plan 2016-2019. This has not yet materialised, although there was some forward momentum as at 2025.

A large proportion of FASD diagnoses comes about via court orders, when an individual arrives in the Criminal Justice System (CJS) and their lawyer requests it before trial. However, it is widely accepted that if early screening / diagnosis and educational interventions happened much earlier, it would be much less likely that individuals would end up in courts in the first place.

Some people question the point of diagnosis since, unlike other neurological disorders, FASD is not (yet) recognised as a disability in Aotearoa NZ. Even those with diagnosed FASD do not necessarily gain access to Disability Support Services (DSS) funding unless they have a proven Intellectual Disability (ID) – i.e. an IQ of less than 70. 

However, recent research in Aotearoa (see below) confirms what other international studies have shown: a diagnosis (especially an early one) results in better healthy outcomes for the individual with FASD in terms of forming a positive 'disability identity' – and for the parent / caregiver / educator in terms of understanding and adapting their responses to the behavioural symptoms of FASD.

Click here for an excellent introduction / overview on Australia's FASD Hub website about the importance of FASD diagnosis.