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Fetal alcohol spectrum disorder: development of consensus referral criteria for specialist diagnostic assessment in Australia

Watkins, Rochelle E., Elliott, Elizabeth J., Wilkins, Amanda, Latimer, Jane, Halliday, Jane, Fitzpatrick, James P., Mutch, Raewyn C., O'Leary, Colleen M., Burns, Lucinda, McKenzie, Anne, Jones, Heather M., Payne, Janet M., D'Antoine, Heather, Miers, Sue, Russell, Elizabeth, Hayes, Lorian, Carter, Maureen and Bower, Carol (2014). Fetal alcohol spectrum disorder: development of consensus referral criteria for specialist diagnostic assessment in Australia. BMC Pediatrics,14(Article No.178).

Document type: Journal Article
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Title Fetal alcohol spectrum disorder: development of consensus referral criteria for specialist diagnostic assessment in Australia
Author Watkins, Rochelle E.
Elliott, Elizabeth J.
Wilkins, Amanda
Latimer, Jane
Halliday, Jane
Fitzpatrick, James P.
Mutch, Raewyn C.
O'Leary, Colleen M.
Burns, Lucinda
McKenzie, Anne
Jones, Heather M.
Payne, Janet M.
D'Antoine, Heather
Miers, Sue
Russell, Elizabeth
Hayes, Lorian
Carter, Maureen
Bower, Carol
Journal Name BMC Pediatrics
Publication Date 2014
Volume Number 14
Issue Number Article No.178
ISSN 1471-2431   (check CDU catalogue open catalogue search in new window)
Scopus ID 2-s2.0-84905912756
Total Pages 12
Place of Publication United Kingdom
Publisher BioMed Central Ltd.
HERDC Category C1 - Journal Article (DIISR)
Abstract Background
Fetal alcohol spectrum disorder (FASD) is known to be under-recognised in Australia. The use of standard methods to identify when to refer individuals who may have FASD for specialist assessment could help improve the identification of this disorder. The purpose of this study was to develop referral criteria for use in Australia.


An online survey about FASD screening and diagnosis in Australia, which included 23 statements describing criteria for referral for fetal alcohol syndrome (FAS) and FASD based on published recommendations for referral in North America, was sent to 139 health professionals who had expertise or involvement in FASD screening or diagnosis. Survey findings and published criteria for referral were subsequently reviewed by a panel of 14 investigators at a consensus development workshop where criteria for referral were developed.


Among the 139 health professionals who were sent the survey, 103 (74%) responded, and 90 (65%) responded to the statements on criteria for referral. Over 80% of respondents agreed that referral for specialist evaluation should occur when there is evidence of significant prenatal alcohol exposure, defined as 7 or more standard drinks per week and at least 3 standard drinks on any one day, and more than 70% agreed with 13 of the 16 statements that described criteria for referral other than prenatal alcohol exposure. Workshop participants recommended five independent criteria for referral: confirmed significant prenatal alcohol exposure; microcephaly and confirmed prenatal alcohol exposure; 2 or more significant central nervous system (CNS) abnormalities and confirmed prenatal alcohol exposure; 3 characteristic FAS facial anomalies; and 1 characteristic FAS facial anomaly, growth deficit and 1 or more CNS abnormalities.


Referral criteria recommended for use in Australia are similar to those recommended in North America. There is a need to develop resources to raise awareness of these criteria among health professionals and evaluate their feasibility, acceptability and capacity to improve the identification of FASD in Australia.
Keywords Fetal alcohol spectrum disorder
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Additional Notes This is an Open Access article distributed under the terms of the Creative Commons Attribution License 4.0, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Description for Link Link to CC Attribution 4.0 License

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