Fetal Alcohol Spectrum Disorder (FASD) Assessment

Services in Hamilton & Surrounding areas

What is FASD
Our Approach
When to get Assessed
How Assessment Can Help
When Assessment May Help
What is Included
Our Process
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Physician-referral-only FASD-related assessment services for individuals and families seeking clarity, understanding, and practical next steps.

Dr. Sala & Associates offers Fetal Alcohol Spectrum Disorder (FASD)-related assessment services in Hamilton and Waterdown in collaboration with Dr. Kim Harris from Navigating Onward, in London.
This service is designed to support a comprehensive assessment to determine if an individual meets the criteria for a diagnosis of this disorder which will also allow access to specific services in the community as well as a better understanding of an individual’s strengths, challenges, and next steps. For many families, the goal is not simply to find a label. It is to better understand what may be happening, why certain difficulties may keep showing up, and what kinds of supports may help at home, school, in healthcare settings, and in the community. It is also helpful to make informed decisions about future care.

This service is currently available by physician referral only

Understanding Fetal Alcohol Spectrum Disorder

Fetal Alcohol Spectrum Disorder, often shortened to FASD, is a lifelong neurodevelopmental condition associated with prenatal alcohol exposure. It can affect how the brain and body develop and function.

FASD can impact many areas of daily life, including attention, learning, memory, executive functioning, emotional regulation, motor skills, language, mental health, adaptive daily living skills, and school or work functioning.

FASD is often misunderstood or missed entirely. Some individuals may be described as having behavioural, emotional, motivational, or compliance-related difficulties when their needs may be better understood through a brain-based, neurodevelopmental lens.

A clearer understanding can help shift the focus from:

“Why is this happening?”

“What supports, accommodations, and next steps may be helpful?”

At Dr. Sala & Associates, our approach is compassionate, strengths-based, and focused on helping families and care teams better understand the whole person.

A Strengths-Based, FASD-Informed Approach

Families often arrive at assessment after a long period of uncertainty. There may have been years of questions about learning, attention, memory, emotional regulation, school performance, social difficulties, or behaviour that do not seem fully explained by previous assessments or diagnoses.

Our role is to help bring clarity to the bigger picture.

An FASD-informed assessment does not look at behaviour in isolation. It considers how the person thinks, learns, remembers, regulates emotions, responds to expectations, manages daily demands, and navigates relationships and environments.

Dr. Sala & Associates is offering this service as a pilot project, in collaboration with Dr. Kim Harris from Navigating Onward, to help strengthen access to FASD-informed care in Hamilton, Waterdown, and surrounding communities.

When an FASD-Related Assessment May Be Considered

An FASD-related assessment may be considered when there is evidence of prenatal alcohol exposure and subsequent difficulties in learning, memory, attention, regulation, development, adaptive functioning, or day-to-day life.

as the following is a sample of difficulties that those with FASD may experience:

Difficulty with attention, focus, or impulse control
Challenges with memory or learning from experience
Trouble with planning, organization, problem-solving, or flexible thinking
Emotional regulation difficulties or frequent overwhelm
Academic challenges that are not fully explained by previous supports
Fine-motor, language, or developmental concerns
Difficulty managing daily routines or age-expected responsibilities
Behaviour that seems inconsistent with the person’s intentions or abilities
Mental health concerns alongside developmental or learning differences
A history of confirmed or suspected prenatal alcohol exposure
A need for clearer recommendations for home, school, healthcare, or community planning

Assessment can help families and care teams understand whether supports and expectations need to be adjusted to better match the individual’s developmental and functional profile.

Moving From Questions to Next Steps

A clearer understanding of FASD-related strengths and challenges can help families, schools, physicians, and support teams respond with more appropriate expectations and supports.

Assessment may help by:

Clarifying strengths and areas of need
Supporting a better understanding of learning, memory, attention, regulation, and daily functioning
Helping families and care teams respond with more appropriate expectations
Informing recommendations for school accommodations or support planning
Identifying whether other concerns may also need attention
Supporting referrals to additional services, when appropriate
Reducing misunderstanding, blame, or frustration
Helping the individual and family move toward practical next steps

The purpose of assessment is not simply to identify difficulties. It is to support a more accurate, compassionate, and useful understanding of the person.

Who You’ll Work With

Our adult therapy clients are seen by experienced, registered clinicians who are matched to your specific needs and goals.

Dr. Michelle Sala｜

PhD • CPsych

The founder and clinical director of Dr. Sala & Associates. With over 25 years of experience, she works with adults navigating anxiety, burnout, grief, life transitions, and identity. Dr. Sala is trained in CBT, mindfulness-based therapy, and ACT, and is a certified hypnotherapist. She is one of the few registered psychologists in the Hamilton area who integrates hypnotherapy into clinical practice. She is fully bilingual and offers sessions in English and French.

Want to learn more about our full team before booking?

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Areas That May Be Explored

FASD-related assessment is a comprehensive process. Depending on the referral question and clinical needs, the assessment may include several areas of functioning.

The assessment may include evaluation of:

General cognitive functioning
Attention and memory
Executive functioning
Fine-motor skills
Language functioning
Academic achievement
Rating scales completed by caregivers, teachers, or other relevant individuals
Screening of mental health and related areas
Review of developmental, medical, educational, and support history
Assessment of facial features associated with FASD, when clinically appropriate

The goal is to understand the individual’s pattern of strengths and needs across multiple areas, rather than focusing on one symptom, diagnosis, or behaviour in isolation.

What to Expect

FASD-related assessment often requires a collaborative understanding of the individual’s background, development, current functioning, and support needs. The exact process may vary depending on the referral question and the information available.

In general, the process may include:

Physician Referral

The process begins with a physician referral. This helps ensure that the referral question is appropriate and that relevant other medical, developmental, or clinical considerations are ruled out.

Intake and Background Information

Our team gathers information about the individual’s current concerns, developmental history, strengths, challenges, and support needs. This may include information from parents, caregivers, guardians, physicians, schools, or other professionals when appropriate.

Review of Records

Relevant records may be reviewed to better understand the individual’s history and current functioning. These may include school records, previous assessments, report cards, Individual Education Plans, medical information, therapy reports, or other available documentation.

Assessment Sessions

Assessment sessions may examine areas such as cognitive functioning, academic skills, attention, memory, executive functioning, language, fine-motor skills, adaptive functioning, and emotional or behavioural functioning.

Rating Scales and Collateral Information

Rating scales and information from caregivers, teachers, or other involved professionals may help provide a fuller picture of how the individual functions across different settings.

Integration of Findings

Assessment information is carefully reviewed and interpreted to understand the individual’s profile of strengths, challenges, and possible support needs.

Feedback and Recommendations

When appropriate, families and referring professionals will receive clear feedback and practical recommendations to support planning across home, school, healthcare, and community settings.

Questions

Do I need a physician referral?

Yes. FASD assessment services at Dr. Sala & Associates are currently available by physician referral only. If you do not yet have a referral, please speak with your or the individual’s physician about your concerns and ask whether an FASD assessment referral may be appropriate.

Is FASD the same as fetal alcohol syndrome?

Fetal Alcohol Syndrome, or FAS, is an older and more specific term that many people still recognize. The broader current term is Fetal Alcohol Spectrum Disorder (FASD). FASD reflects a wider range of possible neurodevelopmental effects associated with prenatal alcohol exposure. Some individuals may have facial features associated with FASD, while others may not. This is one reason assessment needs to consider more than appearance alone.

What concerns might lead to an FASD assessment referral?

In general, a referral may be considered when there is evidence of prenatal alcohol exposure along with difficulties in multiple areas including learning, memory, attention, executive functioning, emotional regulation, adaptive daily living, motor skills, language, academic achievement, or mental health. Some individuals may also have previous diagnoses or suspected concerns related to ADHD, autism, learning disabilities, anxiety, mood concerns, trauma-related difficulties, or behavioural challenges. Assessment can help clarify the broader picture.

Is FASD assessment the same as an ADHD, autism, or psychoeducational assessment?

No. While there are overlaps in the tests used, FASD-related assessment has a different purpose and requires careful consideration of prenatal alcohol exposure, neurodevelopmental functioning, medical and developmental history, and other possible explanations. An ADHD, autism, or psychoeducational assessment may answer important questions, but it may not fully address whether FASD-informed assessment is needed.

What does the assessment look at?

The assessment may examine areas such as general cognitive functioning, attention, memory, executive functioning, fine-motor skills, language, academic achievement, mental health, adaptive functioning, and facial features associated with FASD when clinically appropriate. Information from caregivers, schools, physicians, previous records, and other involved professionals may also be important.

Will the assessment guarantee a diagnosis?

No assessment can guarantee a specific diagnosis. The purpose of the process is to carefully examine the referral question, understand the individual’s strengths and challenges, consider possible explanations, and provide recommendations for next steps. Depending on the findings and the nature of the referral, the outcome may include diagnostic clarification, support recommendations, further referral suggestions, or guidance for home, school, healthcare, and community planning.

Can adults be assessed?

Yes. If an adult FASD-related assessment is being considered, please speak with the referring physician or contact our office to ask about the referral process.

What records are helpful?

Helpful records may include medical information, developmental history, school records, previous psychological or psychoeducational assessments, speech-language or occupational therapy reports, report cards, Individual Education Plans, behaviour plans, support plans, and any available documentation related to prenatal alcohol exposure. Our office can provide more guidance about what information may be needed once a physician referral has been made.

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