International survey of diagnostic services for children with Fetal Alcohol Spectrum Disorders
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Published on: August 5, 2017
Elizabeth Peadon1, Emily Fremantle, Carol Bower
1Australian Paediatric Surveillance Unit, The Children's Hospital at Westmead, Locked Bag 4001, 2145 Westmead, Australia . elizabp5@chw.edu.au
Insights
Specialist clinics for Fetal Alcohol Spectrum Disorder (FASD) diagnosis are mainly in North America. Most use multidisciplinary teams and neurobehavioral assessments, but diagnostic criteria vary, hindering research.
Area of Science:
- Pediatric Health
- Neurodevelopmental Disorders
- Public Health
Background:
- Early diagnosis and intervention for Fetal Alcohol Spectrum Disorder (FASD) are crucial for mitigating secondary social, emotional, and behavioral issues.
- Identifying FASD early also aids in preventing further alcohol-exposed pregnancies.
Purpose of the Study:
- To describe the provision of specialist clinical services for diagnosing and assessing children exposed to alcohol prenatally.
Main Methods:
- Identified FASD diagnostic clinics via literature and internet searches.
- Administered questionnaires to clinics regarding population, staff, assessment processes, and services.
Main Results:
- 34 clinics responded, primarily in North America (29), with others in Africa, Europe, and South America.
- Most clinics (33) utilized multidisciplinary teams, with 32 having staff trained in FASD assessment.
- Neurobehavioral assessment was common (32 clinics), though 11 used varied or adapted diagnostic criteria.
Conclusions:
- FASD diagnostic services are concentrated in North America.
- Most clinics employ recommended multidisciplinary approaches and neurobehavioral assessments.
- Standardizing diagnostic criteria is essential for comparing clinical/research data and advancing FASD intervention trials.
Background:
Early diagnosis and intervention for children with Fetal Alcohol Spectrum Disorder (FASD) reduces the risk of developing a range of secondary social, emotional and behavioural problems and provides an opportunity for prevention of further alcohol exposed pregnancies. The objective of this study was to describe specialist clinical service provision for the diagnosis and assessment of children exposed to alcohol in pregnancy.
Methods:
Fetal Alcohol Spectrum Disorder (FASD) diagnostic clinics were identified through literature and internet searches. Clinics were sent a questionnaire asking for information on the clinic population, clinic staff, assessment process and other services provided.
Results:
Questionnaires were completed for 34 clinics: 29 were in North America, 2 in Africa, 2 in Europe and 1 in South America. No clinics were identified in Asia or Australasia. There was a variety of funding sources, services offered, clinic populations, staff and methods of assessment. Thirty-three clinics had a multi-disciplinary team. In 32 clinics, at least one member of the team had specialist training in assessment of FASD. Neurobehavioural assessment was completed in 32 clinics. Eleven clinics used more than one set of diagnostic criteria or an adaptation of published criteria.
Conclusion:
Diagnostic services are concentrated in North America. Most responding clinics are using a multidisciplinary approach with neurobehavioural assessment as recommended in published guidelines. Agreement on diagnostic criteria would enable comparison of clinical and research data, and enhance FASD research particularly for intervention trials.
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