The objective of this study published in 1991 was to determine if personality and coping style are central determinants of drinking and smoking at risk to fetal health during pregnancy

The aim of this study published in 2008 was to describe the ‘lived’ experiences of New Zealand birth mothers, from pregnancy onwards, of a child/ren diagnosed with FASD (FASD).

The addition of a warning label on alcohol containers is a policy measure yet to be adopted in New Zealand. The current study published in 2009 aims to report the rating of a national sample of 16-40-year-old non-pregnant New Zealand women on a warning label on alcohol containers as a source of information on risks associated with alcohol consumption in pregnancy. A nationwide, cross-sectional survey was conducted in 2005 on a random sample of 1129 non-pregnant women aged 16-40 years.

The study researched alcohol consumption and drinking patterns before and during pregnancy. This was a 1 month self report survey of postnatal women from 21 May-22 June 2006.

This study published in 2009 aims to assess the opinions of New Zealand women on the safety of alcohol consumption in pregnancy and the sociodemographic and lifestyle factors associated with these opinions.

A retrospective survey of 723 post-partum women resident in maternity wards located across New Zealand was conducted using a self-administered questionnaire. Maternal sociodemographic and obstetric characteristics and alcohol intake before and after pregnancy recognition were assessed. This article was published in 2013.

This study published in 2013 aimed to determine the prevalence of unintended pregnancy in women presenting for antenatal care to a large metropolitan hospital in Sydney, Australia, and to investigate health behaviours and demographic factors associated with unintended pregnancy

There is a dearth of studies reporting on patterns and correlates of drinking in early pregnancy prior to stopping on pregnancy recognition, which the current study aims to address. In 2005, a New Zealand nationwide cross-sectional survey was conducted on a random sample of 1,256 women aged 16-40 years. This article was published in 2013.

This study published in 2014 presents findings on women’s deliberations over drinking alcohol during pregnancy, particularly their emotional dimensions, to inform debates about public health messages and practitioner-patient discussions regarding alcohol use during pregnancy

Excessive drinking is linked to negative outcomes in families. From modelling of poor drinking behaviours, family arguments and disrupted family occasions, relationships child injuries, ongoing child neglect and abuse, and domestic violence.

This report summarises the prevalence, social and economical impacts, management and prevention of FASD. It also reports on alcohol consumption and policy context within the Northern Territory.

This overview of alcohol exposure and FASD provides nursing and midwifery professions with fundamental information about the condition.

This study published in 2014 linked birth and hospital records in NSW, Australia. Subjects included primiparous mothers admitted to hospital for MBD due to use of alcohol, opioids or cannabinoids during peri-conception and pregnancy

This article highlights the fact that around 40% of Australian women drink while pregnant and 10% reported binge drinking. The authors conclude that advice about drinking and messages about the risk of FASD are not getting through to women in Australia.

The purpose of this paper is to outline the development of an instrument to assess women’s perception of their entire maternity-care experience. The scales produced from this research offer a means to assess maternity care across the full continuum of care and are brief and easy to use.

This study aimed to examine the extent to which mother-fetal bonding, substance use and mental health through pregnancy predicted postnatal mother-infant bonding.

This study investigated the relationship between motor skills, FASD and prenatal alcohol exposure (PAE) in the Fitzroy Valley.

Case commentary from 2016. It has been recognised for over a decade that FASDs (FASDs), if not identified, can result in miscarriages of justice by reason of profoundly reducing the culpability, and on occasion even the responsibility, of criminal offenders. The potential for such disorders to result in the unreliability of admissions and confessions to police (which may be vital pieces of evidence against accused persons) had also been recognised in principle. However, the decision of the Privy Council in Pora v The Queen [2015] UKPC 9 provides an authoritative legal precedent for recognition of the fact that questioning by police has the potential to yield unreliable and confabulated confessions from persons with FASDs.

This policy document provides a comprehensive overview of the significant and varied harms
associated with alcohol, while making recommendations for addressing these harms. It highlights that a comprehensive, multifaceted approach to reducing alcohol-related harm is required.

This review summarises the behaviours of children with FASD and/or prenatal alcohol exposure (PAE), assessed using the commonly-used Child Behavior Checklist, Teacher Report Form, or Youth Self-Report Form. This review of 23 studies reported that FASD and PAE are associated with problematic behaviour in many, but not all, functional brain domains.

This study explored the relationship between gross motor skills, FASD and prenatal alcohol exposure (PAE) in Australian Aboriginal children.

This is a review of the laws in Western Australia which deal with accused who have been found by a court to be mentally unfit to stand trial.

Sharman’s Stone’s statement is broadly correct. Based on current – albeit scarce – global data, results from the Lililwan project in Fitzroy Crossing reveal among the highest rates per capita of FAS or FASD in the world. However, it is important to note this is a study of a high risk population and cannot be used to make generalisations about Australia as a whole.

This project aimed to find out what WA justice professionals knew about FASD, how it impacted on their work and what information and resources would help them.

This study investigated deficits in visual-motor integration skills among Australian Aboriginal children with FASD or prenatal alcohol exposure (PAE) living in remote areas. Visual-motor integration is the ability to coordinate vision and hand movement to accurately copy complex shapes, which is an important skill for handwriting and other school tasks. Many children in the study had poor visual-motor integration, but more children with FASD had problems with VMI than children without PAE. Children with FASD had additional problems with fine motor coordination.

This study examined all alcohol industry submissions to an Australian Government inquiry into FASD,to assist in understanding how those with vested interests contribute to policy development. The authors concluded that the alcohol industry sought to undermine community concern, debate the evidence, promote ineffective measures and attack independent health professionals and researchers.

This study explored media coverage related to alcohol use during pregnancy and FASD with the aim of identifying ways to improve associated health messages. Researchers identified two frames for media coverage of FASD: sympathy and shame. The authors concluded that media portrayals that encourage women to refrain from alcohol consumption during pregnancy might be more useful than stigmatising and isolating those who do.

This study aims to establish the prevalence of Fetal Alcohol Spectrum Disorder (FASD) among sentenced young people in detention in Western Australia (WA). By identifying the rate of FASD within this population, the study seeks to develop a screening tool that can be utilized for young people entering detention. The translation of these findings will play a crucial role in guiding the management and support of young individuals with FASD in the detention system. Ultimately, the results of this study are expected to have significant implications for the lives of these young people and the future of Australian youth justice services, improving both individual outcomes and systemic responses.

This review investigated the effectiveness of interventions to improve gross motor skills in children with mild to moderate movement disorders.

A multidisciplinary model in the implementation of FASD prevention, diagnosis and therapy approaches is considered best practice. A key challenge for Australian clinicians, policy makers and researchers is to collaborate on a coordinated, national response to FASD that is data-driven and aligned with international guidelines and study protocols.

This paper presents drinking patterns in a group of 1570 pregnant women. The study identified characteristics of pregnant women who either abstain, drink until pregnancy awareness or drink throughout pregnancy.

This position paper outlines the prevalence, prevention, diagnosis, treatment and support of FASD. It proposes 10 recommendations to improve these areas, as well as the overall awareness of FASD in Australia.

Handwriting and drawing (graphomotor) skills were assessed in Australian Aboriginal children with FASD and prenatal exposure to alcohol (PAE) in remote Western Australia. Graphomotor skills were poor and children with FASD performed significantly worse than children without PAE.

This is a report by the Australian Government into a range of issues associated with Aboriginal and Torres Strait Islander experience of law enforcement and justices services.

PhD thesis by Dee Basaraba (Deakin University) which examines the classroom practices required to educate Australian children and young people with FASD.

Australian Government report into the aspects of indefinite detention of people with a cognitive and/or psychiatric impairment.

This review investigated the effectiveness of interventions to improve gross motor skills in children with mild to moderate movement disorders.

This study investigated underlying molecular mechanisms associated with FASD and adverse health outcomes.

This study describes the development of a pilot school-based Alert Program targeted to assist self-regulation in Aboriginal children affected by FASD.

The purpose of this study was to examine prevalence and predictors of alcohol consumption by women prior to awareness of their pregnancy, and trajectories of change to alcohol use following pregnancy recognition.

In this sample of relatively high SES women, most women ceased or reduced drinking once aware of their pregnancy. However, the rate of alcohol-exposed pregnancies was higher than previous estimates when the period prior to pregnancy recognition was taken into account.

This study examined the frequency, correlates and outcomes of alcohol use during breastfeeding.

Data were from an Australian cohort study. Results showed alcohol use was reported by 60.7% and 69.6% of breastfeeding women at 8 weeks and 12 months postpartum, respectively. Breastfeeding women who consumed alcohol were more likely to be born in Australia or another English-speaking country, be tertiary educated and have higher household incomes. Most drank at low levels (<=14 standard drinks per week, <3 per occasion) and employed strategies (e.g. timing of alcohol use) to minimise alcohol passed onto infants via breastmilk. The authors concluded that low level drinking during breastfeeding is not linked with shorter breastfeeding duration or adverse outcomes in infants up to 12 months of age.

The aim of the current study was to report on the diagnostic profile of a group of children who attended the service, to document the extent to which there were comorbid diagnoses and to provide information on the neurocognitive functioning of the children. The current study demonstrates that with the relevant training and expertise, assessment and diagnosis of FASD can be embedded within the existing health services available in Australia.

The first diagnostic centre for FASD in Australia was set up in 2012 involving a range of health professionals providing a multi-disciplinary service. This article outlines the experience of diagnosis from the perspectives of caregivers of children with FASD.

This 25-year study into the baseline rate of microcephaly in Australia confirmed an important link with FASD. It was reported in the Western Australian population that there was a microcephaly prevalence of 1 in 1830 births and the most frequent cause was FASD, particularly in Aboriginal births.

This study set out to describe the prevalence (how many) and characteristics of microcephaly in a geographically defined Australian population. The authors identified a high proportion of cases without known cause, highlighting the need for clinicians to carefully investigate all possibilities, including emerging infections. FASD is an important cause of microcephaly in the Aboriginal population.

This study examined the relationship between maternal alcohol use disorder and child school attendance in Western Australia. Maternal alcohol use disorder was significantly associated with poor attendance for both non-Indigenous and Indigenous children. However, there was no significant difference between timing of diagnosis and poor school attendance.

This study assesses neurodevelopmental outcomes in a population of Australian Aboriginal children with and without prenatal alcohol exposure.

This study examines school achievement in children of Indigenous and non-Indigenous mothers with an alcohol-related diagnosis…

Investigation of 3D facial images of one year old children with prenatal alcohol exposure. Shows subtle facial differences in children with alcohol exposure, even at low levels, when compared to children of abstinent mothers. Important message of biological effect of ethanol.

Prenatal alcohol exposure is important for every mother to consider.
What women need to know:
If you are pregnant, or trying to get pregnant, no amount of alcohol use is safe.
All types of alcohol – inlcuding wine, beer, and hard liquor – have similar risks for your baby.
When a pregnant women drinks so does her baby.

This study linked children of mothers who had an alcohol related disorder to their risk of having contact with the justice system in Western Australia.

This commentary pertains to a study looking at objective 3-dimensional facial imaging and differences between the facial shape of individuals with FAS and individuals without FAS or partial FAS, as well as those with heavy prenatal alcohol exposure (PAE) but without a diagnosis of FAS or partial FAS. The results of this study, with its more precise and objective measures of dose, frequency, and timing of PAE, especially if confirmed by others and in larger samples, will continue the journey toward more robust evidence for informing health policy.

Case commentary from 2017. LCM was a child of 15 whose diagnosis of FASD was not made prior to his being sentenced for manslaughter. The diagnosis arrived at by a multidisciplinary team shortly before his appeal to the Western Australian Court of Appeal in LCM v The State of Western Australia [2016] WASCA 164 resulted in a significant reduction in his sentence.

This study demonstrates that children with FASD have more teacher-reported behavioral impairment than children without FASD. In remote Australian communities, academic performance is poor.

This study used the Fetal Alcohol Syndrome (FAS) Facial Photographic Analysis Software to assess the three sentinel facial features of FAS in a cohort of Australian Aboriginal children from 2D photographs. Results indicated that this assessment method had substantial inter- and intra-rater reliability; and that the African American Lip-Philtrum Guide 2 and Caucasian (Stromland) PFL norms provide the best fit for assessment of Australian Aboriginal children.

This study examined the relationship between a maternal alcohol use diagnosis, the timing of diagnosis, and child protection outcomes in Western Australia. Results showed children of women who were diagnosed were at increased risk of a substantiated child protection allegation and entry into out-of-home care. The highest risk of child protection contact was associated with diagnosis received during pregnancy, and in the years immediately pre- and post-pregnancy.

This report outlines the development and implementation of the Marulu Strategy in the Fitzroy Valley in Western Australia.

A summary of the trial and implementation of the diagnostic instrument for FASD in Australia.

This study published in 2017 analysed hospital admissions of a predominantly Aboriginal cohort of children in the remote Fitzroy Valley in Western Australia during the first 7 years of life.

The issue of alcohol consumption during pregnancy has garnered significant attention in Australia. This article examines how news media and parenting websites framed the issue in 2013–2014, focusing on the themes of ‘contested evidence and advice’ and ‘women’s rights.’ Public health guidelines recommend avoiding alcohol, but debate continues over the evidence and its impact. The article highlights how media reports on new research, both supporting and disputing the risks, and how the ‘women’s rights’ frame emphasizes personal choice over scientific advice, reflecting the complex negotiation of public health guidance during pregnancy.

The challenges of assessing alcohol consumption can be greater in Indigenous communities where there may be culturally distinct approaches to communication, sharing of drinking containers and episodic patterns of drinking. This paper discusses the processes used to develop a tablet computer-based application (‘App’) to collect a detailed assessment of drinking patterns in Indigenous Australians. The key features of the resulting App are described.

The Triple B Pregnancy Cohort Study investigates the effects of parental alcohol, tobacco and other substance use on infant development and family functioning.

This study aimed to estimate the prevalence of FASD among young people in youth detention in Western Australia. A multidisciplinary assessment of 99 young people (10 – 17 years and 11 months) found 89% of young people had at least one domain of severe neurological impairment and 36% were diagnosed with FASD. The findings highlight the vulnerability of young people, particularly Aboriginal youth, within the justice system.

Teratogenicity of heavy prenatal alcohol exposure is established, but uncertainty remains regarding the impact of moderate alcohol exposure on cognitive deficits in infants. Separating in utero effects from environmental confounding is a challenge for observational studies; consideration of alcohol use by partners as well as mothers may help clarify this. This study examined associations between prenatal alcohol use by both mothers and their partners and infant cognitive developmental outcomes at 12-months.

This review aimed to examine the extent and common types of motor impairment present in persons aged over 12 years prenatally exposed to alcohol as evidence for determining the skills that should be assessed and addressed in intervention.
Researchers found some evidence that difficulties with fine motor skills, visual motor integration, and balance skills persist in people who have been prenatally exposed to alcohol. However, most studies did not focus on adolescent or adult participants in isolation, making it difficult to generalize results. It was concluded that a review of functional difficulties in each individual would be required to determine if a motor assessment is warranted.

This paper provides an overview of fetal alcohol spectrum disorder and discusses the role of caseload midwifery as part of a multi-level prevention approach.

This was a retrospective cohort study of women that delivered an infant with an isolated major CHD between January 2010 and April 2017 at a major Australian perinatal centre. The study cohort was compared with a cohort of women with infants without CHD. Cardiac abnormalities were broadly subdivided into the following five categories using the International Classification of Diseases Tenth Revision (ICD-10) as a guide – transposition of the great arteries (TGA), septal defects, right heart lesions (RHL), left heart lesions (LHL), and “other”. Demographic characteristics and obstetric, intrapartum, and perinatal outcomes were compared between the two cohorts.

The objective of this study was to explore the differences in baseline respiratory sinus arrhythmia (RSA) between children with fetal alcohol spectrum disorder (FASD) and typically developing children (TDC) and to investigate whether children with FASD have the capacity to engage in a brief mindfulness exercise.

Prenatal alcohol exposure (PAE) is often linked to significant challenges in self-regulation. Interventions aimed at improving self-regulation in this population have been developed, but further progress could be achieved through the application of a multilevel theoretical framework that describes the development of self-regulation in early childhood. This framework could clarify the mechanisms underlying early adjustment problems in children with PAE and guide the creation of more targeted assessments and interventions. This review aims to: (1) provide an overview of the self-regulatory framework proposed by Calkins and colleagues, (2) examine common self-regulatory difficulties in children with PAE during infancy and early childhood within this developmental context, and (3) explore how the framework can enhance future assessment and intervention efforts for young children affected by PAE. Applying this developmental framework offers a systematic and theory-based approach to improving outcomes for young children with PAE.

This study aims to establish the current knowledge, attitudes, experiences and practices regarding FASD and other neurodevelopmental impairments among youth custodial officers in order to develop training resources for this workforce.

Prenatal alcohol exposure leads to cognitive, behavioral, and neurological deficits in offspring, highlighting the urgent need for effective treatments. Maternal choline supplementation has emerged as a potential intervention. This review examined preclinical and clinical studies on choline supplementation in cases of fetal alcohol exposure to assess its effectiveness. A systematic search of six electronic databases identified 22 relevant studies (including randomized controlled trials, prospective cohort studies, and preclinical research). Choline’s success in preventing deficits varied depending on the timing of intervention relative to alcohol exposure. While preclinical studies showed significant improvements across various outcomes, only one clinical study demonstrated benefits in infants’ information processing. The findings suggest that choline supplementation may help mitigate deficits caused by prenatal alcohol exposure, particularly in preclinical models. However, further clinical trials are needed to evaluate its broader effectiveness in children.

In the 2009 National Health and Medical Research Council (NHMRC) Australian Guidelines to Reduce Health Risks from Drinking, a guideline specific to lactating women was included. For the first time the effect of alcohol at this important developmental stage was nationally and internationally acknowledged. To determine the degree to which maternal health practitioners adopted an Australian national policy guideline (Guideline 4B) on alcohol and breastfeeding into their everyday health practice and the factors associated with adoption. A convenience sample of participants completed an online survey based on the Nursing Practice Questionnaire (NPQ) to elicit measures of knowledge, awareness and practice implementation.

A new Commonwealth FASD Strategy (2018–2028) is being developed and the Australian Government has announced significant funding for the expansion of FASD prevention, diagnostic and intervention services around Australia. Therefore, it is timely to consider what the current state of affairs regarding FASD in Australia is and describe areas for future research and service delivery. This review was published in 2020

Fetal alcohol spectrum disorder (FASD) encompasses a range of difficulties caused by prenatal alcohol exposure. It is a significant but under-recognized and under-diagnosed public health issue in Australia. With the development of a new Commonwealth FASD Strategy (2018–2028) and substantial government funding for prevention, diagnosis, and intervention, it is crucial to review the current state of FASD in Australia and identify areas for future research and service improvements.

The aim of this study is to examine the effectiveness, cost and cost-effectiveness of a multi-strategy practice change intervention in increasing antenatal care addressing the consumption of alcohol by pregnant women.

Gilbert + Tobin aims to prompt governments to develop a more inclusive definition of cognitive impairment (including FASD) for use in law and policy. The policy document was launched by Ms June Oscar AO Aboriginal and Torres Strait Islander Social Justice Commissioner and Chief Justice Wayne Martin AC.

The National Guide is a practical resource intended for all health professionals delivering primary healthcare to Aboriginal and/or Torres Strait Islander people. Its purpose is to provide GPs and other health professionals with an accessible, user-friendly guide to best practice preventive healthcare for Aboriginal and Torres Strait Islander patients.

This policy issues brief outlines the key issues contributing to high rates of alcohol use in pregnancy. It also reviews current policies related to alcohol consumption in pregnancy and FASD. It provides policy and practise recommendations to prevent alcohol consumption in pregnancy.

Fetal alcohol spectrum disorder (FASD) is a major public health issue in Australia, often underdiagnosed and costly. It results from prenatal alcohol exposure and can lead to broad brain injury, but its prevalence in the general population remains unclear. In high-risk groups, Australian studies have found some of the highest FASD rates globally. A common misconception is that a child must have distinct facial features to be diagnosed with FASD; however, these features are present in only a minority of cases. FASD should be viewed as a ‘whole body’ disorder, as it is linked to increased health risks later in life. Clinicians may avoid diagnosing FASD due to stigma concerns, though evidence does not support this. The Australian Guide to the Diagnosis of FASD can help health professionals provide accurate diagnoses, leading to better outcomes through evidence-based interventions and prevention.

Fetal alcohol spectrum disorder (FASD) is a preventable neurodevelopmental disorder caused by prenatal alcohol exposure, significantly affecting Indigenous communities worldwide. Despite numerous prevention interventions, their effectiveness has not been thoroughly evaluated. This systematic review updates the evidence on FASD prevention in Indigenous populations globally, including North America and New Zealand, and provides recommendations for future research.

This study examined the language skills of 98 young people sentenced to detention in Western Australia (WA), who participated in a cross-sectional study examining the prevalence of FASD. Language skills assessed using standardised and non-standardised tasks were analysed by the three major language groups identified: speakers of SAE, Aboriginal English and English as an additional language.

Prenatal alcohol exposure (PAE) can lead to permanent disabilities, including physical, neurodevelopmental, and cognitive impairments, collectively known as fetal alcohol spectrum disorder (FASD). Individuals with FASD are at higher risk of legal issues, including detention. A FASD prevalence study in Western Australia included young people sentenced to detention. Diagnosing FASD requires a multidisciplinary assessment and confirmation of maternal alcohol consumption during pregnancy, which posed significant challenges in accurately assessing PAE for study participants.

The Western Australian Alcohol and Drug Interagency Strategy 2018-2022 provides a guide for government and non-government organisations as well as the wider community to prevent and reduce the adverse impacts of alcohol and other drug use in Western Australia. It references FASD.

We used a systematic review approach to locate all clinical and preclinical studies across a broad range of health outcomes in offspring exposed to prenatal alcohol. Our search encompassed four databases (PubMed, CINAHL, EMBASE and Web of Science) and titles/abstracts from retrieved studies were screened against strict inclusion/exclusion criteria. Published in 2019

Prenatal exposure to alcohol has adverse ramifications on foetal development resulting in developmental abnormalities and major congenital anomalies. Experimental studies have documented effects on kidney structure and function among offspring exposed to alcohol during foetal life; however, human evidence is scarce. The study aimed to determine the development of CKD among a cohort of 30-year-old Australian offspring whose mothers reported consumption of alcohol during pregnancy. The study sample comprised 1626 offspring of the Australia cohort study (MUSP) whose serum creatinine was assessed at 30 years of age and CKD was categorized from stage 1 to stage 5 based on their level of eGFR following the CKD-EPI definition.

The consent and community engagement process for research with Indigenous communities is rarely evaluated. Research protocols are not always collaborative, inclusive or culturally respectful. If participants do not trust or understand the research, selection bias may occur in recruitment, affecting study results potentially denying participants the opportunity to provide more knowledge and greater understanding about their community. Poorly informed consent can also harm the individual participant and the community as a whole.

The purpose of this paper is to report on the feasibility and acceptability of the research protocol for a collaborative cross-generation health study in the community and test recruitment and outcome measures for the main study. This feasibility study included pregnant women who were intending to give birth in the Illawarra-Shoalhaven region in Eastern Australia. The area includes a large, regional referral hospital, with capacity to treat specialist and complex cases. Pregnant women were asked to participate in five data collection waves beginning at 22 weeks gestation and ending with a 6-month post-partum appointment. Recruitment was then extended, via the pregnant women, to also include fathers and maternal grandmothers.

To explore and interpret the messages women receive during their first antenatal care visit, relating to alcohol consumption.

The combined behaviours of alcohol consumption and ineffective or non-use of contraception could place sexually active individuals of reproductive age at risk of unintended alcohol-exposed pregnancy. The first aim of this study published in 2019 was to assess levels of contraceptive use in a sample of university students who reported using alcohol. The second aim was to assess knowledge of contraception, reproduction, risks of alcohol use while pregnant, and attitudes regarding contraception compared with reported contraceptive use behaviour.

The current study published in 2019 characterises the impact on blastocyst, uterine and placental outcomes in a rat model of periconceptional alcohol exposure, in which 12.5% ethanol is administered in a liquid diet from 4 days before until 4 days after conception.

The purpose of this study published in 2019 was to evaluate the available evidence on the association between low-to-moderate prenatal alcohol exposure (PAE) and the development of attention-deficit hyperactivity disorder (ADHD) symptoms in the offspring.

Globally, the public health recommendation for exclusive breastfeeding to the first 6 months of life is not being achieved by many low- and middle-income countries. Many factors have been determined to affect the early cessation of breastfeeding; however, little attention has been paid to the role of alcohol, an increasingly favoured commodity, particularly in these Westernised nations. Maternal healthcare practitioners play a pivotal role in a woman’s breastfeeding journey by providing timely advice that can help support continued breastfeeding. Maternal healthcare practitioners (MHP) from across Australia were invited to take part in a semi-structured telephone interview (n = 19) to elicit their knowledge of a national alcohol policy guideline on alcohol and breastfeeding, their confidence to provide information on this topic, and if they were routinely incorporating conversations on alcohol and breastfeeding into their practice. The results affirmed that the majority of MHP were not aware of the national policy providing direction for safely consuming alcohol during lactation and were not incorporating this information into their practice. This study suggests having a national policy guideline for safe alcohol consumption during lactation has not promoted awareness of this topic among MHP as a potential strategy to support long-term breastfeeding duration.

This invited “Comment” piece in 2019 accompanied a landmark paper by Cook and colleagues (Alcohol Clin Exp Res. 2019 Aug;43(8):1727-1733. doi: 10.1111/acer.14121) which was the first study to demonstrate an association between hypertension and children and adolescents with a FASD. The authors highlight that although animals studies had demonstrated an association between prenatal alcohol exposure and high blood pressure, similar data was lacking in cohorts of people with a FASD diagnosis.

To be included in this review published in 2019, the study must use a structured psychological intervention that aims to improve or change EF in children using either (a) a face‐to‐face format, (b) computerized format, or (c) both. Interventions must be delivered using (a) individual or (b) group format. Finally, interventions will be considered eligible if they are administered either (a) directly to children (e.g., working memory training) or (b) to children and caregivers/families.

Thestudy aimed to explore the lived experiences of Australian caregivers who received a FASD diagnosis for a child in their care, usingthe Australian Guide to the Diagnosis of FASD.

The article underscores the potential of telehealth to bridge gaps in healthcare access for rural and remote populations, highlighting both its benefits and limitations.

This study addresses the limited understanding of the challenges faced by non-custodial youth detention center staff in supporting young people with foetal alcohol spectrum disorder (FASD). A qualitative inquiry was conducted to explore and describe the perspectives of non-custodial staff regarding the value of an FASD prevalence study. Data were gathered through semi-structured interviews and focus groups and analyzed using thematic network analysis. While staff expressed few concerns about the prevalence study itself or its impact on participating youth, several barriers were identified related to the study’s processes, as well as practices and culture within their workplace. These barriers hindered the ability to fully benefit from the research and its findings.

Understanding professionals’ views and needs can help advance service provision and improve future training opportunities, Therefore, the current study examined the experiences of Australian and New Zealand professionals who have attended fetal alcohol spectrum disorder (FASD)-specific training and the impact of this training on their current practices. A total of 52 health and education professionals from Australia and New Zealand completed an online survey that asked about their training experiences; changes in practice following training; their experiences implementing assessments in their workplace; and, for Australian professionals, their experiences of using the recently released Australian Guide to FASD diagnosis.

Fetal alcohol spectrum disorder (FASD) is a common neurodevelopmental condition. Given that individuals with FASD can experience lifelong challenges, one field of research that could be applicable is the paediatric chronic health literature. The aim of the study was to investigate the utility of the Pediatric Quality of Life Inventory (PedsQL) Family Impact Module, designed to measure the impact of paediatric chronic health conditions on caregivers and families. 109 caregivers of children with FASD completed an online survey that assessed a range of areas including, caregiver and family quality of life, caregiver mental health and child behaviour.

The study underscores the importance of using advanced imaging techniques to improve management and outcomes in pregnancies complicated by suspected growth issues.

Information on alcohol consumption in relation to fertility, pregnancy, and breastfeeding was extracted from the websites of 23 alcohol industry-funded bodies (e.g., Drinkaware [United Kingdom] and DrinkWise [Australia]), and 19 public health organizations (e.g., Health.gov and NHS Choices). Comparative qualitative and quantitative analysis of the framing and completeness of this information was undertaken.

Fetal alcohol spectrum disorder (FASD) is a highly prevalent neurodevelopmental disorder associated with prenatal alcohol exposure. Early identification can improve functioning for individuals and reduce costs to society. Gold standard methods of diagnosing FASD rely on specialists to deliver intensive, multidisciplinary assessments. While comprehensive, prevalence rates highlight that this assessment model cannot meet demand, nor is it feasible in remote areas where specialist services are lacking. This project aims to expand the capabilities of remote practitioners in north Queensland, Australia, where 23–94% of the community identify as First Nations people. Integrating cultural protocols with the implementation science theories of Knowledge-To-Action, Experience-Based Co-Design, and RE-AIM, remote practitioners with varying levels of experience will be trained in a co-designed, culturally appropriate, tiered neurodevelopmental assessment process that considers FASD as a potential outcome. This innovative assessment process can be shared between primary and tertiary health care settings, improving access to services for children and families. This project aims to demonstrate that neurodevelopmental assessments can be integrated seamlessly with established community practices and sustained through evidence-based workforce development strategies.

Studies in north-western Australia Aboriginal communities identified executive functioning and behavioural regulation as significant issues for children. Exposure to alcohol prenatally and adverse childhood experiences are known risk factors for impaired self-regulation and executive function, these risk factors being present in remote communities. In response, a partnership was initiated to trial a teacher-delivered self-regulation intervention based on the Alert Program®. While student outcomes were assessed, this paper describes the implementation and impact of the intervention on teachers through the five dimensions of the RE-AIM framework (Reach, Efficacy, Adoption, Implementation, Maintenance). Trained classroom teachers (n = 29) delivered eight Alert Program® lessons to students over 8- weeks. Impact and implementation outcomes were assessed through teacher training and student lesson attendance data, and pre-training and post-intervention teacher questionnaires. Data were analysed using paired-samples t-tests and descriptive statistics. Eighty-one to 100% of prescribed lessons were implemented and teacher understanding of self-regulation and the Alert Program® improved significantly following the intervention (n = 14, p ≤ .001). Most teachers (88%) reported changing their teaching and behaviour management practices because of the intervention and agreed there were benefits in teaching the Alert Program® to students in a region with high reported rates of foetal alcohol spectrum disorder and self-regulation impairment.

The purpose of this study published in 2019 was to undertake a comprehensive review to identify all the available pre-clinical and clinical literature investigating cardiovascular and renal outcomes in offspring with prenatal alcohol exposure.

The population-based (Lililwan) study of fetal alcohol spectrum disorder (FASD) revealed a high prevalence of FASD in the remote communities of the Fitzroy Valley, Western Australia (WA) and confirmed anecdotal reports from families and teachers that challenging child behaviours were a significant concern. In response, Marninwarntikura Women’s Resource Centre initiated a partnership with researchers from The University of Sydney to bring the positive parenting program (Triple P) to the Valley. Triple P has been effective in increasing parenting skills and confidence, and improving child behaviour in various Indigenous communities.

This study published in 2019 examined the effect of an acute but moderate prenatal alcohol exposure (PAE) on glucose metabolism, lipid levels and dietary preference in adolescent and/or adult rat offspring.

Foetal alcohol spectrum disorder (FASD) is a neurodevelopmental impairment that may result in individuals experiencing poor development, cognitive issues and disruptive behaviours. In Australia, the prevalence of FASD is unknown; however, two studies have revealed the prevalence of FASD in high risk populations in Western Australia. Individuals with FASD may experience higher rates of negative outcomes including poor school performance, involvement with the justice system and incarceration, substance use and are at risk of being placed in out-of-home care. Caregivers of children with FASD can experience challenges and high levels of stress due to the disruptive behaviours displayed by many children diagnosed with FASD. Whilst experiences of caregivers raising children with FASD have been documented globally, little is known about the experiences of caregivers in a remote Australian context, particularly from an Australian Aboriginal perspective. This study aimed to investigate the experiences of caregivers in a remote Australian context. The findings will be valuable to inform programs at the family, community and broader policy levels that can help enhance children’s development and wellbeing.

This study explores the association between prospectively substantiated child maltreatment and problem alcohol use in adulthood, addressing a gap in research that predominantly relies on retrospective data. Using a prospective cohort record linkage correlational design, data from a statutory child protection agency were linked with a birth cohort from a major metropolitan maternity hospital, as part of the Mater-University of Queensland Study of Pregnancy in Brisbane, Australia.

This work published in 2019 aimed to identify and map child health services in the very remote Fitzroy Valley, West Kimberley, and document barriers to effective service delivery.

Despite a national focus on closing the gap between Aboriginal and non-Aboriginal child health outcomes in Australia, there remain significant challenges, including provision of health services in very remote communities. The study aimed to identify and map child health services in the very remote Fitzroy Valley, West Kimberley, and document barriers to effective service delivery.

Given that most women who drink alcohol cease consumption upon pregnancy recognition, we aimed to investigate the effect of alcohol around the time of conception on offspring renal development and function. This study was published in 2019

Undertaking research with young people presents an array of methodological challenges. The study report the findings from a qualitative study that took place alongside a fetal alcohol spectrum disorder (FASD) prevalence study among detainees in Australia. Of 38 participants, 27 were Aboriginal youth. Interviews were conducted using “social yarning” and “research topic yarning,” an Indigenous research method which allows for data collection in an exploratory, culturally safe way. A complex interplay emerged between social yarning and research topic yarning which provided a space to explore responsively with participants their experiences of FASD assessments. Flexibility, including language adaptation and visual descriptions about assessments, was utilized to assist participants recall and retell their experiences. There were, however, challenges in gathering data on the assessment experiences of some participants. The study describe how employing a “yarning” method for collecting data could benefit children and young people undergoing neurodevelopmental assessments in the future.

Alcohol consumption during pregnancy carries known risks to the foetus in the form of foetal alcohol spectrum disorder (FASD). One of the interventions for the prevention of FASD is the application of warning labels to packaged alcoholic beverages. Between 2011 and 2018, the Australian Government allowed the alcohol organisation, DrinkWise, to operate an industry self-regulatory scheme to provide alcohol producers with prototype warnings about drinking during pregnancy. In 2018, the government announced that it would be mandating alcohol and pregnancy warnings through Food Standards Australia New Zealand. This section argues that a proper appraisal of the DrinkWise Labelling Scheme at the outset would have demonstrated its inherent regulatory incapacity to operate as an effective health information policy. The DrinkWise Labelling Scheme is missing two essential elements of functional industry self-regulation: a strong normative framework and mechanisms for norm creation, implementation and enforcement.

Screening pregnant women for substance use is highly recommended in antenatal care settings. Although midwives provide routine screening for substance use and referral for treatment in pregnancy, little is known about the barriers and facilitators they experience. The study explored barriers and facilitators experienced by midwives in antenatal settings to screening and referral of pregnant women who use alcohol or other drugs.

PhD Thesis Doctor of Philosophy University of Otago

Preconception is a critical time for the establishment of healthy lifestyle behaviours and psychological well-being to reduce adverse maternal and offspring outcomes. This study aimed to explore relationships between preconception lifestyle and psychological factors and prospectively assessed short- (currently trying to conceive) and long-term (future parenthood aspirations) pregnancy intentions. Data from Wave 3 (age 25-30 years; n = 7656) and Wave 5 (age 31-36 years; n = 4735) from the Australian Longitudinal Study of Women’s Health were used. Pregnancy intentions and parenthood aspirations were evaluated. Logistic regressions explored cross-sectional associations between demographic, lifestyle and psychological factors and pregnancy intentions/parenthood aspirations.

Young people who were sentenced to detention participated in a FASD prevalence study in Western Australia. The diagnosis of FASD requires a multidisciplinary assessment and confirmation of maternal alcohol consumption during pregnancy. Obtaining accurate assessment of PAE for young people participating in the study was challenging.

The aims of the current study published in 2020 were to: (i) report on the diagnostic profile of a group of children assessed for FASD (FASD) using the Australian Guide to the Diagnosis of FASD; and (ii) to provide information and recommendations for paediatricians and/or multidisciplinary teams conducting FASD assessments, including utilising the Australian Guide to the Diagnosis of FASD, and details of how to do FASD assessment.

This 2020 article focuses on the hope, relationships and educational experiences of 38 detained youth in Western Australia. The study uses a ‘social yarning’ approach.

In this work published in 2020, the effects of moderate ethanol exposure throughout pregnancy on kidney development were examined using a rat model. Rats were fed a liquid diet containing 6% ethanol (vol/vol) or control (0% ethanol) throughout pregnancy.

The aim of this study published in 2020 was to gauge the planned preconception health behaviours and attitudes towards being asked about pregnancy intention by a general practitioner (GP) among people of reproductive age in Australia.

This 2020 article outlines how individuals with FASD may experience inequalities with the justice system. It focuses on why assessment, diagnosis and intervention is important and the role of health and justice professionals in promoting more equitable outcomes for individuals with FASD involved with the justice system.

This 2019 report presents initial findings on the mental health of 465 justice-involved young people.

The aim of this study published in 2020 was to gauge the planned preconception health behaviours and attitudes towards being asked about pregnancy intention by a general practitioner (GP) among people of reproductive age in Australia.

The objective of this study published in 2020 was to investigate the relationship between maternal alcohol-use disorder and multiple biological and social child outcomes, including birth outcomes, child protection, justice contact, and academic outcomes for both Indigenous and non-Indigenous children.

The aim of this study published in 2020 was to review the impact of prenatal alcohol exposure on the outcomes of the mother and child.

This report published in 2020 outlines the development of the digital online Getting on with it (GOWI) pilot between NOFASD and Dr Anita Gibbs over the course of 2019, and includes a combined evaluation report of an internal brief survey as well as an external telephone-based evaluation undertaken in early 2020 by an independent, external contractor

This study published in 2020 examined whether drinking or smoking while breastfeeding was associated with reductions in Australian National Assessment Program-Literacy and Numeracy assessments. Data was sourced from The Growing Up in Australia Study. This is an ongoing longitudinal study of 5107 infants and mothers recruited in 2004 and followed over time every two years.

A critical review of existing research was conducted in 2020 using a critical interpretive synthesis approach. Results revealed that whilst many studies discussed impacts at the body functions and structures level of children with FASD, they often did not consider the activity, participation, and environmental factors also contributing to the daily functioning of this population. Several studies discussed caregiver experiences and challenges raising a child with FASD; however, no studies investigated the lived experiences relating to impacts across activities and environments from children’s perspectives. In addition, the focus on deficits overshadowed investigation into the strengths of children with FASD, leaving a gap in the picture of their daily lives.

Despite women’s awareness that drinking alcohol in pregnancy can lead to lifelong disabilities in a child, it appears that an awareness alone does not discourage some pregnant women from drinking. To explore influences on pregnant women’s choices around alcohol use, we conducted interviews and group discussions with 14 Indigenous Australian and 14 non-Indigenous pregnant women attending antenatal care in a range of socioeconomic settings. This article was published in 2020

The aim of this study published in 2020 was to describe the demographic and neurocognitive profile of the first 199 individuals diagnosed with FASD in PATCHES Paediatrics clinics.

In the present study, we conducted a preliminary investigation to examine facial morphology in autistic children with and without prenatal alcohol exposure. This was published in 2020

This 2020 article describes the process of mapping referral pathways to develop a localised resource to enhance the journey to diagnosis, treatment and support for FASD (FASD) in a regional community setting.

While FASD (FASD) has primarily been thought of as a neurodevelopmental condition, research is beginning to highlight its ‘whole-body’ implications. Accordingly, the current study published in 2020 sought to provide a snapshot of potential health issues.

This study published in 2020 explores the cognitive and behavioural difficulties and impairments experience by children with FASD aged between four and 12 years from the perspective of caregivers.

The aim of this study was to evaluate a co-design method used to design an online education package about inclusive education for children with disability in mainstream schools. The study design was a multiple methods evaluation informed by participatory and transformative research paradigms, incorporating design sciences and public service approaches.

The current study published in 2020 utilised a moderate, episodic exposure model in rats to mimic ‘special occasion’ drinking, which is reported to be common during pregnancy. Our objective was to examine the consequences of this prenatal alcohol exposure on reproductive parameters in female offspring.

The purpose of this study published in 2019 was to understand the experiences and contextual factors that influence the ability of midwives to provide appropriate support to women regarding alcohol and other drug (AOD)e use during pregnancy, in the Queensland context

Published in 2020 this article reports on a cross‐sectional survey of Australian women in preconception, stratified by pregnancy planning stage (active planners (currently trying to conceive) vs. non‐active planners (pregnancy planned within 1–5 years)), assessed health behaviours and their alignment to preconception guidelines.

This review published in 2020 will discuss the evidence that indicates low-dose and early prenatal alcohol exposure can increase the risk of mental illness in offspring and discuss the mechanistic pathways that may be involved.

Researchers partnered with the local Aboriginal health organization and schools to develop and pilot a manualized version of the Alert Program® in the Fitzroy Valley, north Western Australia, a region with documented high rates of FASD and early life trauma. Published in 2020

In a study of 39 children with FASD and 29 comparison children published in 2020, we found that social cognition (specifically recognizing emotions) was the only significant independent predictor of teacher-rated adaptive functioning even after including IQ, executive functioning, and adverse childhood experiences into the model. In this current study, Māori (Indigenous people of Aotearoa New Zealand) were overrepresented; therefore, the research was supported by a strong partnership with Te Wāhanga Hauora Māori (Māori Health Service). Aotearoa New Zealand’s colonized history is recognized and findings are discussed with regard to both the psychological literature and a Te Ao Māori worldview.

The aim of this study published in 2020 was to explore experiences of caregivers of children, adolescents and young adults diagnosed with FASD. More specifically, we examined the relationship between shame, guilt, pride, self compassion and caregiver psychological distress. It was hypothesised that shame, guilt, pride and self-compassion would be uniquely associated with caregiver psychological distress.We also examined differences between biological and non-biological caregivers on these variables. It was hypothesised that relative to non-biological caregivers, biological parents would (i) report significantly higher levels of psychological distress, guilt and shame and (ii) report significantly lower self-compassion scores.

This study published in 2020 reports on a reduction in reported prenatal alcohol exposure in an Aboriginal community setting during a period of prevention activities and provides initial evidence for a community‐led strategy that might be applicable to similar communities

Sleep problems are a common clinically reported area of concern for children and adolescents with FASD (FASD). However, limited empirical research has been undertaken investigating sleep problems for children with FASD. The current study published in 2020 aimed to examine the associations between parent-reported sleep problems in children with FASD and child behaviour, caregiver mental health and health-related quality of life and family functioning.

This article discusses the importance of introducing mandatory alcohol pregnancy warning labels in Australia and New Zealand.

This paper published in 2020 analyses the content of news media messages on drinking during pregnancy in Australia over an 18-year period to understand whether and how the nature of messages communicated to women has changed over time.

The aim of this study published in 2020 was to asses public support for a range of recommended alcohol control initiatives across seven countries with varying sociocultural profiles.

Maternal behaviours in pregnancy associated with adverse pregnancy, birth and health outcomes include tobacco smoking, poor nutrition, alcohol consumption and low physical activity, collectively referred to as the SNAP risk factors. In this study published in 2020 seven electronic databases were searched for studies that examined the effect of interventions addressing multiple SNAP behaviours.

This study published in 2020 describes the conception, implementation and evaluation of a training intervention aiming to upskill the custodial workforce in the management of youth with FASD and NDI; 117 staff participated in the intervention, and 109 completed pre- and post-intervention surveys. Improvements were seen across almost all knowledge and attitude items, and the intervention was considered highly necessary, appropriate and valuable by the workforce.

The Australian Paediatric Surveillance Unit (APSU) has been prospectively collecting national data on rare childhood conditions since 1993, with monthly reporting of cases by paediatricians. In this report we describe annual results from studies for ten communicable diseases and complications of communicable diseases that were conducted using APSU surveillance in 2019 and place these in an historic context.

Exposure to alcohol prenatally and adverse childhood experiences are known risk factors for impaired self-regulation and executive function, these risk factors being present in remote communities. In response, a partnership was initiated to trial a teacher-delivered self-regulation intervention based on the Alert Program®. While student outcomes were assessed, this paper published in 2020 describes the implementation and impact of the intervention on teachers through the five dimensions of the RE-AIM framework (Reach, Efficacy, Adoption, Implementation, Maintenance).

Article by Dr Nicki Jackson, Executive Director Alcohol Healthwatch on the decades it can take for collective advocacy efforts to achieve success in getting effective policies and interventions over the line.

Antenatal clinical practice guidelines recommend routine assessment of women’s alcohol consumption during pregnancy. The delivery of advice and referral when necessary are also recommended. However, evidence suggests there are barriers to the uptake of best care guidelines. Effective, cost-effective and affordable implementation strategies are needed to ensure the intended benefit of guidelines are realized through addressing identified barriers. This paper published in 2020 describes the protocol for evaluating the efficiency and affordability of a practice change intervention compared to usual practice in an implementation trial.

This annotated 2019-2020 bibliography has been curated by members of the University of Queensland Programming in Developmental Disease Research Group

Young people with FASD (FASD) in Aotearoa New Zealand are both primed for, and hindered within the youth justice (YJ) system. This research published in 2020 provides a fresh perspective on how social workers can take a lead role in ensuring young people with FASD receive neurodevelopmentally appropriate interventions both within the YJ system and upon return to their communities.

A letter published in 2020 on the profound effect alcohol has had on her paediatric practice.

Our primary objective of this work published in 2020 was to formally identify the views of people living with FASD, their parents/caregivers, service providers and the general public on the research priorities for FASD and alcohol use on pregnancy in Australia. Our secondary objective was to provide an overview of current research in the highest priority areas identified.

The objective of this study published in 2020 was to test the associations between maternal prenatal alcohol and tobacco exposures and depressive symptoms in the offspring, adjusting for a wide range of potential confounders.

This study published in 2020 interviewed 26 staff from 18 organizations involved in referral and co-ordination, case management, or treatment and support services for women with (or at high risk of) PAE in the Greater Newcastle region in Australia.

The study published in 2020 identified where Australian women obtained information about alcohol during pregnancy, their preferred sources of information, and their perceptions of the role of health professionals in providing information.

Data from the birth cohort of the Longitudinal Study of Australian Children (LSAC) was used. Mothers of 3447 children provided information on alcohol consumption during pregnancy, children’s sleep problems from 2- to 9-years, and potential confounders associated with sleep problems. Children were classified into Prenatal Exposure (PAE) groups based on distinct patterns of maternal drinking during pregnancy: abstinent, occasional, low, moderate, and heavy. The effect of PAE on the number and persistence of sleep problems across childhood (2-9 years) was examined. The outcomes of this study were published in 2021.

The alcohol guideline 3: women who are pregnant or breastfeeding, makes direct reference to FASD. It recommends not drinking alcohol is the safest for women who are pregnant, planning a pregnancy or breastfeeding. The report was published by the National Health and Medical Research Council (NHMRC).

This book reflects multidisciplinary and cross-jurisdictional analysis of issues surrounding FASDs (FASD) and the criminal justice system, and the impact on Aboriginal children, young people, and their families

We used data from the Raine Study, a multi-generational birth cohort study, to examine the association between prenatal alcohol exposure and the risk of harmful alcohol use in offspring at the age of 17 years. This study was published in 2020.

Eighty-seven participants attended a workshop to support community-based professional development and co-design of a novel assessment approach. Qualitative data collection included video recording of the workshop, and small group discussions, for which a narrative analysis was utilised. Quantitative data collection included self-report questionnaires to understand current community practices and three key constructs: practitioner knowledge, attitudes, and intentions for future practice. The outcomes of this study were published in 2021.

Noncommunicable chronic disease underlies much of the life expectancy gap experienced by Aboriginal and Torres Strait Islander people. Modifying contributing risk factors; tobacco smoking, nutrition, alcohol consumption, physical activity, social and emotional wellbeing (SNAPS) could help close this disease gap. This scoping review published in 2021 identified and describes SNAPS health promotion programs implemented for Aboriginal and Torres Strait Islander people in Australia.

The aim of this study published in 2021 was to explore associations between lifestyle/psychological factors and long-term pregnancy intentions in women who go on to become pregnant. Data from the cohort born 1973-1978 from the Australian Longitudinal Study of Women’s Health were utilised. Women were included if they had a new pregnancy occurring between Waves 3 and 5, resulting in 2203 women for analysis.

The objective of this study published in 2021 was to characterise early motor function in children later diagnosed with neurodevelopmental disorders relative to typically developing children or normative data.

Aboriginal leaders invited us to examine the frequency and reasons for emergency department presentations by children in remote Western Australia, where Prenatal Alcohol Exposure is common. Published in 2021

Theoretical perspectives and empirical evidence suggest that maternal bonding and negative affect play a role in supporting infant social-emotional development. However, the complex pathways likely to exist between these constructs remain unclear, with limited research examining the temporal and potentially bi-directional associations between maternal bonding and negative affect across pregnancy and infancy.

To determine whether social networking site posts can be used as a source of feedback during public consultation for guidelines, the authors aimed to collect posts on social networking sites (Twitter and Reddit) related to the Australian alcohol guidelines. They aimed to identify: (i) which guideline recommendations the public were interested in (and discussed most), (ii) whether social networking site posts provides feedback that could be used for public consultation for guidelines, and (iii) any misinterpretations. The outcomes of this study were published in 2021.

The aim of this research published in 2021 was to determine the unmet workforce development needs of a regional workforce providing care and support to youth involved with the justice system. Interviews were conducted with 29 participants from 14 organisations to understand the support provided to youth, existence and uptake of referral pathways, and unmet needs.

In September 2019, an inquiry was referred to the Senate Community Affairs References Committee into effective approaches to prevention and diagnosis of FASD and strategies for optimising life outcomes for people living with FASD.

The final outcomes of the senate inquiry were released in March 2021.

The preconception period provides a significant opportunity to engage women in healthy behaviour change for improved maternal and child health outcomes. However, there is limited research exploring women’s pregnancy planning in Australia. This study published in 2021 investigated associations between pregnancy planning, socio-demographics and preconception health behaviours in Australian women. A retrospective cross-sectional survey of pregnant women >=18-years-of-age recruited through a Victorian public maternity service and a national private health insurer.

In this study, we examined macrostructure and microstructure elements in the oral and written narrative texts of 24 adolescent students of a youth detention centre. The students, who were aged 14- to 17- years, were all speakers of Standard Australian English, and 11 (46%) students met criteria for language disorder (LD). The outcomes of this study were published in 2021.

This systematic review of qualitative studies involving pregnant and recently postpartum women seeks to understand the barriers and facilitators that influence alcohol use in pregnancy. Social relationships and norms, stigma, trauma and other stressors, alcohol information and messaging, and access to trusted equitable care and essential resources were identified as themes that impact women’s alcohol use, abstention and reduction.

Understanding the factors that contribute to women’s alcohol use in pregnancy is critical to supporting women’s health and wellness and preventing FASD. A systematic review of qualitative studies involving pregnant and recently postpartum women was undertaken to understand the barriers and facilitators that influence alcohol use in pregnancy. The review was published in 2021.

This research investigated the communication skills of adolescents in youth detention in Western Australia, a context in which FASD is highly prevalent and Aboriginal young peoples are over-represented.

Many children affected by FASD exhibit neurocognitive delays that contribute to secondary consequences, including a disrupted school experience. Educators often have limited knowledge or experience in the identification, referral, management and accommodation of students with FASD. Effective resources and tools for educators are crucial to ensure these students are supported in their ongoing learning, development and school participation. This scoping review published in 2021 aims to identify and evaluate resources for educators that aid in the identification, management, or accommodation of students with FASD.

The objective of this study published in 2021 was to examine pre- to postnatal changes in drinking for women and men and assess the role of education level in these changes.

We conducted a systematic review to synthesize evidence regarding oral and written communication skills of adolescents with PAE or FASD and how they compare with those with no PAE. This study was published in 2021.

The current clinical study published in 2021 examined the association between heavy PAE and indirect measures of adiposity in adolescence.

This study published in 2021 aimed to systematically review screening and assessment approaches and therapeutic interventions for young people with neurodevelopmental disorders in the youth justice system.

Abuse of methamphetamine (METH), an illicit psychostimulant, is a growing public health issue. METH abuse during pregnancy is on the rise due to its stimulant, anorectic, and hallucinogenic properties. METH can lead to multiple organ toxicity in adults, including neurotoxicity, cardiovascular toxicity, and hepatotoxicity. It can also cross the placental barrier and have long-lasting effects on the fetus. This review summarizes neurotoxicity, cardiovascular toxicity, hepatotoxicity, toxicity in other organs, and biomonitoring of prenatal METH exposure, as well as the possible emergence of sensitization associated with METH. The study proposed the importance of gut microbiota in studying prenatal METH exposure. There is rising evidence of the adverse effects of METH exposure during pregnancy, which are of significant concern.

This study published in 2021 examines the associations of substance use disorders in pregnancy with a set of neonatal outcomes. Three linked datasets of a 10-year period (2007-2016) from New South Wales, Australia, were examined.
Pregnant women were identified positive for substance use disorders when at least one hospital admission during pregnancy or delivery had opioid, or cannabis, or stimulant, or alcohol or two or more of the four substance groups related ICD-10-AM diagnostic code.

This systematic literature published in 2021 review aims to identify demographic, health and psycho-social variables associated with alcohol consumption during pregnancy which may lead to FASD.

This study published in 2021 investigates the associations between maternal health and health-related behaviours (nutrition, physical activity, alcohol consumption and smoking) both during pregnancy and up to 15 months from childbirth and children’s health outcomes during infancy and adolescence (general health, presence of a chronic illness, and physical health outcome index)

The affectional bond experienced by a mother toward her developing fetus/infant has been theorized to be a critical factor in determining infant developmental outcomes; yet there remains a paucity of research in this area, and a lack of high-quality longitudinal studies. This study aimed to examine the extent to which mother-to-infant bonding predicted infant development in a multi-wave longitudinal pregnancy cohort study (N = 1,347).

The preconception period provides a unique opportunity to optimize the health of women and children. High rates of alcohol use and unintended pregnancies are common across many Western societies and alcohol exposed pregnancies (AEPs) are a possible unintended outcome. The aim of the current study published in 2021 was to evaluate preconception interventions for the prevention of AEPs.

This Medical Journal of Australia Supplement published in 2021 was sponsored by the University of Sydney and the Guidelines for the Treatment of Alcohol Problems. It provides an overview of recommendations from the new Australian guidelines for the treatment of alcohol problems.

The aim of this study published in 2021 was to describe the birth prevalence and characteristics of congenital heart defects in a geographically defined Australian population.

This study aims to identify behavioural, normative and control beliefs regarding alcohol use during pregnancy among a sample of women using the theory of planned behaviour as a theoretical framework.

Substance use during pregnancy is a major health issue for both the mother and the fetus, but it also represents an important public health concern.: The aim of this review was to summarize and compare recommendations from recently published guidelines on substance use during pregnancy and especially regarding alcohol, smoking, and drug use.

Prevention approaches specific to prenatal alcohol exposure (PAE) and foetal alcohol spectrum disorder (FASD) have been identified as urgently needed in Australia, including in Aboriginal and Torres Strait Islander communities. However, very little work has aimed to describe and evaluate health promotion initiatives, especially those developed in rural and remote areas. The results of the work in Alice Springs was published in 2021.

The objective of this study published in 2021 was to systematically review and conduct meta-analysis on studies that report the type and prevalence of functional and structural ear abnormalities among children with prenatal alcohol exposure and/or FASD (FASD).

Binge-level prenatal alcohol exposure (PAE) causes developmental abnormalities, which may be mediated in part by epigenetic mechanisms. Despite this, few studies have characterised the association of binge PAE with DNA methylation in offspring. We investigated the association between binge PAE and genome-wide DNA methylation profiles in a sex-specific manner in neonatal buccal and placental samples. Published in 2021

For individuals with FASD, brain-based deficits translate into impulsive behaviors and poorly thought-out decision-making, coupled with an inability to anticipate and recognize the sometimes very severe consequences of their behaviors. Not unexpectedly, individuals with FASD frequently find themselves disproportionately involved in the criminal justice system and mental health services. For some individuals with FASD, these behaviors can also include firesetting. First responders, like other health and legal professionals, are often unable to recognize the behavioral indicators of FASD, primarily due to a lack of training. This article will outline key behavioral symptoms of FASD as well as provide first responders with suggestions as to how to best support individuals when FASD is suspected. The brief quote that follows highlights some of the key challenges facing individuals with FASD and how poor decision-making and impulsiveness can result in severe consequences for the individual and those around them.

This study published in 2021 examined the frequency of periconception alcohol use (prior to pregnancy awareness) and the extent to which adolescent and young adult alcohol use prospectively predict periconception use.

This paper published in 2022 aimed to document alcohol use during pregnancy and determine predictors of ongoing use, including knowledge and agreement with national alcohol guideline recommendations.

Language disorder is highly prevalent in youth justice; however, orofacial, oromotor, speech, and voice anomalies have been largely overlooked. The aims of this exploratory study published in 2022 were to identify the prevalence of orofacial, oromotor, speech, and voice anomalies among adolescents in youth detention and to examine how these compare between adolescents with and without PAE.

There is a paucity of prospective longitudinal studies examining the associations between maternal use of alcohol and tobacco during pregnancy and the risk of cannabis use in offspring. The aim of this study was to examine the association between prenatal alcohol and tobacco exposures and offspring cannabis use.

Neurodevelopmental disorders (NDD), including cerebral palsy, autism spectrum disorder and foetal alcohol spectrum disorder, are characterised by impaired development of the early central nervous system, impacting cognitive and/or physical function. Early detection of NDD enables infants to be fast-tracked to early intervention services, optimising outcomes. Aboriginal and Torres Strait Islander infants may experience early life factors increasing their risk of neurodevelopmental vulnerability, which persist into later childhood, further compounding the health inequities experienced by First Nations peoples in Australia. The LEAP-CP prospective cohort study will investigate the efficacy of early screening programmes, implemented in Queensland, Australia to earlier identify Aboriginal and Torres Strait Islander infants who are ‘at risk’ of adverse neurodevelopmental outcomes (NDO) or NDD.

The Asking Questions about Alcohol in Pregnancy (AQUA) study, established in 2011, is a pre-birth cohort of 1570 mother and child pairs designed to assess the effects of low to moderate prenatal alcohol exposure and sporadic binge drinking on long-term child development. The current follow-up of the children, now aged 6 to 8 years, aims to strengthen our understanding of the relationship between these levels of prenatal alcohol exposure and neuropsychological functioning, facial dysmorphology, and brain structure & function. Published 2021

Prenatal alcohol exposure (PAE) is associated with a range of adverse offspring neurodevelopmental outcomes. Several studies suggest that PAE modifies DNA methylation in offspring cells and tissues, providing evidence for a potential mechanistic link to FASD (FASD). This paper systematically reviewed existing evidence on the extent to which maternal alcohol use during pregnancy is associated with offspring DNA methylation.

This scoping review published in 2022 aimed to identify and evaluate publicly available educator resources that aid in the identification, and support of students with FASD in primary/elementary school. In addition, educators and FASD experts were consulted to obtain feedback on currently available resources, and key issues and priorities for FASD resources.

This review published in 2022 proposes a theoretical framework to support professionals in collaborating with families in the provision of services for children with FASDs (FASD). Existing models of family-directed care and family contextual factors relevant to planning interventions were reviewed. This information was adapted and integrated in the context of available evidence regarding the provision of evidence-based approaches for children with FASD and their families.

Young people with neurodevelopmental disorders are overrepresented in the youth justice system and face many disadvantages due to their impairments. This study published in 2022 investigated what factors predict and contribute to the behavior of youth justice professionals working in the Queensland (QLD) youth justice system, utilizing a behavior change wheel framework and providing helpful directions to better support young people with neurodevelopmental conditions who are involved with the QLD youth justice system.

Impairments caused by pre-natal alcohol exposure contribute to the over-representation of individuals with FASD in the United States juvenile and adult criminal justice systems. These same impairments can equally impact on individuals with FASD who are witnesses to or victims of crime who also have to navigate the complexities of the criminal justice system. Individuals with FASD are particularity at risk of confabulation when they are subjected to tactics, such as stressful and anxiety-provoking situations, threats, and leading, suggestive, or coercive questioning. This article serves as a beginner’s guide for professionals working in criminal justice settings by (a) providing research-based overviews of FASD and confabulation, (b) describing how FASD may lead to confabulation, and (c) suggesting ways that professionals can modify protocols when interacting with individuals with FASD.

This paper published in February 2022 outlines developments for the prevention of FASD and the diagnosis and support of children and young people living with FASD in Australia. It describes some of the key policy and practice initiatives since 2016, including the National FASD Strategic Action Plan 2018-2028, and considers further opportunities for responding to the needs of children and families affected by FASD. This paper is intended to provide an overview of the key issues for child and family practitioners who may encounter children and families living with FASD.

Implementation of antenatal clinical guideline recommendations are implemented for addressing maternal alcohol consumption is sub-optimal There is a complete absence of evidence of the cost and cost-effectiveness of delivering practice change interventions addressing maternal alcohol consumption amongst women accessing maternity services. The study sought to determine the cost, cost-consequence and cost-effectiveness of developing and delivering a multi-strategy practice change intervention in three sectors of a health district in New South Wales, Australia.

The aims of this systematic review published in 2022 are to identify FASD screening tools and examine their performance characteristics.

Accurate information on dose, frequency and timing of maternal alcohol consumption is critically important when investigating fetal risks from prenatal alcohol exposure. Identification of distinct alcohol use behaviours can also assist in developing directed public health messages about possible adverse child outcomes, including FASD. This study published in 2022 aimed to determine group-based trajectories of time-specific, unit-level, alcohol consumption using data from 1458 pregnant women in the Asking Questions about Alcohol in Pregnancy (AQUA) longitudinal study in Melbourne, Australia.

This study aims to integrate cultural considerations and developmental screening into a First Nations child health check. The ‘Share and Care Check’, an optimised child health check, was co-designed with a remote Aboriginal Community Controlled Health Organisation and led by Aboriginal Health Practitioners/Workers. Data obtained from questions regarding cultural and developmental aspects of health can assist health providers regarding the best pathway of support for a child and their family. This could ultimately contribute to closing the gap through the provision of holistic culturally appropriate services. This paper was published in 2022.

This study evaluates the impact of FASD (FASD) on child and family functioning. Caregivers of 35 children with FASD were surveyed. The study looks at Child-health-related functioning, family impact, impact on siblings and caregiver stress.

This study aimed to examine health-related variables in a cohort of expectant fathers to identify potential focus areas for interventions designed to optimise health and wellbeing outcomes. 498 partners of pregnant women who accessed antenatal services at a large maternity unit in a Western Australian hospital were recruited as part of the ORIGINS Project.

Clinical guideline recommendations for addressing alcohol consumption during pregnancy are sub-optimally implemented and limited evidence exists to inform practice improvements. This study aims to estimate the effectiveness of a practice change intervention in improving the provision of antenatal care addressing alcohol consumption during pregnancy in public maternity services. A randomised stepped-wedge controlled trial was undertaken with all public maternity services in three sectors (one urban, two regional/rural) of a single local health district in New South Wales, Australia. Five thousand six hundred ninety-four interviews/online questionnaires were completed by pregnant women.

Alcohol labelling laws and policy are contentious and highly politicized. Very few countries have been able to implement health warnings on alcohol labels due to complex legal and governance systems and coordinated industry lobbying. In 2020, Australia and New Zealand implemented a mandatory and evidence-based legal standard for pregnancy warning labels on alcohol products. This article discusses some of the challenges faced in achieving policy change and how these barriers were overcome by public health advocacy groups to build the evidence, counter industry conflicts of interest, consumer test health messages, mobilize community support and gather political support.

Since the 2016 release of the Australian Guide to the Diagnosis of FASD (FASD), considerable progress has been made in the identification and diagnosis of the disorder. As part of a larger process to review and update the Guide, this study aims to identify review priorities from a broad range of stakeholders involved in the assessment and diagnosis of FASD. Sixty-two stakeholders, including healthcare practitioners, researchers, other specialists, individuals with cultural expertise, lived experience and consumer representatives completed an online survey asking them to describe up to five priorities for the review of the Australian Guide to the Diagnosis of FASD.

This paper explores the lived experiences of adolescents with FASD (FASD) to understand: the ways in which their challenges influence daily functioning; and the personal assets and external resources that facilitate participation. Semi-structured interviews were conducted with four adolescents with FASD aged 13 to 15 years. Findings illustrated the barriers adolescents experienced regarding their daily functioning and independence. Additionally, incorporating strengths into daily activities appeared to reduce anxiety and improve participation, and adolescents desired for their unique characteristics to be recognized and appreciated.

Neurodevelopmental impairments resulting from FASD can increase the likelihood of justice system involvement. This study compared offence characteristics in young people with FASD to demographically matched controls in Western Australia, uncovering relationships between personal attributes and offence characteristics. After controlling for demographic factors, regression analyses showed FASD participants were more likely than controls to be charged with reckless driving, breach of bail/community orders, property damage, and disorderly behaviour. These findings suggest justice-involved individuals with FASD have unique offending profiles, having implications for sentencing, diversionary/crime prevention programs and interventions.

Recognition of FASD within Australia has continued to grow, particularly with the development of the Australian Diagnostic Guide, yet the availability of FASD-specific services continues to be limited. This paper presents the views and experiences of the six sites across Australia involved indeveloping a FASD Model of Care in their local area.

The Australian Child Rights Taskforce considers the mistreatment and over-representation of Aboriginal and Torres Strait Islander children in youth detention to be a national crisis that requires urgent action. In 2020, the unequal positioning of Aboriginal and Torres Strait Islander children in Australia was shown by an incarceration rate that was 17 times higher than the incarceration rates of Australian youth of all other ethnicities combined. Although Aboriginal and Torres Strait Islander children represent only 6% of the Australian population aged 10–17 years, each day, on average they comprised 48% of those in youth detention. From age 10 years, the most vulnerable and marginalised young people in Australia, many with complex physical and mental health needs, disability needs, and social needs, are criminalised, punished, and removed from their family and community during crucial stages of their development.

The beverage alcohol industry (manufacture, marketing, distribution, and retail) is often seen as playing a role in FASD prevention strategies such as health warning labels. This paper explores the nature of the relationship between the industry and prevention programming. The study considers the place of alcohol in society; the prevalence, social and economic costs of FASD; the ethical notion of alcohol-related harm and then move onto the question of public health partnerships with the industry including the potential conflicts of interests and ethical challenges in such partnerships. Two case studies drawn from Canadian, Australian and New Zealand contexts are presented.

This comprehensive clinical paediatric assessment examines 103 young people sentenced to detention in Western Australia (WA) and participating in the first FASD (FASD) prevalence study. The findings of multiple and serious impairments and health issues, through completion of comprehensive clinical paediatric and multidisciplinary health and neuro-developmental assessments for this study, support their routine provision to all young people on entry to systems of juvenile justice.

This study investigates where pregnant women obtain information about alcohol use in pregnancy and the relationship between the information source used and women’s demographic characteristics and alcohol use.

Prenatal alcohol exposure can contribute to long term adverse health outcomes. Development of the skeletal system begins at the early embryonic stage and continues into early adulthood but the effect of prenatal alcohol exposure on skeletal growth is relatively unexplored in a clinical population. This study examines bone, fat, and muscle accrual in children and adolescents diagnosed with, or at risk of, FASDs (FASDs). By adolescence, those with FASD were shorter and had lower areal bone mineral density and lean tissue mass than typically developing peers. Overall, adolescents diagnosed with FASDs had greater odds of impairments to bone and body composition.

This systematic review aims to document the range and prevalence of eye abnormalities reported on children with prenatal exposure to alcohol and/ or FASD.

This study examines the effect of practice change intervention to support the implementation of guideline-recommended care for addressing alcohol use in pregnancy on self-reported alcohol use during pregnancy through a randomised, stepped-wedge controlled trial within the Hunger New England Local Health District (NSW, Australia).

As part of the Yapatjarrathati project, 47 remote health providers and community members attended a two-day workshop presenting a prototype of a culturally-safe, tiered neurodevelopmental assessment that can identify FASD in primary healthcare. Narrative analysis of the workshop transcript highlighted a collective sense of compassion for those who use alcohol to cope with intergenerational trauma, but exhaustion at the cyclical nature of FASD. There was a strong desire for a shared responsibility for First Nations children and families and a more prominent role for Aboriginal Health Workers in the assessment process. This study emphasised the benefit of continued co-design to ensure health implementation strategies match the needs of the community.

This study evaluated the effectiveness of a mass media campaign highlighting the potential harms associated with drinking alcohol during pregnancy and whether this altered females’ intentions to abstain during pregnancy after campaign exposure.

This book chapter gives an overview of the past two decades of Australian FASD research, from fiction to fact to challenges of the future.

People with FASD encounter a range of health and allied health providers and require specialised support to ensure health services are provided safely and effectively. However, not all health professionals possess the knowledge or expertise required for the identification, assessment, referral and management of FASD. Accessible resources for understanding and managing FASD can help create awareness in health professionals and ensure patients receive the correct diagnosis and timely access to the necessary supports and services. This scoping review aims to identify and analyse FASD resources for health professionals.

This study sought to determine data collection approaches in Australian cohort studies and explore the potential impact on reported prenatal alcohol exposure (PAE) prevalence and patterns. PAE prevalence was estimated as 48% (95% CI: 38 to 57%). Use of trained assessors was an influencing factor of the prevalence estimates when data were collected via interview. Alcohol-focused studies reported higher prevalence of PAE, regardless of method of survey administration. Where interviewer training is not possible, self-administered questionnaires was found most likely provide the most reliable PAE estimates.

This study evaluated the use of the Model of Engaging Communities Collaboratively (MECC) to guide the Jandu Yani U (For All Families) project, in which the Triple P – Positive Parenting Program was collaboratively adapted for use in very remote Aboriginal communities in Western Australia.

People with FAS are at risk of having adverse childhood experiences, especially those with child protection and/or justice system involvement. The complex relationship between FASD and psychosocial vulnerabilities in the affected individual is an important clinical risk factor for comorbidity. This study explored the ACEs and associated stressors in individuals with FASD, investigated the association between ACEs and negative outcomes, and examined the relationship between ACEs and comorbid conditions such as mood and neurodevelopmental disorders.

This study published in 2021 explored the adverse childhood experiences (ACEs) and associated stressors in individuals with FASD; compared the ACEs profiles of those who had been involved with the child protection system only, justice system only, both or neither; examined the relationship between ACEs and comorbid conditions such as mood and neurodevelopmental disorders.

Research has suggested that information communicated by public health and industry-funded organizations differ, as organizations linked to industry have tended to downplay risks with alcohol more broadly and pregnancy specifically. This study describes communication of health risks associated with alcohol use during pregnancy on Twitter by Australian-based organizations and stakeholders. 

This study explored whether exposure to either an ‘ambiguous consumption’ prototype (no amount of alcohol specified) or a ‘small consumption’ prototype (‘small’ amount of alcohol specified) had an impact on prototype perceptions of, and willingness to use, small amounts of alcohol during pregnancy.

This study captures an international perspective on current FASD diagnostic criteria, as well as potential barriers and facilitators towards a globally unified approach to FASD diagnosis. A lack of collaboration was identified as a key barrier, while strong leadership in guideline creation and implementation emerged as a central facilitator. These barriers and facilitators can be used to guide future collaborative efforts towards implementing consistent diagnostic criteria.

Consequences for children born with birth defects and developmental disabilities encompassed by FASD are profound, affecting all areas of social, behavioural and cognitive functioning. Given the strong evidence for a core deficit in executive functioning, underpinned by impaired self-regulation skills, there has been a growing focus on the development of interventions that enhance or support the development of executive functions. This review aims to synthesise the evidence for structured psychological interventions that explicitly aim to improve executive function in children. The review also sought to ascertain if the effectiveness of interventions were influenced by characteristics of the intervention, participants or type of executive function targeted by the intervention.

This study aims to improve understanding of criminogenic risk factors, particularly the role of informant-rated executive functioning in the age of offending onset among young people. the study reviewed 100 file records to gather information on criminogenic factors (out-of-home care, adverse childhood experiences, school disengagement, negative peer association, age of substance use onset), and found only age of substance use onset to be a significant predictor of age of offending onset.

This study explored whether the effectiveness of practice change intervention on provision of antenatal care addsing alcohol consumpmption differed between subgroups of pregnant women and types and location of maternity services. These exploratory results suggest that the intervention may have had similar effects between different subgroups of women and types and location of services, with the exception of women who were non-Aboriginal and women who had not consumed alcohol, for whom the intervention was potentially more effective.

FASD is a high prevalence but underdiagnosed group of disorders affecting between 17 and 36% of individuals in criminal justice settings. Little research has been completed on how to best support individuals with these conditions in criminal justice settings. This article proposes a renewed focus on applying and adapting the Risk-Need-Responsivity (RNR) approach to individuals with FASD in criminal justice settings. This will assist in better determining the needs and interventions likely to effect change and reduce recidivism for this prominent criminal justice-based population. The RNR approach has been used with multiple corrections populations to determine the need and most appropriate interventions, as well as how to best allocate scarce resources. As the prevalence of FASD becomes better understood and recognized, evidence-based approaches to addressing this specific sub-population are necessary to effect change and reduce recidivism and ongoing involvement in the criminal justice system.

Individuals with FASD are over-represented within the justice system and have significant employment challenges. The primary aim of this scoping review was to ascertain available employment resources for FASD individuals particularly those involved in the justice system. Secondary aims were to determine available evidence-based interventions for the justice workforce and employment providers.

Early diagnosis of children with FASD assists in implementing critical early support. The challenge lies in having a diagnostic process that enables valid and reliable assessment of domains of functioning in young children, with the added complexity that many children will also have co-occurring exposure to childhood adversity that is likely to impact these domains. This study examines diagnostic assessment of FASD in young children using the Australian Guide to the Diagnosis of FASD. Ninety-four children (aged 3 to 7 years) with confirmed or suspected prenatal alcohol exposure were referred to two specialist FASD clinics for assessment in Queensland, Australia.

This review paper gives a comprehensive overview of FASD research globally. This paper includes a review of: international prevalence of FASD; the mechanisms and pathophysiology of prenatal alcohol exposure; diagnosis, screening and prevention; management; quality of life; and outlook.

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. Published in 2022, this paper describes the approach to policy and practice impact taken by this CRE, including stakeholder engagement processes and the key principles that underlie the approach. The publication provides examples of policy and practice influence in FASD prevention, diagnosis and management that have been achieved over the past five years and discusses challenges that are routinely faced in the translation of work.

There have been significant advances in assessment processes and diagnostic criteria since the effects of prenatal alcohol exposure were first described in the medical literature. However, a key issue that continues to plague the FASD field is a lack of agreement regarding terminology, and criteria for describing and diagnosing FASD. A significant opportunity exists for the FASD field to work together and utilise the best available evidence to advance an empirically based approach to FASD diagnosis.

Underpinned by an Indigenist research methodology, this article presents findings from a collaboration of Aboriginal and non-Aboriginal peoples to develop an Australian FASD (FASD) Indigenous Framework during 2021 to 2023. The FASD Indigenous Framework unfolds the changes that non-Aboriginal clinicians and Aboriginal peoples each need to make in their respective ways of knowing, being and doing in order to facilitate access to healing-informed, strengths-based and culturally responsive FASD knowledge, assessment, diagnosis and support services among Aboriginal peoples. These knowledges were mapped against Aboriginal cultural responsiveness and wellbeing frameworks and collaboratively and iteratively reflected upon throughout. This article brings together Aboriginal wisdom (strengths-based, healing-informed approaches grounded in holistic and integrated support) and Western wisdom (biomedicine and therapeutic models) in relation to FASD.

This study aims to understand service users’ experiences at a recently established student-led interprofessional neurodevelopmental clinic for children and adolescents with suspected or confirmed prenatal alcohol exposure.

This paper explores the available literature to understand how risks regarding prenatal alcohol exposure are perceived.Three dimensions of risk perceptions were identified—perceived susceptibility, perceived severity, and affective risk perception. Three influencing factors of these dimensions were also identified: information, sociocultural, and individual. These dimensions and influencing factors were brought together to create the proposed novel Pregnancy Alcohol Risk Perception (PARP) conceptual model.

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 (in FASD diagnosis and management using the biopsychosocial-spiritual-cultural framework. Social workers are often first to identify children’s emotional, behavioural, and learning difficulties that may be a characteristic of FASD.

This systematic review describes allied health and educational interventions and their effectiveness for children and adolescents with FASD (FASD), to appraise the quality and strength of these studies. The systematic review included 25 studies with 735 participants. Body function and structure, activity, behaviour, and sense of self outcomes were pooled.

Individuals with lived experience of FASD hold expertise on their own lives and family needs, and their insights on the assessment and diagnostic process are valuable to improving service delivery and informing the provision of meaningful, person- and family-centred care. This systematic review draws on qualitative evidence on the lived experiences of the diagnostic assessment process for FASD.

This study aims to explore alcohol use intentions during pregnancy, using variables from the theory of planned behavior, the prototype/willingness model and personality variables. the study also investigated whether priming participants with exposure to prototypes describing different alcohol use behaviors had an impact on intentions. 746 women aged 20 to 45 years, were randomized to be prompted to think of one of two different types of behaviors, i.e., small level of alcohol use in pregnancy and ambiguous level of alcohol use in pregnancy. they then completed measures of theoretical variables, impulsivity, venturesomeness, and self-efficacy. Participants then answered whether they intended to use alcohol during a future pregnancy.

This report shares review findings of the National FASD (FASD) Strategic Action Plan 2018-2028 implementation. The review’s aim is to inform the Australian Government if the plan is on-track to achieving its goals.

Children with FASD have PAE and significant sleep disturbances. What is not clear is the relative contribution of exposure to early life adversity to these disturbances. This study examines how exposure to adversity impacts frequent insomnia symptoms and nightmares in children with FASD and “At Risk” designations.

This paper evaluates a project across six sites in Australia which aimed to help increase FASD knowledge and diagnostic capacity.

From 31 July 2023, alcoholic products sold in Australia and New Zealand will be required by law to display a visible pregnancy health warning. Since this decision in July 2020 for these warnings to be mandated, they have been appearing on alcoholic products. This national poll asked Australians to recall whether they have seen the pregnancy health warning on alcoholic
products.

This paper explores the importance of incorporating lived experience into training for clinicians and health professionals working with people with FASD and their families.

This paper discusses various areas for increased involvement by Indigenous men in future FASD research, prevention, care and support.

This article explores factors outside of current FASD diagnostic criteria that could be included as part of a holistic assessment process to ensure better support to improve outcomes.

This scoping review looked at the evidence available for understanding the resource implications and service features for the assessment and diagnostic process for FASD.

This paper looked at the neurocognitive profiles of the siblings of people with and without neurodevelopmental conditions (NDCs), and if there were associations with objective test performance and self-reported psychosocial functioning.

This study looks at whether lung function, wheeze, and the number of respiratory infections is different for children with prenatal alcohol exposure (PAE) compared with children who were not exposed.

The Lililwan Project was the first Australian population-based prevalence study of FASD (FASD) using active case ascertainment. Conducted in 2010-2011, the study included 95% of all eligible children aged 7-9 years living in the very remote Aboriginal communities of the Fitzroy Valley, Western Australia. The Bigiswun Kid Project follows up the Lililwan cohort in 2020-2022 at age 17-19 years. The aims of this project are to identify adolescents’ needs and build knowledge to inform services to improve the health and well-being of adolescents in remote Aboriginal communities.

This editorial looks at the Frontiers in Neuroscience Research Topic titled: Perspectives and recent advances in FASDs research.

This study used semi-structured interviews to explore the perspectives of seven caregivers of adolescents with FASD (FASD) in Australia.

This paper outlines the development and co-design of the “Strong Born” Campaign, which was created by the National Aboriginal Community Health Controlled Organisation in order to address a gap in health promotion around FASD in Aboriginal Communities.

This study looked at the neuropsychological profiles of adolescents with and without prenatal alcohol exposure (PAE) and identified neuropsychological tasks predictive of PAE-group membership.

This study looked at Australian psychologists’ baseline levels of knowledge and practices in the assessment of FASD in order to develop training and improve future diagnostic capacity.

This systematic review of 32 studies highlighted that most FASD research focused on 3-12 year olds and that there is growing evidence for the effectiveness of interventions.

This study examined what information is being provided to women and their partners during pregnancy about alcohol use..

This article highlights efforts up until 2014 to recognise and prevent FASD in Australia. ..

Are mothers-to-be adequately informed about the dangers of drinking during pregnancy?

This study examines how the Australian media portray alcohol and pregnancy and how women respond…

This study aimed to determine how common fetal alcohol syndrome and partial fetal alcohol syndrome was in the Fitzroy Valley…

A survey of caregivers in the Fitzroy Valley was carried out to determine how common alcohol use was and what were the patterns use…

Australian Government report into the harmful use of alcohol in Aboriginal and Torres Strait Islander communities…

This article reviews legal approaches in Australia, New Zealand and internationally…

This study explores the advice that health professionals provide to pregnant women about alcohol consumption…

This study aimed to identify the factors which would allow women to provide accurate data on alcohol use in pregnancy.

This article considers whether or not the law in Australia should respond to the problem of FASD by allowing the involuntary treatment and detention of pregnant women.

This commentary considers the issues around the need for a single diagnostic criteria internationally…

This study assessed the perceptions among health professionals about screening for FASD in Australia…

A panel of 13 health professionals, researchers, and consumer and community representatives attended a 2-day consensus development workshop…

This review provides an overview on how common FASD is in Australia (its prevalence) and the need for better data to inform this knowledge…

This article reports on the beliefs and attitudes of women in Western Australia to alcohol use during pregnancy and motivations for behaviour change…

This study aimed to assess the value of a FASD assessment tool for use in remote Aboriginal communities in Australia…

This article discusses the challenges that FASD presents to the legal system and laws in Australia…

This article reports on community involvement in a project to develop a diagnostic instrument for FASD in Australia…

Young people need to be properly assessed for cognitive impairment or functional problems.

This article discusses the strategies to address foetal alcohol spectrum disorder with a focus on prevention.

This study investigated what proportion of birth defects are related to alcohol use during pregnancy.

This article reports on a survey of health professionals to evaluate their familiarity with and use of five existing diagnostic guidelines for FASD.

This article reports on a survey of health professionals to evaluate their familiarity with and use of five existing diagnostic guidelines for FASD.

This systematic review examined which fine motor skills are impaired in children with FASD and prenatal alcohol exposure…

This article examined alcohol-use disorders in pregnant women and the extent of under-reporting…

This study evaluated whether a standard measure of motor skills used in FASD diagnosis was applicable to an Aboriginal population of children.

The Australian Government’s FASD Action Plan inform future direction to address the harmful impact of FASD on children and families.

Western Australian Government report into FASD in the state.

The Productivity Commission’s report into equitable access to legal and justice system for all Australians.

This study was conducted in the Kimberly region (Western Australia) to determine what factors are associated with knowledge about drinking during pregnancy.

This article identifies issues which should guide FASD policy development in Australia.

This study evaluated three different advertising concepts addressing alcohol and pregnancy with women living in Perth…

This study investigates midwives’ knowledge, attitudes and practice in relation to alcohol consumption during pregnancy and FASD.

This article provides an overview of the Asking Questions about Alcohol (AQUA) study which examines the effects of low to moderate alcohol use during pregnancy.

This article provides an overview of FASD policy, health prevention, diagnosis and management in Australia.

This report looks at ways to support women who use alcohol during pregnancy and the best methods to reduce these behaviours.

This review looked at gross motor skills in children with FASD where moderate to heavy drinking was carried out during pregnancy.

This article outlines the protocols established to guide a study into how common (i.e the prevalence) of FASD was in the Fitzroy Valley in Western Australia.

Landmark Australian Government report into FASD in Australia.

This article reviews the evidence of risks in fetal development from low to moderate levels of prenatal drinking.

This Western Australian study investigated the link between heavy prenatal drinking and stillbirth.

This study investigated the accuracy and ease of use of screening for alcohol and other drugs at an antenatal service.

Australian Government report into the high levels of involvement of Indigenous juveniles and young adults in the criminal justice system.

This study examined women’s alcohol consumption in pregnancy and potential predictors of alcohol consumption.

The aim of this study is to determine the prevalence and correlates of alcohol use in pregnancy and lactation.

This study surveyed 1103 Australian women about their knowledge and attitudes related to drinking alcohol during pregnancy.

This study aimed to assess the effectiveness of alcohol documentation in a Child Development Service and the knowledge, attitudes and practice of health practitioners.

While the findings of the meta-analysis should reassure women who have consumed alcohol at low levels during pregnancy, the risk of fetal growth and preterm birth increased.

This study examined the relationships between prenatal alcohol exposure and achievement in reading, writing, spelling and numeracy in children.

This study examined the association between maternal alcohol use disorder (AUD) and intellectual disability in children.

This commentary explores the possibility that a policy of abstinence (i.e not drinking alcohol) for pregnant women may lead to termination of pregnancy.

This article describes the background to a FASD prevalence study which commenced in 2010 in the Fitzroy Valley in Western Australia.

This article explores the fact that the rate of infant deaths is three times higher in indigenous children than non-indigenous Australians.

This article reports on a survey of health professionals to evaluate their familiarity with and use of five existing diagnostic guidelines for FASD.

This study analysed population data about mothers who used alcohol in pregnancy and their geographic location (metropolitan, regional and remote).

This article evaluates the Alcohol and Pregnancy Project which targeted health professionals in Western Australia.

This study evaluated an education program alcohol consumption in pregnancy and fetal alcohol syndrome (FAS) targetting health professionals in Western Australia.

This study aimed to assess the knowledge, attitudes and practice of paediatricians in Western Australia in relation to fetal alcohol syndrome (FAS).

This article outlines a project management approach used in the Alcohol and Pregnancy Project.

This article outlines a project management approach used in the Alcohol and Pregnancy Project.

This article discusses the barriers health professionals have to addressing prenatal alcohol use and the strategies to overcome them.

This study aimed to assess women’s compliance with different Australian guidelines on alcohol intake during pregnancy.

This article considers the relationship between FASD and ADHD and whether some of the interventions used in ADHD may be adapted for people with FASD.

The effect of alcohol consumption in pregnancy depends on the amount of alcohol consumed each time, the frequency and duration of alcohol use.

This study considered the use of the “composite method” in assessment of alcohol effects on the fetus.

This study investigated the association between dose, pattern, and timing of prenatal alcohol exposure (PAE) and birth defects. Compared with abstinence, heavy alcohol use in the first trimester was associated with a fourfold increase in risk of birth defects. The study found no association between low or moderate prenatal alcohol exposure and birth defects.

This 8-year longitudinal study of mothers who drank alcohol during their pregnancy looked at the impact on behaviours in children over two years old.

This article looks at the challenge of convincing governments to collect information on congenital anomalies (also called birth defects).

This study aimed to assess the value of extending notification to the Western Australian birth defects register beyond the age of one.

Unpublished Masters Thesis
Massey University, Wellington New Zealand

The challenge for the Australian health professional is agreeing on a model for diagnosing and treating FASD.

This systematic review aims to identify and evaluate the evidence for drug and non-drug interventions for children with FASD.

This study aimed to investigate the association of dose and timing of prenatal alcohol exposure with early language acquisition.

This study investigated the relationship between alcohol use during pregnancy and the size of babies in Western Australia.

The author argues for a national approach in Australia to data gathering for children with rare diseases, such as FASD…

This study reviewed pregnancy records of women with children diagnosed with fetal alcohol syndrome (FAS) at a Queensland hospital.

This article describes specialist clinical services which diagnose and assess children exposed to alcohol in pregnancy around the world.

This article highlights the pivotal role obstetricians play in advising women of the effects of alcohol on the fetus and reducing fetal exposure.

This study aimed to describe the causes and effects of fetal alcohol syndrome (FAS) as observed by Australian paediatricians.

A review of the Australian Paediatric Surveillance Unit (APSU) services over the past 14 years.

NSW report investigates opportunities to enhance diversion at all stages of the criminal justice system for people with cognitive and mental health impairments.

This study investigated alcohol use in women in Western Australia around the time of conception.

This study aimed to establish how common (i.e prevalence) of fetal alcohol syndrome is in the state of Victoria.

This study examined the effects of moderate levels of alcohol consumption during pregnancy on 14 year-old children’s intellectual ability, learning and attention.

This article discusses the clinical features of FASD and the role of the general practitioner in prevention and management.

This review considered international policies and guidelines related to drinking alcohol during pregnancy.

This study aimed to identify the prevalence and characteristics of women using drugs and alcohol while pregnant or breastfeeding.

This study aimed to examine the obstetric and newborn outcomes for women with an alcohol-related hospital admission during pregnancy.

This study aimed to assess paediatricians’ knowledge, attitudes and practices of fetal alcohol syndrome (FAS) and alcohol use during pregnancy.

This study aimed to identify the characteristics of women who consume alcohol during pregnancy.

This study investigated the knowledge, attitudes and behaviours of health professionals related to drinking and pregnancy.

There is an urgent need for research to provide accurate information on the frequency of Fetal Alcohol Syndrome (FAS) in specific communities.

This review of the literature for fetal alcohol syndrome (FAS) aims to provide an understanding of the diagnostic features, causes and effects of FAS.

This study aimed to establish the prevalence of fetal alcohol syndrome (FAS) in the top end of the Northern Territory.

This study investigated effects of adding a new source of data from the Rural Paediatric Service to statistics about birth defects in Western Australian children.

This article reviews the effectiveness of prevention programs in lowering the incidence of FAS.

This study looked at infant outcomes of mothers drinking prior to pregnancy.

This study investigated the relationship between alcohol consumption during pregnancy and birthweight of 900 women.

This article illustrates seven cases of fetal alcohol syndrome (FAS).