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A modified Delphi study of screening for fetal alcohol spectrum disorders in Australia

Watkins, Rochelle, Elliott, Elizabeth, Halliday, Jane, O'Leary, Colleen, D'Antoine, Heather, Russell, Elizabeth, Hayes, Lorian, Peadon, Elizabeth, Wilkins, Amanda, Jones, Heather, McKenzie, Anne, Miers, Sue, Burns, Lucinda, Mutch, Raewyn, Payne, Janet, Fitzpatrick, James, Carter, Maureen, Latimer, Jane and Bower, Carol (2013). A modified Delphi study of screening for fetal alcohol spectrum disorders in Australia. BMC Pediatrics,13(13):1-12.

Document type: Journal Article
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IRMA ID cmartelxPUB164
NHMRC Grant No. CB634341
JH1021252
CB & JMP 572742
EJE457084 & 1021480
EJE & CB 402784
Jl FT0991861
Title A modified Delphi study of screening for fetal alcohol spectrum disorders in Australia
Author Watkins, Rochelle
Elliott, Elizabeth
Halliday, Jane
O'Leary, Colleen
D'Antoine, Heather
Russell, Elizabeth
Hayes, Lorian
Peadon, Elizabeth
Wilkins, Amanda
Jones, Heather
McKenzie, Anne
Miers, Sue
Burns, Lucinda
Mutch, Raewyn
Payne, Janet
Fitzpatrick, James
Carter, Maureen
Latimer, Jane
Bower, Carol
Journal Name BMC Pediatrics
Publication Date 2013
Volume Number 13
Issue Number 13
ISSN 1471-2431   (check CDU catalogue open catalogue search in new window)
Start Page 1
End Page 12
Total Pages 12
Place of Publication United Kingdom
Publisher BioMed Central Ltd.
HERDC Category C1 - Journal Article (DIISR)
Abstract Background
There is little reliable information on the prevalence of fetal alcohol spectrum disorders (FASD) in Australia and no coordinated national approach to facilitate case detection. The aim of this study was to identify health professionals’ perceptions about screening for FASD in Australia.

Method
A modified Delphi process was used to assess perceptions of the need for, and the process of, screening for FASD in Australia. We recruited a panel of 130 Australian health professionals with experience or expertise in FASD screening or diagnosis. A systematic review of the literature was used to develop Likert statements on screening coverage, components and assessment methods which were administered using an online survey over two survey rounds.

Results
Of the panel members surveyed, 95 (73%) responded to the questions on screening in the first survey round and, of these, 81 (85%) responded to the second round. Following two rounds there was consensus agreement on the need for targeted screening at birth (76%) and in childhood (84%). Participants did not reach consensus agreement on the need for universal screening at birth (55%) or in childhood (40%). Support for targeted screening was linked to perceived constraints on service provision and the need to examine the performance, costs and benefits of screening.
For targeted screening of high risk groups, we found highest agreement for siblings of known cases of FASD (96%) and children of mothers attending alcohol treatment services (93%). Participants agreed that screening for FASD primarily requires assessment of prenatal alcohol exposure at birth (86%) and in childhood (88%), and that a checklist is needed to identify the components of screening and criteria for referral at birth (84%) and in childhood (90%).

Conclusions
There is an agreed need for targeted but not universal screening for FASD in Australia, and sufficient consensus among health professionals to warrant development and evaluation of standardised methods for targeted screening and referral in the Australian context. Participants emphasised the need for locally-appropriate, evidence-based approaches to facilitate case detection, and the importance of ensuring that screening and referral programs are supported by adequate diagnostic and management capacity.

Additional Notes This is an Open Access article distributed under the terms of the Creative Commons Attribution License 3.0, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Description for Link Link to CC Attribution 3.0 License
Link to published version
URL https://creativecommons.org/licenses/by/3.0/au/legalcode
http://www.biomedcentral.com/1471-2431/13/13/abstract


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