Publications

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.

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.

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.

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.