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Decade-first guidance on FASD diagnosis
The ‘groundbreaking’ guidelines aim to improve assessment and diagnosis of the disorder and arm GPs with more confidence.
The refreshed guidelines aim to support practitioners in assessment and diagnosis of FASD across the lifespan with a ‘non-judgemental approach’.
First-of-their-kind guidelines for the assessment and diagnosis of foetal alcohol spectrum disorder (FASD) are now available to GPs, offering practical help and diagnostic criteria.
Led by a University of Queensland (UQ) research team, the guidelines were developed over four years through collaboration with healthcare professionals, researchers, cultural experts, and families and carers, with a goal of changing the life course for individuals living with FASD.
They aim to support healthcare providers in assessments that may result in a diagnosis of FASD and outline the recommended assessment principles and diagnostic criteria.
With the guidelines last updated in 2016, GP and Chair of RACGP Specific Interests Child and Young Person’s Health, Dr Tim Jones, welcomes the latest edition for ‘an important area’.
‘It is fantastic to see ongoing respectful development of guidelines to support early identification and linking to diagnostic and support services for FASD in Australia, particularly with a healthy focus on a non-judgemental approach,’ he told newsGP.
‘FASD is a highly common condition in our high-risk populations here in Australia, up to one in five births in our highest risk populations, and yet we know that it remains under-recognised as a condition.’
Screening and diagnosis is one of the four priorities of the National FASD Strategic Action Plan 2018–28, along with prevention, support and management, and a focus on people at increased risk.
Under the plan, increasing capacity for families to access FASD diagnostic services and the capability of healthcare professionals to identify and refer for diagnosis where necessary, remain key policy initiatives.
The new national FASD guidelines build on previous advice from the 2016 version and include:
- Aboriginal and Torres Strait Islander peoples’ perspectives
- living and lived experience perspectives
- the importance of clinical judgement to enable person-centred assessment across a wide range of contexts
- updates to the structure of diagnostic criteria and terminology.
In developing the guidelines, researchers conducted a comprehensive review that included understanding people’s lived experiences of the assessment process. They examined more than 300 research papers to understand the link between prenatal alcohol exposure and diagnostic outcomes.
Dr Natasha Reid from UQ’s Child Health Research Centre is the study’s lead, which she says is a ‘groundbreaking development to help understand the unique challenges and strengths’ of people with FASD, enabling them to better access tailored support.
‘FASD is a lifelong disability arising from prenatal exposure to alcohol, but every individual is unique with areas of both strength and challenges,’ she said.
‘We hope these new guidelines will enhance assessment and diagnostic practices, improve service accessibility, reduce stigma, and ultimately improve the quality of life for all people living with FASD in Australia.’
While the research team notes that FASD is typically diagnosed in specialist clinics, the new guidelines encourage all practitioners, regardless of setting or discipline, to ‘contribute where they can’ to the assessment.
Citing previous research suggesting that
only 16% of Australian health professionals can accurately identify the essential clinical features of FASD, Dr Jones said the new guidelines are valuable, and GPs are well placed to initiate assessment in a non-judgemental way.
‘It’s critical that as GPs we take the lead on growing our confidence in this area so that we can improve outcomes for the families we serve,’ he said.
‘We know that early identification and linking to the right supports makes a huge difference to outcomes for families and that kids with FASD need specific understanding and care.
‘We need to recognise that families at risk of FASD frequently suffer from the most fragmented care and a well-placed, respectful and holistic GP is likely to be the first professional who can recognise the signs if they are aware of them.’
The new guide has been approved by the National Health and Medical Research Council after meeting the standards for clinical practice guidelines.
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