Responding to fetal alcohol spectrum disorder in Australia

Abstract

Fetal alcohol spectrum disorder (FASD) is a significant public health issue in Australia that is poorly diagnosed, chronic and costly. FASD is a diffuse acquired brain injury secondary to prenatal alcohol exposure. The prevalence rate of FASD among the general population in Australia is currently unknown; however, an Australian study in a selected high‐risk population reported some of the highest rates of FASD in the world. A common misconception among clinicians is that a child must have ‘the face’ of FASD to have the disorder. This is incorrect. The three sentinel facial features only occur in the minority of individuals with FASD. FASD should be considered as a ‘whole body’ disorder as increased susceptibility to chronic health problems suggests suboptimal in utero environments places the individual at risk of later disease. Clinicians are reluctant to consider FASD as a possible diagnosis because of the concern of inducing stigma; however, this concern is neither supported by the evidence nor patient stories. The Australian Guide to the Diagnosis of FASD is now available to assist health professionals in providing timely and accurate diagnoses, which can lead to improved outcomes via evidence‐based intervention and is an important first step in future prevention.

Outcomes and needs of health and education professionals following fetal alcohol spectrum disorder‐specific training

“…A frequently reported limiting factor was a lack of time and resources to be able to provide the neurodevelopmental assessments that are required. Of note, the assessment framework recommended for FASD is beneficial for all individuals with complex neurodevelopmental presentations . Therefore, increased resources would enable the provision of neurodevelopmental assessments where required for all complex presentations, including FASD.…”

“…Of note, the assessment framework recommended for FASD is beneficial for all individuals with complex neurodevelopmental presentations. 2 Therefore, increased resources would enable the provision of neurodevelopmental assessments where required for all complex presentations, including FASD. This will then allow accurate identification of neurodevelopmental impairments, appropriate treatment planning and access to disability funding schemes where appropriate.…”

“…Prenatal alcohol exposure results in structural and functional alterations in fetal brain development and is associated with a wide range of impairments, including cognitive, behavioural and emotional difficulties . FASD is currently under‐ or misdiagnosed in Australia and New Zealand; in part, this is likely due to a lack of awareness by health professionals …”

“…An early diagnosis can change things for us to start putting plans in place earlier’ (Shelton et al . 2018: 4) . This highlights the urgent need for training and improved recognition by professionals.…”

“…1 FASD is currently under-or misdiagnosed in Australia and New Zealand; in part, this is likely due to a lack of awareness by health professionals. 2,3 Lack of knowledge or awareness of FASD by professionals has been consistently documented both nationally and internationally as a barrier for families trying to access FASD-related services. [4][5][6] This is concerning as an early diagnosis is required to prevent the secondary conditions (i.e.…”