Fetal alcohol spectrum disorder identification in Australia: A qualitative analysis of perspectives from psychologists and individuals with lived and living experience

BACKGROUND: Fetal alcohol spectrum disorder (FASD) is a neurodevelopmental disorder associated with prenatal alcohol exposure (PAE). In Australia, there are several barriers to assessment, including a limited number of FASD-informed clinicians. This study aimed to understand the perspectives of psychologists, parents, caregivers, and adults with FASD on the current assessment process, as well as methods to improve FASD training and universal screening of PAE.

METHODS: Two groups of (1) psychologists and (2) parents, caregivers, and adults with FASD were interviewed about their experiences of FASD assessment and their recommendations for training and universal screening of PAE. Thematic analysis was employed to code data.

RESULTS: Five key themes were identified: (1) stigma and stereotypes of PAE, (2) support for universal screening of PAE, (3) differential, co-occurring, and missed diagnoses, (4) lack of support following diagnosis, and (5) need for improved training for psychologists. Stereotypes of women who drink were present across themes, with both groups discussing the importance of PAE assessment for all women during antenatal care and when presenting for assessment of neurodevelopmental disorders. The importance of training more FASD-informed clinicians who can understand the uniqueness of each individual with FASD was highlighted, with hopes of improving diagnostic capacity as well as support offered by psychologists.

CONCLUSIONS: Recognition of the impact of PAE is growing in Australia; however, there is a need to embed this topic within university training for psychologists.