Fetal alcohol spectrum disorder: counting the invisible - mission impossible?

Chudley, Albert E.

doi:10.1136/adc.2008.137109

Cited by 34 publications

(20 citation statements)

References 13 publications

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“…Early diagnosis and intervention may also prevent or ameliorate long‐term adverse effects and secondary disabilities in adolescents and adults 3,9,19,20 . In addition, diagnosing FAS and reporting it to epidemiological surveillance systems 8,9,21 allows estimation of prevalence which informs the development and evaluation of policies and strategies for intervention, prevention, diagnosis, management, education and other services for children, women and families 9,22,23 . Accurate prevalence data guide advocacy for services and also allow estimation of the cost of FAS to individuals, families and society.…”

Section: Discussionmentioning

confidence: 99%

Changes in health professionals' knowledge, attitudes and practice following provision of educational resources about prevention of prenatal alcohol exposure and fetal alcohol spectrum disorder

Payne

Henley²,

D’Antoine

et al. 2011

Paediatric Perinatal Epid

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We provided health professionals in Western Australia (WA) with educational resources about prevention of prenatal alcohol exposure and fetal alcohol spectrum disorder and assessed changes in their knowledge, attitudes and practice concerning fetal alcohol syndrome (FAS) and alcohol consumption in pregnancy. Following our 2002 survey of health professionals in WA, we developed and distributed educational resources to 3348 health professionals in WA in 2007. Six months later we surveyed 1483 of these health professionals. Prevalence rate ratios [PRR] and 95% confidence intervals [CI] were calculated to compare 2007 results with results from the 2002 survey. Of the 1001 responding health professionals, 69.8% had seen the educational resources; of these 77.1% have used them and 48.5% said the resources had assisted them to change their practice or their intention to change their practice. Compared with 2002, there was an increase in the proportion who knew all the essential features of FAS from 11.7% to 15.8% [PRR 1.35; 95% CI 1.09, 1.67] and had diagnosed FAS, from 4.8% to 7.3% [PRR 1.52; 95% CI 1.08, 2.13]. In 2007, 98.1% of health professionals stated they would advise pregnant women to consider not drinking at all or advise them that no alcohol in pregnancy is the safest choice. Health professionals surveyed in 2007 have increased their knowledge, changed their attitudes and practice about FAS, and altered the advice they give to pregnant women about alcohol consumption since our survey in 2002. It is essential that we build on this change and continue to support health professionals' knowledge, attitudes and practice about the prevention of prenatal alcohol exposure and fetal alcohol spectrum disorder. The educational resources for health professionals may be ordered as hard copies and downloaded from the internet http://www.ichr.uwa.edu.au/alcoholandpregnancy.

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Section: Discussionmentioning

confidence: 99%

Changes in health professionals' knowledge, attitudes and practice following provision of educational resources about prevention of prenatal alcohol exposure and fetal alcohol spectrum disorder

Payne

Henley²,

D’Antoine

et al. 2011

Paediatric Perinatal Epid

View full text Add to dashboard Cite

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“…This weakness of the former diagnostic guidelines mainly impacted the diagnosis of ARND, given that diagnosis is based primarily on the neurodevelopmental impairments the child exhibits as the characteristic facial traits and growth deficits associated with FAS and pFAS are often absent with ARND. Yet, ARND is recognized to be the largest category of affected individuals, representing as many as 80–90% of FASD cases [13]. In addition to the ambiguity surrounding the diagnosis of FASD, the neurodevelopmental assessment is thought to be the lengthiest and most cumbersome component of the diagnostic evaluation [14].…”

Section: Introductionmentioning

confidence: 99%

Neurodevelopmental profile of Fetal Alcohol Spectrum Disorder: A systematic review

et al. 2017

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BackgroundIn an effort to improve the screening and diagnosis of individuals with Fetal Alcohol Spectrum Disorder (FASD), research has focused on the identification of a unique neurodevelopmental profile characteristic of this population. The objective of this review was to identify any existing neurodevelopmental profiles of FASD and review their classification function in order to identify gaps and limitations of the current literature.MethodsA systematic search for studies published up to the end of December 2016 reporting an identified neurodevelopmental profile of FASD was conducted using multiple electronic bibliographic databases. The search was not limited geographically or by language of publication. Original research published in a peer-reviewed journal that involved the evaluation of the classification function of an identified neurodevelopmental profile of FASD was included.ResultsTwo approaches have been taken to determine the pathognomonic neurodevelopmental features of FASD, namely the utilization of i) behavioral observations/ratings by parents/caregivers and ii) subtest scores from standardized test batteries assessing a variety of neurodevelopmental domains. Both approaches show some promise, with the former approach (which is dominated by research on the Neurobehavioral Screening Tool) having good sensitivity (63% to 98%), but varying specificity (42% to 100%), and the latter approach having good specificity (72% to 96%), but varying sensitivity (60% to 88%).ConclusionsThe current review revealed that research in this area remains limited and a definitive neurodevelopmental profile of FASD has not been established. However, the identification of a neurodevelopmental profile will aid in the accurate identification of individuals with FASD, by adding to the armamentarium of clinicians. The full review protocol is available in PROSPERO (http://www.crd.york.ac.uk/PROSPERO/); registration number CRD42016039326; registered 20 May 2016.

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“…The umbrella term FASD describes disabilities [15,16] that include fetal alcohol syndrome (FAS), partial FAS (PFAS) and neurodevelopmental disorder-alcohol exposed (ND-AE) [17]. The prevalence of FASD has been reported as 2-5% in the USA [18] and in Canada it is estimated as 1/100 births [19]. FASDs are under-diagnosed and under-reported in Australia [20] where the prevalence is reported as 1.7/1,000 live births and 4.7/1,000 Indigenous live births [21].…”

Section: Introductionmentioning

confidence: 99%

Midwives' knowledge, attitudes and practice about alcohol exposure and the risk of fetal alcohol spectrum disorder

Payne

Watkins

Jones

et al. 2014

BMC Pregnancy Childbirth

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BackgroundMidwives are an influential profession and a key group in informing women about alcohol consumption in pregnancy and its consequences. There are no current quantitative Australian data on midwives’ knowledge, attitudes and practice in relation to alcohol consumption during pregnancy and Fetal Alcohol Spectrum Disorder. We aimed to reduce this knowledge gap by understanding midwives’ perceptions of their practice in addressing alcohol consumption during pregnancy.MethodsThis cross-sectional study was conducted at 19 maternity sites across the seven health regions of country Western Australia. A questionnaire was designed following review of the literature and other relevant surveys. Midwifery managers of the maternity sites distributed questionnaires to all midwives working in their line of management. A total of 334 midwives were invited to participate in the research and (n = 245, 73.4%) of these were eligible.ResultsThe response fraction was (n = 166, 67.8%). Nearly all (n = 151, 93.2%) midwives asked pregnant women about their alcohol consumption during pregnancy and (n = 164, 99.4%) offered advice about alcohol consumption in accordance with the Australian Alcohol Guideline, which states “For women who are pregnant or planning a pregnancy, not drinking is the safest option”. Nearly two thirds (n = 104, 64.2%) of the midwives informed pregnant women about the effects of alcohol consumption in pregnancy, they did not always use the recommended AUDIT screening tool (n = 66, 47.5%) to assess alcohol consumption during pregnancy, nor conduct brief intervention when indicated (n = 107, 70.4%). Most midwives endorsed professional development about screening tools (n = 145, 93.5%), brief intervention (n = 144, 92.9%), and alcohol consumption during pregnancy and FASD (n = 144, 92.9%).ConclusionNearly all midwives in this study asked and advised about alcohol consumption in pregnancy and around two thirds provided information about the effects of alcohol in pregnancy. Our findings support the need for further professional development for midwives on screening and brief intervention. Policy should support midwives’ practice to screen for alcohol consumption in pregnancy and offer brief intervention when indicated.

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Fetal alcohol spectrum disorder: counting the invisible - mission impossible?

Cited by 34 publications

References 13 publications

Changes in health professionals' knowledge, attitudes and practice following provision of educational resources about prevention of prenatal alcohol exposure and fetal alcohol spectrum disorder

Changes in health professionals' knowledge, attitudes and practice following provision of educational resources about prevention of prenatal alcohol exposure and fetal alcohol spectrum disorder

Neurodevelopmental profile of Fetal Alcohol Spectrum Disorder: A systematic review

Midwives' knowledge, attitudes and practice about alcohol exposure and the risk of fetal alcohol spectrum disorder

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