Fetal Alcohol Spectrum Disorder (FASD) is a neurodevelopmental disorder caused by prenatal alcohol exposure (PAE). Recognition of FASD within Australia has continued to grow, particularly with the development of the Australian Diagnostic Guide, yet the availability of FASD-specific services continues to be limited. This paper presents the views and experiences of the six sites across Australia that were involved in developing a FASD Model of Care (MoC) in their local area. Each site completed an online survey that included forced-choice questions (e.g., ‘What challenges did you face with creating your Model of Care’) and free-text options (e.g., ‘Describe the process of establishing a FASD clinic at your site’). Follow-up interviews were completed with each site to ensure results were accurately captured. Eight key themes were revealed: 1) importance of the FASD Coordinator position, 2) clinicians’ attitudes impact clinic success, 3) MDT co-location as a contributor to success, 4) improved FASD awareness, 5) inadequate planning for local contexts, 6) developing local networks, 7) difficulty maintaining community engagement and 8) challenges with the Australian diagnostic guide.  These themes are discussed within the Australian FASD context, advocating for the need to expand and improve these service offerings.

Current research on perceptual organization in schizophrenia frequently employs shapes with regularly sampled contours (fragmented stimuli), in noise fields composed of similar elements, to elicit visual abnormalities. However, perceptual organization is multi-factorial and, in earlier studies, continuous contours have also been employed in tasks assessing the ability to extract shapes from a background. We conducted a systematic review and meta-analysis of studies using closed-contour stimuli, including the Embedded Figures Test (EFT) and related tasks, both in people with schizophrenia and in healthy schizotypes and relatives, considered at increased risk for psychosis. Eleven studies met the selection criteria for inclusion in the meta-analysis, including six that used a between-groups study design (i.e., perceptual organization abilities of schizophrenia/high-risk groups were compared to healthy or clinical controls), and five that treated schizophrenia symptoms or schizotypy traits and indices of perceptual organization as continuous variables. Effect sizes and heterogeneity statistics were calculated, and the risk of publication bias was explored. A significant, moderate effect for EFT performance was found with studies that compared performance of schizophrenia/high-risk groups to a healthy or patient comparison group (d = −0.523, p < 0.001). However, significant heterogeneity was also found amongst the schizotypy, but not schizophrenia studies, as well as studies using accuracy, but not reaction time as a measure of performance. A non-significant correlation was found for the studies that examined schizophrenia symptoms or schizotypy traits as continuous variables (r = 0.012, p = 0.825). These results suggest that deficits in perceptual organization of non-fragmented stimuli are found when differences between schizophrenia/high-risk groups and comparison groups are maximized. These findings should motivate further investigation of perceptual organization abilities with closed-contour stimuli both in schizophrenia and high-risk groups, which is pertinent to current initiatives to improve the assessment and treatment of cognition in schizophrenia.

Contour integration is impaired in schizophrenia patients, even at the first episode, but little is known about visual integration abilities prior to illness onset. To examine this issue, we compared undergraduate students high and low in schizotypal personality traits, reflecting putative liability to psychosis, on two psychophysical tasks assessing local and global stages of the integration process. The Radial Frequency Jittered Orientation Tolerance (RFJOT) task measures tolerance to orientation noise at the local signal level, when judging global stimulus orientation, whilst the Radial Frequency Integration Task (RFIT) measures the ability to globally integrate the local signals that have been extracted during shape discrimination. Positive schizotypy was assessed with the Perceptual Aberration (PAb) scale from the Wisconsin Schizotypy Scales-Brief. On the RFJOT task, the High PAb group (n = 55) tolerated statistically significantly less noise (d = −0.494) and had a lower proportion of correct responses (d = −0.461) than the Low PAb group (n = 77). For the RFIT there was no statistically significant difference in integration abilities between the High and Low PAb groups. High and Low PAb groups also differed on other positive and disorganized (but not negative) schizotypy traits, hence poorer performance on the RFJOT may not be solely related to unusual perceptual experiences. These findings suggest that difficulties with local noise tolerance but not global integration occur in healthy young adults with high levels of schizotypal personality traits, and may be worth investigating as a marker of risk for schizophrenia.

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