ric), and dependent living conditions. 
Differential Diagnosis
Disorders that are attributable to the physiolo gical effects associated with postnatal use
of a substance, another medical condition, or environmental neglect. Other consid-
erations include the physiological effects of po stnatal substance use, such as a medication,
alcohol, or other substances; disorders due to another medical condition, such as traumatic
brain injury or other neurocognitive disorder s (e.g., delirium, majo r neurocognitive dis-
order [dementia]); or environmental neglect.
Genetic and teratogenic conditions. Genetic conditions such as Williams syndrome,
Down syndrome, or Cornelia de Lange syndro me and other teratogeni c conditions such as
fetal hydantoin syndrome and maternal phen ylketonuria may have similar physical and
behavioral characteristics. A careful review of prenatal exposure history is needed to clar-
ify the teratogenic agent, and an evaluation by  a clinical geneticist may be needed to dis-
tinguish physical characteristics associated with these and other genetic conditions. 
Comorbidity
Mental health problems have been identified in more than 90% of individuals with histo-
ries of significant prenatal alcohol exposu re. The most common co-occurring diagnosis is
attention-deficit/hyperactivity disorder, bu t research has shown that individuals with
ND-PAE differ in neuropsychological charac teristics and in their responsiveness to phar-