Management Of Fetal Alcohol Spectrum Disorders Research Articles

Fetal Alcohol Spectrum Disorders and Inadequacy of Care: Importance of Raising Awareness in Clinical Practice.

Prenatal alcohol exposure is one of the major avoidable causes of developmental disruption and health abnormalities in children. Fetal alcohol spectrum disorders (FASDs), a significant consequence of prenatal alcohol exposure, have gained more attention recently. This review aims to provide a narrative approach to the scientific literature on the history, clinical presentation, diagnosis, and management of FASDs. A literature search in PubMed, ScienceDirect, and Google Scholar online databases was conducted. The dates of publications ranged from 2000 to 2023. FASD presentations tend to persist into adulthood, which, combined with environmental factors, potentially lead to secondary psychosocial problems and disabilities. This review covers different aspects of FASDs regarding the concept of the umbrella term and public health, somatic, and psychiatric perspectives. FASD management remains an obstacle to health professionals, and mental health problems are underestimated. Its management involves a multi-disciplinary team, which varies according to the patient's individual needs. FASD diagnosis and management have not been sufficiently established and tailored. Stigma, cultural contexts, knowledge gaps, and the heterogeneity of clinical manifestations are significant barriers to an accurate diagnostic process. Further development of early interventions and the elaboration of complex treatment approaches are needed.

Fetal Alcohol Spectrum Disorders and Social Work Practice in Australia: A Narrative Literature Review

ABSTRACT In Australia, it has been well documented that the leading preventable cause of nongenetic neurodevelopmental disability (NDD) is Fetal Alcohol Spectrum Disorder (FASD). This review explores literature informing Australian social work in the context of FASD. It highlights the need for increased social work research to inform evidence-based practice (EBP) in FASD diagnosis and management using the biopsychosocial-spiritual-cultural (BPSSC) framework. Social workers are often first to identify children's emotional, behavioural, and learning difficulties that may be a characteristic of FASD. Nonetheless, there is limited knowledge and understanding about how social workers in Australia address FASD. We argue that research about FASD and social work practice can improve social workers’ understanding of the BPSSC characteristics and management of FASD across the life course and contribute to EBP development in these areas in Australian social work. IMPLICATIONS Social workers have an emerging role in the holistic assessment, diagnosis, and management of FASD in Australia. Social workers are well placed in being first to recognise and identify an individual’s emotional, behavioural, sociocultural, and learning difficulties that are characteristics of FASD. Social workers can contribute to ongoing care in a tailored FASD management plan that links the caregivers to appropriate local community resources, service provision, and disability supports.

Fetal alcohol spectrum disorder resources for health professionals: a scoping review protocol

IntroductionPeople with fetal alcohol spectrum disorder (FASD) encounter a range of health and allied health providers and require specialised support to ensure health services are provided safely and effectively. Not...

It takes a village: Influencing policy and practice to prevent alcohol use in pregnancy and promote better outcomes for individuals living with Fetal Alcohol Spectrum Disorder

Fetal Alcohol Spectrum Disorder (FASD) is a neurodevelopmental disorder caused by exposure to alcohol in utero. It has pervasive, lifelong impacts and is recognised as a major public health concern in many countries where alcohol is used. The FASD Research Australia Centre of Research Excellence (CRE) was funded by the National Health and Medical Research Council to generate and translate evidence to address prevention, diagnosis, and management of FASD in Australia. The current paper describes the approach to policy and practice impact taken by our CRE, including our stakeholder engagement processes and the key principles that underlie our approach. We provide examples of policy and practice influence in FASD prevention, diagnosis and management that have been achieved over the past five years and discuss challenges that are routinely faced in the translation of our work.

Available prevention and management interventions for fetal alcohol spectrum disorder (2007 to 2017)

Abstract Background The global prevalence of Fetal Alcohol Spectrum Disorder (FASD) remains high despite the various preventive and management interventions that have been designed and implemented to tackle the issue in various settings. The scoping review aims to identify and classify prevention and management interventions of FASD reported globally across the life span and to map the concentration of these interventions across the globe. Methods We conducted a scoping review searching databases such as Ebsco Host (Academic Search Complete, ERIC, SoINDEX, Health Source: Nursing/Academic Edition, CINAHL, Medline and Psych-ARTICLES), SAGE Journals, Sabinet and PubMed. Two reviewers independently screened studies for eligibility and used the Effective Public Health Project assessment tool to assess the methodological rigour of the included studies. A framework approach to data analysis was done and a narrative approach was used to synthesise and report on the findings. Results Thirty-two prevention intervention studies and 41 management intervention studies were identified. All the interventions were reported to be effective or showed promising outcomes for the prevention and management of FASD, except four. Although Europe and Africa have a relatively higher prevalence of FASD, the lowest number of interventions to address FASD were identified in these regions. Most of the interventions for FASD were reported in North America with comparatively lower FASD prevalence. Conclusions The uneven distribution of interventions designed for FASD vis-à-vis the burden of FASD in the different regions calls for a concerted effort for knowledge and intervention sharing to enhance the design of contextually sensitive preventive and management policy in the different regions. Key messages There are effective interventions for the prevention and management of FASD, however, the interventions were not distributed according to the burden of FASD in different regions. There is a great need to share and implement context/culturally appropriate interventions for the prevention and management of FASD among regions.

Review of Fetal Alcohol Spectrum Disorder (FASD) among Aboriginal and Torres Strait Islander people

Fetal Alcohol Spectrum Disorder (FASD) is a preventable, lifelong disability that disproportionately affects Aboriginal and Torres Strait Islander people. This review provides a comprehensive synthesis of the available information on FASD among Aboriginal and Torres Strait Islander people, with reference to the limitations on population-based data and evaluated programs. The review outlines; the harms of alcohol use in the context of colonisation, cultural perspectives on assessment and diagnosis, effective prevention programs and a summary of state and national policies. Health impacts, educational outcomes and the effects of FASD on vulnerable populations such as children in protection and young people in the justice system, are also discussed. Specific perspectives on why women drink during pregnancy and the role of Aboriginal women in preventing FASD are explored. Recommendations include that there be greater focus on the benefits of involving men in the prevention and management of FASD and that future FASD prevention strategies for Aboriginal and Torres Strait Islander people should be community identified, led, and driven. FASD assessment, treatment and public health programs must also consider the history of trauma incurred by Aboriginal and Torres Strait Islander communities as a result of colonisation.

It takes a village: Influencing policy and practice to prevent alcohol use in pregnancy and promote better outcomes for individuals living with Fetal Alcohol Spectrum Disorder.

Fetal Alcohol Spectrum Disorder (FASD) is a neurodevelopmental disorder caused by exposure to alcohol in utero. It has pervasive, lifelong impacts and is recognised as a major public health concern in many countries where alcohol is used. The FASD Research Australia Centre of Research Excellence (CRE) was funded by the National Health and Medical Research Council to generate and translate evidence to address prevention, diagnosis, and management of FASD in Australia. The current paper describes the approach to policy and practice impact taken by our CRE, including our stakeholder engagement processes and the key principles that underlie our approach. We provide examples of policy and practice influence in FASD prevention, diagnosis and management that have been achieved over the past five years and discuss challenges that are routinely faced in the translation of our work.

The Distribution of Available Prevention and Management Interventions for Fetal Alcohol Spectrum Disorder (2007 to 2017): Implications for Collaborative Actions.

The global prevalence of Fetal Alcohol Spectrum Disorder (FASD) remains high despite the various preventive and management interventions that have been designed and implemented to tackle the issue in various settings. The aim of the scoping review is to identify and classify prevention and management interventions of FASD reported globally across the life span and to map the concentration of these interventions across the globe. We searched some selected databases with predefined terms. Framework and narrative approaches were used to synthesize and report on the findings. Thirty-two prevention intervention studies and 41 management interventions studies were identified. All the interventions were reported to be effective or showed promising outcomes for the prevention and management of FASD, except four. Although Europe and Africa have a relatively higher prevalence of FASD, the lowest number of interventions to address FASD were identified in these regions. Most of the interventions for FASD were reported in North America with comparatively lower FASD prevalence. The uneven distribution of interventions designed for FASD vis-à-vis the burden of FASD in the different regions calls for a concerted effort for knowledge and intervention sharing to enhance the design of contextually sensitive preventive and management policy in the different regions.

To what extent is\xa0Fetal Alcohol Spectrum Disorder considered in policy-related documents in South Africa? A document review

BackgroundSouth Africa is considered to have the highest prevalence of fetal alcohol spectrum disorder (FASD) globally. Nevertheless, the extent to which the South African government has responded to the high FASD prevalence at the policy level is unclear. Herein, we aimed to identify targeted and generic clauses that could be attributed to the prevention and management of FASD in relevant South African policy documents.MethodsWe conducted a search of two search engines (PubMed and Google) and the websites of South African national and provincial departments from January to April 2018. A total of 33 policy documents were included in this review. Using content analysis, we sought documents that mention the terms ‘fetal alcohol syndrome’ and ‘fetal alcohol spectrum disorder’. The Framework method was also used to thematically identify specific and generic clauses attributed to the prevention and management of FASD in South Africa.ResultsThe content analysis indicated that 12 policy documents contained the searched terms. Findings from the thematic analysis showed that targeted and generic clauses for FASD exist in various policy documents. Some of the generic clauses focused on the regulation of liquor outlets, enforcement of liquor laws, and the general management of persons with mental and educational challenges. Specific clauses focused on creating platforms to improve the awareness, screening, identification and support for individuals with FASD.ConclusionsThere is a noticeable increase in the number of policy documents that considered elements of FASD enacted in the last decade. Although this study revealed the existence of targeted and generic clauses that could be attributed to the prevention and management of FASD, the sustained high prevalence of FASD in South Africa, as reported in the literature, calls for more holistic and comprehensive approaches to tackle the FASD problem in South Africa.

Policymakers' Perspectives Towards Developing a Guideline to Inform Policy on Fetal Alcohol Spectrum Disorder: A Qualitative Study.

Fetal alcohol spectrum disorder (FASD) has a high prevalence in South Africa, especially among the poor socioeconomic communities. However, there is no specific policy to address FASD. Using a qualitative study design, we explored the perspectives of policymakers on guidelines/policies for FASD, current practices and interventions, and what practices and interventions could be included in a policy for FASD. The data analysis was done using the Framework Method. Applying a working analytical framework to the data, we found that there is no specific policy for FASD in South Africa, however, clauses of FASD policy exist in other policy documents. Preventive services for women and screening, identification, assessment, and support for children are some of the current practices. Nevertheless, a multi-sectoral collaboration and streamlined program for the prevention and management of FASD are aspects that should be included in the policy. While there are generic clauses in existing relevant policy documents, which could be attributed to the prevention and management of FASD, these clauses have not been effective in preventing and managing the disorder. Therefore, a specific policy to foster a holistic and coordinated approach to prevent and manage FASD needs to be developed.

Australia plays ‘catch-up’ with Fetal Alcohol Spectrum Disorders

Elliott, E. (2014). Australia plays ‘catch-up’ with Fetal Alcohol Spectrum Disorders. The International Journal Of Alcohol And Drug Research, 3(1), 121-125. doi:http://dx.doi.org/10.7895/ijadr.v3i1.177Australians are amongst the highest consumers of alcohol worldwide, and "risky" drinking is increasing in young women. Contrary to the advice in national guidelines, drinking in pregnancy is common. Many women don’t understand the potential for harm to the unborn child and 20% have a "tolerant" attitude to drinking during pregnancy. As attitude, rather than knowledge, predicts risk of drinking in a future pregnancy, this presents a challenge for public health campaigns. Alcohol is teratogenic, crosses the placenta, and contributes to a range of physical, developmental, learning and behavioural problems, including fetal alcohol spectrum disorders (FASD). As nearly half of all pregnancies in Australia are unplanned, inadvertent exposure to alcohol is common. Good-quality prevalence data on FASD are lacking in Australia, although alcohol use at "risky" levels is well documented in some disadvantaged communities. In the last decade, clinicians, researchers, governments and non-governmental organizations have shown renewed interest in addressing alcohol use in pregnancy and FASD. This has included a parliamentary inquiry into FASD, provision of targeted funding for FASD, and development of educational materials for health professionals and the general public. Key challenges for the future are to prevent FASD and to offer timely diagnosis and help to children and families living with FASD. The implementation of evidence-based interventions known to decrease access to, and excessive use of, alcohol in our society will aid in the prevention of FASD. The development of national diagnostic tools for screening and diagnosis, and the training of health professionals in the management of FASD, are urgently needed.