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

BMC Pediatrics

Carol Bower⁸  Maureen Carter¹  Lorian Hayes⁴  Elizabeth Russell⁹  Sue Miers³  Heather D’Antoine^1,10  Janet M Payne⁸  Heather M Jones⁸  Anne McKenzie⁸  Lucinda Burns²  Colleen M O’Leary⁶  Raewyn C Mutch⁷  James P Fitzpatrick⁵  Jane Halliday^1,11  Jane Latimer⁵  Amanda Wilkins⁷  Elizabeth J Elliott⁵  Rochelle E Watkins⁸ 

[1]Nindilingarri Cultural Health Services, Fitzroy Crossing, Australia

[2]National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia

[3]National Organisation for Fetal Alcohol Spectrum Disorders, Adelaide, Australia

[4]Centre for Chronic Disease, School of Medicine, University of Queensland, Brisbane, Australia

[5]The George Institute for Global Health, Sydney Medical School, University of Sydney, Sydney, Australia

[6]Centre for Population Health Research, Curtin University, Perth, Australia

[7]Department of Health Western Australia, Child and Adolescent Health Service, Perth, Australia

[8]Telethon Kids Institute, The University of Western Australia, Perth, Australia

[9]Russell Family Fetal Alcohol Disorders Association, Cairns, Australia

[10]Menzies School of Health Research, Charles Darwin University, Darwin, Australia

[11]Public Health Genetics, Genetic Disorders, Murdoch Childrens Research Institute, Melbourne, Australia

关键词: Consensus;    Referral;    Fetal alcohol spectrum disorder;   

Others  :  1138601
DOI  :  10.1186/1471-2431-14-178

 received in 2014-03-21, accepted in 2014-06-27,  发布年份 2014

【 摘 要 】

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.

Method

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.

Results

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.

Conclusion

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.

【 授权许可】

   
2014 Watkins et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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