Fetal alcohol spectrum disorder (FASD) describes a wide range of brain and developmental differences that may be found in children with prenatal alcohol exposure (PAE). The development of new tools for early identification of children at-risk for FASD will facilitate access to early intervention programs that can change the lives of children and their families impacted by FASD. This study is validating a new biomarker tool and assessment process that has the potential to aid in the diagnosis of children where there are concerns about their development in the context of PAE. The study team, using the Translating to the Community (T2C) protocol, will recruit children and youth who have confirmed PAE and who have been seen for comprehensive multidisciplinary assessment at the Manitoba FASD Clinic. Validation of this tool and process will be helpful to clinicians who may see a child who may be at risk due to prenatal exposure to alcohol. It will inform new processes of identification of at-risk children, particularly where PAE is suspected. The study will improve our understanding of the many factors that determine both risk as well as resilience in FASD outcomes. Equally as important, this study will inform a range of health and community programs to support best outcomes for these children and their families.