Abstract Fetal alcohol spectrum disorders (FASD) are a sur-prisingly common, yet under-identified set of lifelong neurodevelopmental disabilities with substantial economic and social costs—and high rates of debilitating secondary conditions. An advance in the field of FASD is a proposed diagnostic category included in the 2013Diagnostic and Sta-tistical Manual for Mental Health Disorders (DSM-5): BNeurobehavioral Disorder Associated with Prenatal Alcohol Exposure^(ND-PAE). With clinical guidelines to inform its use, appropriate recognition of ND-PAE can allow wider iden-tification of individuals impacted by alcohol’s teratogenic ef fects. Accurately recognizing that a diagnosis of ND-PAE might apply can inform health and mental health providers about when to refer for specialty assessment, and suggest when and how to adapt usual treatments or access tailored interventions. This paper explains the evolution in diagnostic terms, discusses clinical use of ND-PAE, explores dilemmas, and presents ideas forBFASD-informed care^for individuals who meet proposed ND-PAE criteria. KeywordsFASD. Fetal alcohol spectrumdisorders. Fetal alcohol syndrome. Alcohol-related neurodevelopmental disorder.Partial fetal alcohol syndrome.Alcohol-relatedbirth defects. Treatment. Diagnosis.Diagnostic techniques and procedures.Nomenclature.Prenatal exposure delayed