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Misdiagnosis!– or, How Much Harm Can a Bad Snapshot Really Do?

This is the fifth blog continuing our family’s saga of considering whether to adopt our daughter’s biological sister, who was exposed to alcohol in utero.

In looking for evidence of Fetal Alcohol Syndrome, doctors a few years ago commonly examined photographs looking at the eye size and shape, the “flatness” of the face, the nasal bridge. At one point I was told that “almond-shaped eyes and a flat nasal bridge are indicators for Fetal Alcohol Syndrome”.

Hello?! !? The child is Korean, remember? She’s supposed to have almond-shaped eyes and a flat nasal bridge! Am I in the 21st century in a major West Coast city or not?

At a recent conference I learned that doctors now look at the height of the eye opening at widest point, or something like that—not the shape of the eye—and this is not affected by racial differences. Like I said, a few years make a big difference in a fairly new field.

To complicate matters, this baby also had ptosis, a droopy eyelid. (Remember in the first blog in this series I said the only kind of surgery that most bothered me was the idea of eye surgery?) Ptosis is slightly more common among alcohol-exposed kids. Alcohol exposure in utero can increase the likelihood of many disorders such as heart murmurs and septal defects, cleft lip or palate, kidney and joint problems. However in most cases where these defects occur, they are not caused by alcohol.

Fairly new at this time was a computerized system to analyze the features in photos, especially the three features I mentioned: upper lip, philtrum (groove above lip), and eyes.

I would later learn that the computer analysis was normed based on photographs of kids in the foster care population of a certain area. Guess what—the foster care population used included African-American kids and European-American kids, but no Asian kids.

The computerized analysis of the baby’s facial features initially came back from the FAS Clinic saying my daughter had moderate (3 on a scale of one to five) features for FAS. Our doctor, who does pre-adoption consultations, did not think this boded well. She later said that her first reaction when she saw the pictures was “oh no, this is a little girl who may have suffered some significant damage”.

Now for the tiny little thing that changes a life: my doctor observed that in the photo the baby was slightly sucking on her lip. This of course could impact the appearance of the upper lip and philtrum. So we had to ask the US adoption agency to ask the Korean adoption agency to get new photos taken and sent. This provided a small ray of hope, but we had to wait over six weeks for the new pictures.

Please see these related blogs:

At Least–3 Reasons Not To Drink While Pregnant


What An Adoption Doctor Did for Us

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About Pam Connell

Pam Connell is a mother of three by both birth and adoption. She has worked in education, child care, social services, ministry and journalism. She resides near Seattle with her husband Charles and their three children. Pam is currently primarily a Stay-at-Home-Mom to Patrick, age 8, who was born to her; Meg, age 6, and Regina, age 3, who are biological half-sisters adopted from Korea. She also teaches preschoolers twice a week and does some writing. Her activities include volunteer work at school, church, Cub Scouts and a local Birth to Three Early Intervention Program. Her hobbies include reading, writing, travel, camping, walking in the woods, swimming and scrapbooking. Pam is a graduate of Seattle University and Gonzaga University. Her fields of study included journalism, religious education/pastoral ministry, political science and management. She served as a writer and editor of the college weekly newspaper and has been Program Coordinator of a Family Resource Center and Family Literacy Program, Volunteer Coordinator at a church, Religion Teacher, Preschool Teacher, Youth Ministry Coordinator, Camp Counselor and Nanny. Pam is an avid reader and continuing student in the areas of education, child development, adoption and public policy. She is eager to share her experiences as a mother by birth and by international adoption, as a mother of three kids of different learning styles and personalities, as a mother of kids of different races, and most of all as a mom of three wonderful kids!