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.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Price excludes VAT (USA)
Tax calculation will be finalised during checkout.
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.
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.
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.
American Bar Association (2012). Commission on Youth Risk: Resolution to recognize FASD 112B. http://www.abanow.org/2012/06/2012am112b/. Accessed 1 Oct 2012.
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.
Australian Bureau of Statistics Census of Population and Housing 2016 (2016). Canberra, Australian Capital Territory: Australian Government.
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.
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.
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.
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.
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.
Bracken, B., & McCallum, S. (1998). Universal non verbal intelligence test. Itasca, IL: Riverside Publishing.
Bridge, P. (2011). Ord Valley Aboriginal Health Service’s fetal alcohol spectrum disorders program: Big steps, solid outcome. Australian Indigenous Health Bulletin, 11(4).
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
Department of Education Funding for Students with Disability (2016). In D. o. Education (Ed.). Perth, Western Australia: Western Australian Government.
Douglas, H. (2010). The sentencing response to defendants with Foetal Alcohol Spectrum Disorder. Criminal Law Journal, 34, 221–239.
Australian Guidelines to Reduce Health Risks from Drinking Alcohol (2009). Canberra, Australian Capital Territory: Australian National Health and Medical Research Council.
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.
Dudley, A., Reibel, T., Bower, C., & Fitzpatrick, J. (2015). Critical review of the literature: fetal alcohol spectrum disorders. Perth: Telethon Kids Institute.
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.
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.
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.
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.
Eyberg, S., & Pincus, D. (1999). Eyberg child behavior inventory and Sutter-Eyberg student behavior inventory revised: professional manual. Lutz, FL: Psychological Assessment Resources Inc.
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.
Taking more action to prevent Fetal Alcohol Spectrum Disorders (2016). In D. o. Health (Ed.). Canberra, Australian Capital Territory: Australian Government.
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.
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.
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.
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.
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.
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.
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.
Gioia, G., Isquith, P., Guy, S., & Kenworthy, L. (2000). Behavior rating inventory of executive function (BRIEF). San Antonio: Psychological Assessment Resources.
Global status report of alcohol and health - 2014 (2014). Luxembourg: World Health Organisation.
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.
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.
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.
Llorente, A., Williams, J., Satz, P., & D’Elia, L. (2003). Children’s color trails Test™ (CCTT™). Lutz: Psychological Assessment resources.
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.
Miller, D. C. (2010). Best practices in school neuropsychology. Guidelines for effective practice, assessment, and evidence-based intervention. New Jersey: Wiley.
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.
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.
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.
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.
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.
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.
Ospina, M., & Dennett, L. (2013). Systematic review on the prevalence of fetal alcohol spectrum disorders. Edmonton: Institute of Health Economics.
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.
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.
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.
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.
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.
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.
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.
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.
Pestell, C., & Paul, A. (2015). Assessment of capacity in young offenders. InPsych: The Bulletin of the Australian Psychological Society Ltd, 37(4), 17.
Poole, N. (2008). Fetal alcohol spectrum disorder (FASD) prevention: Canadian perspectives. Alberta: Public Health Agency of Canada.
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.
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.
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.
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.
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.
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.
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.
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.
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.
Vasilevski, V., & Tucker, A. (2015). Wide-ranging cognitive deficits in adolescents following early life maltreatment. Neuropsychology, 30(2), 239–246. doi:10.1037/neu0000215.
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.
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.
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.
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.
Westerman, T. (2010). Engaging Australian Aboriginal youth in mental health services. Australian Psychologist, 45(3), 212–222. doi:10.1080/00050060903451790.
Western Australian Fetal Alcohol Spectrum Disorder Model of Care (2010). (pp. 1–60). Perth: Health Networks Branch, WA Department of Health.
Williams, M., & Shellenberger, S. (1996). “How does your engine run?” A leader’s guide to the Alert Program for Self-Regulation. Albuquerque: TherapyWorks, Inc.
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.
About this article
Cite this article
Fitzpatrick, J.P., Pestell, C.F. Neuropsychological Aspects of Prevention and Intervention for Fetal Alcohol Spectrum Disorders in Australia. J Pediatr Neuropsychol 3, 38–52 (2017). https://doi.org/10.1007/s40817-016-0018-8