The aim of the article is to describe the communication profiles of five young children with fetal alcohol spectrum disorder (FASD) from 4 to 58
months of age. A collective case-study design following a quantitative and descriptive approach was used to describe the communication profiles
of the participants. The results are described according to the participants’ case histories and a four-level early communication assessment framework.
The significant findings were that all participants were in foster care, and presented with incomplete case histories, general developmental
delays and delays regarding all aspects of their communication abilities. An increase in the severity of the spectrum disorder across the participants’
combined communication profiles was also identified. Participants presented with complex multiple neurodevelopmental needs that
should be viewed within a developmental systems and ecological framework. The importance of early identification, diagnosis and assessment
of infants and young children prenatally exposed to alcohol, the identification of precursors to communication impairment at a very early age,
and the need for individualised early communication intervention to improve developmental outcomes within a family-centred approach are
discussed. Suggestions for future research to accumulate knowledge about FASD in the field of early communication intervention are made.