Advertisement

Journal of Pediatric Neuropsychology

, Volume 3, Issue 1, pp 38–52 | Cite as

Neuropsychological Aspects of Prevention and Intervention for Fetal Alcohol Spectrum Disorders in Australia

  • James P. FitzpatrickEmail author
  • Carmela F. Pestell
Review Article

Abstract

The term fetal alcohol syndrome (FAS) was coined in 1973 to describe children with characteristic facial features, growth disorder and developmental delay associated with prenatal alcohol exposure. Yet, it was not until almost 20 years later that Australian researchers published on the public health significance of the range of conditions by then collectively termed fetal alcohol spectrum disorders (FASD). Similarly, the response to FASD within the government and various sectors of Australian society has been variable. Barriers in addressing FASD in the Australian context include a heavy drinking culture and large populations living in regional or remote communities and addressing FASD in high-risk populations such as juveniles in detention, some Aboriginal communities and “fly in-fly out” mining communities. Early Australian research was epidemiological, documenting notifications of FAS to birth defect registries and pediatric surveillance systems. The past decade has seen a rapid growth in Australian research into the full spectrum of FASD. Australian FASD diagnostic guidelines have recently been developed, a national FASD Action Plan has been endorsed, national and population-based data on FASD prevalence has been reported and large FASD intervention and prevention studies are underway within a National Centers of Research Excellence framework. In recent years, there has been a greater focus on neuropsychological aspects of FASD in diagnosis and intervention, with pediatric neuropsychologists playing a key role. 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.

Keywords

Fetal alcohol spectrum disorders (FASD) Neuropsychology Epidemiology Prevention Intervention Child development 

Notes

Compliance with Ethical Standards

Conflict of Interest

Dr. Fitzpatrick is Director of PATCHES Paediatrics, and Dr Fitzpatrick and Dr Pestell provide clinical services through PATCHES Paediatrics.

Human and Animal Rights and Animal Consent

This article does not contain any studies with human participants or animals performed by any of the authors.

References

  1. 2010 National Drug Strategy Household Survey report (2011). In A. I. o. H. a. Welfare (Ed.), Drug statistics series (PHE 145 ed.). Canberra, Australian Capital Territory: Australian Government.Google Scholar
  2. 2013 National Drug Strategy Household Survey detailed report (2014). In A. I. o. H. a. Welfare (Ed.), (pp. 1–148). Canberra, Australian Capital Territory: Australian Government.Google Scholar
  3. Allen, K., Riley, M., Goldfeld, S., & Halliday, J. (2007). Estimating the prevalence of fetal alcohol syndrome in Victoria using routinely collected administrative data. Australian & New Zealand Journal of Public Health, 31(1), 62–66.CrossRefGoogle Scholar
  4. American Bar Association (2012). Commission on Youth Risk: Resolution to recognize FASD 112B. http://www.abanow.org/2012/06/2012am112b/. Accessed 1 Oct 2012.
  5. Astley, S. J., & Clarren, S. K. (2000). Diagnosing the full spectrum of fetal alcohol-exposed individuals: introducing the 4-digit diagnostic code. Alcohol, 35(4), 400–410.CrossRefGoogle Scholar
  6. Australian Bureau of Statistics Census of Population and Housing 2016 (2016). Canberra, Australian Capital Territory: Australian Government.Google Scholar
  7. Bertrand, J. (2009). Interventions for children with fetal alcohol spectrum disorders (FASDs): overview of findings for five innovative research projects. Research in Developmental Disabilities, 30(5), 986–1006. doi: 10.1016/j.ridd.2009.02.003.CrossRefPubMedGoogle Scholar
  8. Boulton, J. (2008). The impact of alcohol abuse on the development of children in indigenous communities with reference to Fitzroy crossing. NutriDate, 19(4), 1–5.Google Scholar
  9. Bouma, G. D. (2015). The role of demographic and socio-cultural factors in Australia’s successful multicultural society: how Australia is not Europe. Journal of Sociology. doi: 10.1177/1440783315584210.Google Scholar
  10. Bower, C., & Elliott, E. (2016). Report to the Australian Government Department of Health: “Australian Guide to the diagnosis of Fetal Alcohol Spectrum Disorder (FASD)”. Perth, Western Australia: Telethon Kids Institute.Google Scholar
  11. Bower, C., Silva, D., Henderson, T. R., Ryan, A., & Rudy, E. (2000). Ascertainment of birth defects: the effect on completeness of adding a new source of data. Journal of Paediatrics and Child Health, 36(6), 574–576.CrossRefPubMedGoogle Scholar
  12. Bracken, B., & McCallum, S. (1998). Universal non verbal intelligence test. Itasca, IL: Riverside Publishing.Google Scholar
  13. Bridge, P. (2011). Ord Valley Aboriginal Health Service’s fetal alcohol spectrum disorders program: Big steps, solid outcome. Australian Indigenous Health Bulletin, 11(4).Google Scholar
  14. Bruce, K. J. P. F., Pearson, G., Carter, M., Oscar, J., Daube, M., et al. (2016). Making FASD history: Marulu fetal alcohol spectrum disorders prevention strategy. 2015 Annual Report to Western Australian Government Department of Aboriginal Affairs. Perth: Telethon Kids Institute.Google Scholar
  15. Bush, K., Kivlahan, D. R., McDonell, M. B., Fihn, S. D., & Bradley, K. A. (1998). The AUDIT alcohol consumption questions (AUDIT-C): an effective brief screening test for problem drinking. Ambulatory Care Quality Improvement Project (ACQUIP). Alcohol Use Disorders Identification Test. Archives of Internal Medicine, 158(16), 1789–1795.CrossRefPubMedGoogle Scholar
  16. Canadian Bar Association (2010). Resolution 10-02-A: Fetal Alcohol Spectrum Disorder in the Criminal Justice System. http://www.cba.org/CBA/resolutions/pdf/10-02-A.pdf. Accessed 12 July 2012.
  17. Carmichael Olson, H., & Montague, R. (2011). An innovative look at early intervention for children affected by prenatal alcohol exposure. In S. Adobato & D. Cohen (Eds.), Prenatal alcohol use and fetal alcohol spectrum disorders: Diagnosis, assessment and new directions in research and multimodal treatment (1st ed., pp. 64–107). Oak Park, Illinois: Bentham Science Publishers Ltd.Google Scholar
  18. Chudley, A. E., Conry, J., Cook, J. L., Loock, C., Rosales, T., & LeBlanc, N. (2005). Fetal alcohol spectrum disorder: Canadian guidelines for diagnosis. CMAJ, 172(5 Suppl), S1–S21. doi: 10.1503/cmaj.1040302.CrossRefPubMedPubMedCentralGoogle Scholar
  19. Colvin, L., Payne, J., Parsons, D., Kurinczuk, J. J., & Bower, C. (2007). Alcohol consumption during pregnancy in Nonindigenous West Australian women. Alcoholism: Clinical and Experimental Research, 31(2), 276–284. doi: 10.1111/j.1530-0277.2006.00303.x.CrossRefGoogle Scholar
  20. Commonwealth Action Plan to reduce the Impact of Fetal Alcohol Spectrum Disorders (FASD) 2013–2017 (2014). In A. G. D. o. Health (Ed.), (pp. 1–4). Canberra, Australian Capital Territory.Google Scholar
  21. Cook, J. L., Green, C. R., Lilley, C. M., Anderson, S. M., Baldwin, M. E., Chudley, A. E., et al. (2016). Fetal alcohol spectrum disorder: a guideline for diagnosis across the lifespan. CMAJ, 188(3), 191–197. doi: 10.1503/cmaj.141593.CrossRefPubMedPubMedCentralGoogle Scholar
  22. Crawford-Williams, F., Steen, M., Esterman, A., Fielder, A., & Mikocka-Walus, A. (2015). "If you can have one glass of wine now and then, why are you denying that to a woman with no evidence": knowledge and practices of health professionals concerning alcohol consumption during pregnancy. Women and Birth, 28(4), 329–335. doi: 10.1016/j.wombi.2015.04.003.CrossRefPubMedGoogle Scholar
  23. DeGregorio, L. J., & McLean, S. D. (2013). The cognitive profiles of maltreated children in care and their educational needs: supporting good outcomes. Children Australia, 38(1), 28–35. doi: 10.1017/cha.2012.47.CrossRefGoogle Scholar
  24. Department of Education Funding for Students with Disability (2016). In D. o. Education (Ed.). Perth, Western Australia: Western Australian Government.Google Scholar
  25. Douglas, H. (2010). The sentencing response to defendants with Foetal Alcohol Spectrum Disorder. Criminal Law Journal, 34, 221–239.Google Scholar
  26. Australian Guidelines to Reduce Health Risks from Drinking Alcohol (2009). Canberra, Australian Capital Territory: Australian National Health and Medical Research Council.Google Scholar
  27. Dudgeon, P. (2000). Counselling with indigenous people. In P. Dudgeon, D. Garvey, & H. Pickett (Eds.), Working with Indigenous Australians: a handbook for psychologists (pp. 249–270). Perth: Gunada Press.Google Scholar
  28. Dudley, A., Reibel, T., Bower, C., & Fitzpatrick, J. (2015). Critical review of the literature: fetal alcohol spectrum disorders. Perth: Telethon Kids Institute.Google Scholar
  29. Eades, S. (2003). Bibbulung Gnarneep Study: A longitudinal study of a population based cohort of urban Aboriginal children in Western Australia. Determinants of health outcomes during early childhood of Aboriginal children residing in an urban area. The University of Western Australia.Google Scholar
  30. Elliott, E. J., Payne, J., Haan, E., & Bower, C. (2006). Diagnosis of foetal alcohol syndrome and alcohol use in pregnancy: a survey of paediatricians’ knowledge, attitudes and practice. Journal of Paediatrics and Child Health, 42(11), 698–703. doi: 10.1111/j.1440-1754.2006.00954.x.CrossRefPubMedGoogle Scholar
  31. Elliott, E. J., Payne, J., Morris, A., Haan, E., & Bower, C. (2008a). Fetal alcohol syndrome: a prospective national surveillance study. Archives of Disease in Childhood, 93(9), 732–737. doi: 10.1136/adc.2007.120220.CrossRefPubMedGoogle Scholar
  32. Elliott, E. J., Payne, J., Morris, A., Haan, E., Bower, C., Elliott, E. J., et al. (2008b). Fetal alcohol syndrome: a prospective national surveillance study. [Research Support, Non-U.S. Gov’t]. Archives of Disease in Childhood, 93(9), 732–737.CrossRefPubMedGoogle Scholar
  33. Eyberg, S., & Pincus, D. (1999). Eyberg child behavior inventory and Sutter-Eyberg student behavior inventory revised: professional manual. Lutz, FL: Psychological Assessment Resources Inc.Google Scholar
  34. Fast, D. K., & Conry, J. (2009). Fetal alcohol spectrum disorders and the criminal justice system. Developmental Disabilities Research Reviews, 15(3), 250–257. doi: 10.1002/ddrr.66.CrossRefPubMedGoogle Scholar
  35. Taking more action to prevent Fetal Alcohol Spectrum Disorders (2016). In D. o. Health (Ed.). Canberra, Australian Capital Territory: Australian Government.Google Scholar
  36. Fitzpatrick, J., & Kinniburgh-White, R. (2014). The Marulu School Clinics: team-based child health services in remote Australia. Patches Paediatrics Annual Report 2013 (pp. 1–56). Perth: Telethon Kids Institute/Patches Paediatrics.Google Scholar
  37. Fitzpatrick, J. P., Elliott, E. J., Latimer, J., Carter, M., Oscar, J., Ferreira, M., et al. (2012). The Lililwan Project: study protocol for a population-based active case ascertainment study of the prevalence of Fetal Alcohol Spectrum Disorders (FASD) in remote Australian Aboriginal communities. BMJ Open, 2(3), doi: 10.1136/bmjopen-2012-000968.
  38. Fitzpatrick, J. P., Latimer, J., Carter, M., Oscar, J., Ferreira, M. L., Carmichael Olson, H., et al. (2015a). Prevalence of fetal alcohol syndrome in a population-based sample of children living in remote Australia: the Lililwan Project. Journal of Paediatrics and Child Health, 51(4), 450–457. doi: 10.1111/jpc.12814.PubMedGoogle Scholar
  39. Fitzpatrick, J. P., Latimer, J., Ferreira, M. L., Carter, M., Oscar, J., Martiniuk, A. L. C., et al. (2015b). Prevalence and patterns of alcohol use in pregnancy in remote Western Australian communities: the Lililwan Project. Drug and Alcohol Review, 34(3), 329–339. doi: 10.1111/dar.12232.CrossRefPubMedGoogle Scholar
  40. Freckelton, I. (2012). Expert evidence by mental health professionals: the communication challenge posed by evidence about Autism Spectrum Disorder, brain injuries, and Huntington’s Disease. International Journal of Law and Psychiatry, 35(5–6), 372–379. doi: 10.1016/j.ijlp.2012.09.008.CrossRefPubMedGoogle Scholar
  41. Freckelton, I. (2013). Fetal alcohol spectrum disorder and the law in Australia: the need for awareness and concern to translate into urgent action. [Editorial Legal Cases]. Journal of Law & Medicine, 20(3), 481–492.Google Scholar
  42. Garvey, D., Dudgeon, P., & Kearins, J. (2000). Australian psychology has black history. In P. Dudgeon, D. Garvey, & H. Pickett (Eds.), Working with Indigenous Australians: a handbook for psychologists (pp. 231–248). Perth: Gunada Press.Google Scholar
  43. Gioia, G., Isquith, P., Guy, S., & Kenworthy, L. (2000). Behavior rating inventory of executive function (BRIEF). San Antonio: Psychological Assessment Resources.Google Scholar
  44. Global status report of alcohol and health - 2014 (2014). Luxembourg: World Health Organisation.Google Scholar
  45. Gooda, M. (2010). Social justice report. In A. a. T. S. I. S. J. Commissioner (Ed.), 2010 Social Justice Report. Aboriginal and Torres Strait Islander Social Justice Commissioner (p. 158). Sydney: Australian Human Rights Commission.Google Scholar
  46. Guidelines for the provision of psychological services for, and the conduct of psychological research with, Aboriginal and Torres Strait Islander People of Australia (2008). Australian Psychological Society.Google Scholar
  47. Harris, K. R., & Bucens, I. K. (2003). Prevalence of fetal alcohol syndrome in the Top End of the Northern Territory. Journal of Paediatrics & Child Health, 39(7), 528–533.CrossRefGoogle Scholar
  48. Llorente, A., Williams, J., Satz, P., & D’Elia, L. (2003). Children’s color trails Test™ (CCTT™). Lutz: Psychological Assessment resources.Google Scholar
  49. Meurk, C., Lucke, J., & Hall, W. (2014). A bio-social and ethical framework for understanding fetal alcohol spectrum disorders. Neuroethics, 7(3), 337–344. doi: 10.1007/s12152-014-9207-2.CrossRefGoogle Scholar
  50. Miller, D. C. (2010). Best practices in school neuropsychology. Guidelines for effective practice, assessment, and evidence-based intervention. New Jersey: Wiley.Google Scholar
  51. Mutch, R., Watkins, R. E., Jones, H., & Bower, C. (2013). Fetal alcohol spectrum disorder: knowledge, attitudes and practice in the Western Australian justice system. Perth: Telethon Institute for Child Health Research, Centre for Child Health Research, The University of Western Australia.Google Scholar
  52. Mutch, R. C., Watkins, R., & Bower, C. (2014). Fetal alcohol spectrum disorders: notifications to the Western Australian Register of Developmental Anomalies. Journal of Paediatrics and Child Health. doi: 10.1111/jpc.12746.PubMedGoogle Scholar
  53. Mutch, R. C., Watkins, R., & Bower, C. (2015). Fetal alcohol spectrum disorders: notifications to the Western Australian Register of Developmental Anomalies. Journal of Paediatrics and Child Health, 51(4), 433–436. doi: 10.1111/jpc.12746.PubMedGoogle Scholar
  54. O’Connor, J., Chur-Hansen, A., & Turnbull, D. (2015). Professional skills and personal characteristics for psychologists working in an Urban Australian context with indigenous clients. Australian Psychologist, 50(6), 464–474. doi: 10.1111/ap.12125.CrossRefGoogle Scholar
  55. O’Leary, C., Leonard, H., Bourke, J., D’Antoine, H., Bartu, A., & Bower, C. (2013a). Intellectual disability: population-based estimates of the proportion attributable to maternal alcohol use disorder during pregnancy. Developmental Medicine and Child Neurology, 55(3), 271–277. doi: 10.1111/dmcn.12029.CrossRefPubMedGoogle Scholar
  56. O’Leary, C. M., Taylor, C., Zubrick, S. R., Kurinczuk, J. J., & Bower, C. (2013b). Prenatal alcohol exposure and educational achievement in children aged 8–9 years. Pediatrics, 132(2), e468–e475. doi: 10.1542/peds.2012-3002.CrossRefPubMedGoogle Scholar
  57. Ospina, M., & Dennett, L. (2013). Systematic review on the prevalence of fetal alcohol spectrum disorders. Edmonton: Institute of Health Economics.Google Scholar
  58. Parliament of Australia House of Representatives Inquiry into Foetal Alcohol Spectrum Disorder (2011). http://www.aph.gov.au/house/committee/spla/fasd/index.htm. Accessed January 2011.
  59. Payne, J., Elliott, E., D’Antoine, H., O’Leary, C., Mahony, A., Haan, E., et al. (2005). Health professionals’ knowledge, practice and opinions about fetal alcohol syndrome and alcohol consumption in pregnancy. [Research Support, Non-U.S. Gov’t]. Australian and New Zealand Journal of Public Health, 29(6), 558–564.CrossRefPubMedGoogle Scholar
  60. Payne, J., France, K., Henley, N., D’Antoine, H., Bartu, A., O’Leary, C., et al. (2011a). Changes in health professionals’ knowledge, attitudes and practice following provision of educational resources about prevention of prenatal alcohol exposure and fetal alcohol spectrum disorder. Paediatric and Perinatal Epidemiology, 25(4), 316–327. doi: 10.1111/j.1365-3016.2011.01197.x.CrossRefPubMedGoogle Scholar
  61. Payne, J. M., France, K. E., Henley, N., D’Antoine, H. A., Bartu, A. E., Mutch, R. C., et al. (2011b). Paediatricians’ knowledge, attitudes and practice following provision of educational resources about prevention of prenatal alcohol exposure and Fetal Alcohol Spectrum Disorder. Journal of Paediatrics and Child Health, 47(10), 704–710. doi: 10.1111/j.1440-1754.2011.02037.x.CrossRefPubMedGoogle Scholar
  62. Peadon, E., & Elliott, E. J. (2010). Distinguishing between attention-deficit hyperactivity and fetal alcohol spectrum disorders in children: clinical guidelines. [Review]. Neuropsychiatric Disease and Treatment, 6, 509–515.CrossRefPubMedPubMedCentralGoogle Scholar
  63. Peadon, E., Fremantle, E., Bower, C., & Elliott, E. J. (2008). International survey of diagnostic services for children with Fetal Alcohol Spectrum Disorders. BMC Pediatrics, 8, 12. doi: 10.1186/1471-2431-8-12.CrossRefPubMedPubMedCentralGoogle Scholar
  64. Peadon, E., Rhys-Jones, B., Bower, C., & Elliott, E. J. (2009). Systematic review of interventions for children with Fetal Alcohol Spectrum Disorders. BMC Pediatr, 9. doi: 10.1186/1471-2431-9-35.
  65. Peadon, E., Payne, J., Henley, N., D’Antoine, H., Bartu, A., O’Leary, C., et al. (2010). Women’s knowledge and attitudes regarding alcohol consumption in pregnancy: A national survey. BMC Public Health, 10, doi: 10.1186/1471-2458-10-510.
  66. Pestell, C., & Paul, A. (2015). Assessment of capacity in young offenders. InPsych: The Bulletin of the Australian Psychological Society Ltd, 37(4), 17.Google Scholar
  67. Poole, N. (2008). Fetal alcohol spectrum disorder (FASD) prevention: Canadian perspectives. Alberta: Public Health Agency of Canada.Google Scholar
  68. Popova, S., Lange, S., Bekmuradov, D., Mihic, A., & Rehm, J. (2011). Fetal alcohol spectrum disorder prevalence estimates in correctional systems: a systematic literature review. Canadian Journal of Public Health, 102(5), 336–340.PubMedGoogle Scholar
  69. Ranzijn, R., McConnochie, K., Clarke, C., & Nolan, W. (2007). “Just another white-ology”: psychology as a case study. Counselling, Psychotherapy, and Health. Indigenous Special Issue, 3(2), 21–34.Google Scholar
  70. Rasmussen, C., & Bisanz, J. (2009). Exploring mathematics difficulties in children with fetal alcohol spectrum disorders. Child Development Perspectives, 3(2), 125–130. doi: 10.1111/j.1750-8606.2009.00091.x.CrossRefGoogle Scholar
  71. Reid, N., Dawe, S., Shelton, D., Harnett, P., Warner, J., Armstrong, E., et al. (2015). Systematic review of fetal alcohol spectrum disorder interventions across the life span. Alcoholism: Clinical and Experimental Research. doi: 10.1111/acer.12903.Google Scholar
  72. Salter, C. (2013). Conducting communication assessments with school aged Aboriginal children in the Kimberley region of Australia. Australian Review of Applied Linguistics, 36(3), 316–334.CrossRefGoogle Scholar
  73. Streissguth, A. P., Randels, S. P., & Smith, D. F. (1991). A test-retest study of intelligence in patients with fetal alcohol syndrome: implications for care. Journal of the American Academy of Child and Adolescent Psychiatry, 30(4), 584–587. doi: 10.1097/00004583-199107000-00009.CrossRefPubMedGoogle Scholar
  74. Streissguth, A. P., Bookstein, F. L., Barr, H. M., Sampson, P. D., O’Malley, K., & Young, J. K. (2004). Risk factors for adverse life outcomes in fetal alcohol syndrome and fetal alcohol effects. Journal of Developmental & Behavioral Pediatrics, 25(4), 228–238.CrossRefGoogle Scholar
  75. Strong Spirit Strong Future: Promoting Healthy Women and Pregnancies project (2014). http://www.dao.health.wa.gov.au/Informationandresources/Engagingthecommunity/CommunityPrograms/StrongSpiritStrongFuture.aspx. Accessed January 2015.
  76. Tamana, S., Pei, J., Massey, D., Massey, V., & Rasmussen, C. (2014). Neuropsychological impairments and age-related differences in children and adolescents with fetal alcohol spectrum disorders. Journal of Population Therapeutics and Clinical Pharmacology, 21(2), e167–e180.PubMedGoogle Scholar
  77. Vasilevski, V., & Tucker, A. (2015). Wide-ranging cognitive deficits in adolescents following early life maltreatment. Neuropsychology, 30(2), 239–246. doi: 10.1037/neu0000215.
  78. Vicary, D. A., & Bishop, B. J. (2005). Western psychotherapeutic practice: engaging aboriginal people in culturally appropriate and respectful ways. Australian Psychologist, 40(1), 8–19. doi: 10.1080/00050060512331317210.CrossRefGoogle Scholar
  79. Watkins, R. E., Elliott, E. J., Mutch, R. C., Payne, J. M., Jones, H. M., Latimer, J., et al. (2012). Consensus diagnostic criteria for fetal alcohol spectrum disorders in Australia: A modified Delphi study. BMJ Open, 2(5), doi: 10.1136/bmjopen-2012-001918.
  80. Watkins, R. E., Elliott, E. J., Wilkins, A., Mutch, R. C., Fitzpatrick, J. P., Payne, J. M., et al. (2013). Recommendations from a consensus development workshop on the diagnosis of fetal alcohol spectrum disorders in Australia. BMC Pediatr, 13(1), doi: 10.1186/1471-2431-13-156.
  81. Watkins, R. E., Elliott, E. J., Wilkins, A., Latimer, J., Halliday, J., Fitzpatrick, J. P., et al. (2014). Fetal alcohol spectrum disorder: Development of consensus referral criteria for specialist diagnostic assessment in Australia. BMC Pediatr, 14(1), doi: 10.1186/1471-2431-14-178.
  82. Westerman, T. (2010). Engaging Australian Aboriginal youth in mental health services. Australian Psychologist, 45(3), 212–222. doi: 10.1080/00050060903451790.CrossRefGoogle Scholar
  83. Western Australian Fetal Alcohol Spectrum Disorder Model of Care (2010). (pp. 1–60). Perth: Health Networks Branch, WA Department of Health.Google Scholar
  84. Williams, M., & Shellenberger, S. (1996). “How does your engine run?” A leader’s guide to the Alert Program for Self-Regulation. Albuquerque: TherapyWorks, Inc.Google Scholar

Copyright information

© American Academy of Pediatric Neuropsychology 2017

Authors and Affiliations

  1. 1.Telethon Kids InstituteThe University of Western AustraliaPerthAustralia
  2. 2.The George Institute for Global Health, Sydney Medical SchoolUniversity of SydneySydneyAustralia
  3. 3.Discipline of Paediatrics and Child Health, Sydney Medical SchoolUniversity of SydneySydneyAustralia
  4. 4.School of PsychologyUniversity of Western AustraliaPerthAustralia

Personalised recommendations