In a way, we were lucky. Not quite 20 years had passed since Jones and Smith had named fetal alcohol syndrome and labeled it a “tragic disorder”.1 Having recently been granted custody of Andrew, my husband’s grandson, we had taken him for a checkup with a savvy new pediatrician. He had noted one-and-a-half-year-old Andrew’s low birth weight, and the fact that his mother was a heavy drinker. Was this a case of FAS, he wondered, and referred us to a geneticist at Toronto’s respected Hospital for Sick Children. It was 1992, well before multidisciplinary teams became the gold standard for diagnosis, so it was just the three of us and the doctor. Her observations included that Andrew’s head circumference was below the second percentile, the back of his skull appeared small compared with his face size, his little fingers were abnormal, and his eye openings were small. The overall conclusion was unequivocal: “Andrew clearly has a number of dysmorphic features typical of fetal alcohol syndrome.”

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