News & Views

Action to identify and prevent FASD in high-risk communities

Helen Signy

Published 15 July 2016. doi: http://dx.doi.org/10.17061/phrp2631637
Citation: Signy H. Action to identify and prevent FASD in high-risk communities. Public Health Res Pract. 2016;26(3):e2631637

  • Citation

The implementation of a $10.5 million Federal budget measure to target fetal alcohol spectrum disorders (FASD) will start in the second half of 2016 following consultation with stakeholders, a spokesperson for the Federal Department of Health has confirmed.

The ‘Taking more action to prevent fetal alcohol spectrum disorders’ measure was announced in the May budget to boost prevention of FASD in high-risk remote and rural communities. It will include the establishment of a FASD Clinical Network, a FASD diagnostic clinic, a Model of Care for Communities, and expansion of the FASD Technical Network.

The spokesperson said there would be a targeted competitive grant funding process to achieve the intended outcomes, which aim to improve the diagnosis of FASD in high-risk communities.

Identification of FASD is key

Dr John Crozier, co-chair of the National Alliance for Action on Alcohol, said a clinical network could coordinate services and provide clinician training in identifying and preventing FASD. Ultimately, what was needed was a whole-of-government approach to FASD, with an overarching strategy focusing on prevention, intervention, diagnosis and management.

He said diagnosis of FASD and access to services were often missed, with clinicians failing to make the link between alcohol exposure during pregnancy and disorders such as autism, attention disorders, global development delays and oppositional defiant disorder.

“There are 428 different defined syndromes or conditions, all of which can be a consequence of alcohol exposure during pregnancy, especially the early phases when the woman doesn’t know she’s pregnant,” he said.

“Many clinicians aren’t aware of the range of presentations of FASD, so clinical education is a very important initial element, prevention is a second pillar of the use of the funds, and the third is research.”

A successful project targeting FASD

While the prevalence of FASD in Australia is not known, a population-based study in WA indicated it was as high as 19% of children in one remote Indigenous community – one of the highest rates in the world.

“It will likely be the same in communities all over the Northern Territory, Western Australia, NSW and Queensland – it’s potentially another stolen generation of children and a threat to the continuation of culture,” said study author Elizabeth Elliott, Professor in Paediatrics and Child Health at the University of Sydney.

Professor Elliott led the Lililwan Project in partnership with the Indigenous community in Fitzroy Crossing, WA, which provided services through a multidisciplinary team and resulted in a range of outcomes spanning psychology, speech, motor skills, academic achievement and conduct problems. The project has also seen funding for a strategic direction for FASD, the development of Australian diagnosis guidelines, and has informed the United Nations and the World Health Organisation.

Last year, Professor Elliott established Australia’s first dedicated centre for diagnosis and treatment of FASD at The Children’s Hospital at Westmead, Sydney. Predominantly caring for non-Indigenous children, the clinic’s caseload consists mainly of children in foster care who have been removed from their biological mothers due to alcohol abuse, Professor Elliott said.

“Clearly prevention, I think, is the key target, and education is a big component, particularly identifying women of childbearing age who are drinking […] We also need early identification at a primary care level.”