Development of an Australian FASD Indigenous Framework: Aboriginal Healing-Informed and Strengths-Based Ways of Knowing, Being and Doing

Abstract

Aboriginal culture intuitively embodies and interconnects the threads of life that are known to be intrinsic to human wellbeing: connection. Therefore, Aboriginal wisdom and practices are inherently strengths-based and healing-informed. Underpinned by an Indigenist research methodology, this article presents findings from a collaboration of Aboriginal and non-Aboriginal peoples to develop an Australian Fetal Alcohol Spectrum Disorder (FASD) Indigenous Framework during 2021 to 2023. The FASD Indigenous Framework unfolds the changes that non-Aboriginal clinicians and Aboriginal peoples each need to make in their respective ways of knowing, being and doing in order to facilitate access to healing-informed, strengths-based and culturally responsive FASD knowledge, assessment, diagnosis and support services among Aboriginal peoples. Drawing on the Aboriginal practices of yarning and Dadirri, written and oral knowledges were gathered. These knowledges were mapped against Aboriginal cultural responsiveness and wellbeing frameworks and collaboratively and iteratively reflected upon throughout. This article brings together Aboriginal wisdom (strengths-based, healing-informed approaches grounded in holistic and integrated support) and Western wisdom (biomedicine and therapeutic models) in relation to FASD. From a place of still awareness (Dadirri), both forms of wisdom were drawn upon to create Australia’s first FASD Indigenous Framework, a new practice in the assessment and diagnosis of FASD, which offers immense benefit to equity, justice, support and healing for Aboriginal families with a lived experience of FASD.

Factors to be considered as part of a holistic assessment for fetal alcohol spectrum disorder: A scoping review

“…Cultural connections and developing a strong cultural identity was found to reduce recidivism and improve health and wellbeing (Rogers et al, 2013). Thus, gathering and prioritizing information about a person's culture and identity should be considered a critical component of a holistic assessment approach (Hewlett et al, 2023). This is also fundamental to the development of recommendations and support plans for all Australians, especially First Nations peoples and those from culturally and linguistically diverse backgrounds.…”

“…Results from this review only skimmed the surface on the links between strengths of cultural connections, self‐identity and health and wellbeing. Further research should focus on the specifics of what information should be collected as part of the assessment process, and the most appropriate ways to collect this information to effectively inform holistic assessments for First Nations peoples (Hewlett et al, 2023). Understanding what culture‐centered assessment and diagnostic processes look like will increase cultural responsiveness and contribute to improved outcomes for First Nations people with FASD.…”

“…The current scoping review forms part of a larger evidence review process (e.g., see Hayes et al, 2022; Hayes et al, 2023; Hewlett et al, 2023) supporting the review and update of the Guide. The current review focused on identifying the factors outside of the diagnostic criteria (i.e., PAE, dysmorphology, neurodevelopmental impairments, and growth restriction) that could be part of a holistic assessment process when considering a FASD diagnosis as one possible outcome.…”

“…Notably, one key area being considered in the revision of the Guide is how to increase cultural responsiveness of the assessment process (Hayes et al, 2022; Hewlett et al, 2023). Despite being a culturally diverse nation with over 60,000 years of history, Australian clinical practice guidelines have not always considered historical and cultural context (Laycock et al, 2011).…”

“Our Mothers Have Handed That to Us. Her Mother Has Handed That to Her”: Urban Aboriginal and Torres Strait Islander Yarning about Community Wellbeing, Healthy Pregnancies, and the Prevention of Fetal Alcohol Spectrum Disorder

“…In a demonstration of resilience, Indigenous cultural approaches to family remain significant aspects of community life [2,6]. Cultural family practices support parental and child health and wellbeing, including the prevention of fetal alcohol spectrum disorder (FASD) in urban communities [2,7].…”