Objectives <p>An important component of a fetal alcohol spectrum disorder (FASD) diagnostic assessment requires a child’s caregiver and educator (i.e., informants) to complete questionnaires to describe functioning across settings. Concerns about questionnaire responses, as evidenced by elevated validity scales, seem to occur more frequently in our FASD diagnostic clinic than in other assessment settings. However, validity scales, including high negative responding and inconsistent responding, may provide clinically relevant information rather than indicate compromised validity. The overall goal of this study was to describe the trends in response styles across informants of children and adolescents with prenatal alcohol exposure and determine whether specific factors are related to particular response styles.</p> Methods <p>Charts of 225 children and adolescents seen between 2017 and 2023 were included (<i>M</i>_<i>age</i> = 10.40&#xa0;years, <i>SD</i>_<i>age</i> = 3.15; 54.22% male; 55.56% diagnosed with FASD). We used the validity scales from the Behavior Rating Inventory of Executive Function (BRIEF), BRIEF, Second Edition (BRIEF2), and the Behavior Assessment System for Children, Third Edition (BASC-3).</p> Results <p>Although the rates of high negative responding and inconsistent responding were generally higher in this sample than in published norms, they varied by questionnaire and informant. Certain child characteristics, but not informant characteristics, were related to response styles. Informants tended to have similar patterns for high negative responding but not inconsistent responding across questionnaires.</p> Conclusions <p>The results of this study suggest that families and educators of children with PAE with specific profiles may especially benefit from additional services, support, and validation of their experiences.</p>