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Improving Early Detection and Treatment of Fetal Alcohol Spectrum Disorder using community-based, culturally-appropriate, screening.

The Challenge

Fetal alcohol spectrum disorder (FASD) refers to the range of problems caused by exposure to alcohol during pregnancy. If a woman drinks alcohol while she is pregnant, the alcohol crosses the placenta from her blood into the baby’s bloodstream and the baby is exposed to similar concentrations of alcohol as the mother. 

The effects of alcohol on a fetus include harm to the development of the fetal nervous system, including the brain under-nourishment of the growing baby in some cases, alcohol can cause changes in the development of the baby’s face, resulting in certain facial features. 

Babies severely affected by FASD are at risk of dying before they are born.  Not all babies exposed to alcohol develop FASD. The risk of harm to the fetus is highest when exposure to alcohol occurs regularly or due to frequent binge drinking during pregnancy. 

Research suggests that FASD occurs in between 1.1% and 5.0% of children in Western countries. However, data shows that the rate of alcohol consumption is highest in rural and remote areas, where there is a relatively greater proportions of Aboriginal than non-Aboriginal people.  One Australian study on a remote Indigenous community found an estimated rates of FASD of 12%-19.4%. 

The three main features used to make a diagnosis of FASD are:

  1. significant problems with learning and behaviour (particularly understanding consequences of actions and impulsive behaviour);

  2. certain facial features that are known to be associated with FASD;

  3. a history of prenatal alcohol exposure. 

In addition to the health impacts of FASD, studies show that young people with FASD are overrepresented in the youth justice system. An Australian study found a prevalence rate of 36% in a Western Australian youth justice setting. 

Research has found that active case ascertainment is the most effective method of identifying children with FASD, enabling these children to be referred for specialist treatment to mitigate life-long impacts of the condition.   

In Aboriginal communities in particular, a combination of stigma associated with the possible consumption of alcohol during pregnancy, and historic fear of child removal, discourages many Aboriginal parents from presenting their children to be screened and provided with treatment. 

The key barriers to improving the improving health and life outcomes for children with FASD includes: 

  1. lack of awareness of the risks of consuming alcohol in pregnancy, and the key features of FASD in children;

  2. low take up of screening due to stigma or fear of child removal; - lack of access to cost-effective screening services locally; 

  3. lack of appropriately skills, and culturally-aware, health professionals to conduct screening and diagnosis; uncertainty about the long-term cost of assessment and treatment 

Theory of Change

Offering a dedicated mobile FASD Screening Service, staffed by qualified and trained Nurse Practitioner and Aboriginal Health Workers, will increase the confidence of parents to allow their child to undergo screening and the accuracy of diagnosis and treatment referrals.

Anticipated Outcomes

Short-Intermediate Term Outcomes

  1. Improved health literacy around alcohol consumption during pregnancy. 

  2. Increased utilisation of screening services. 

  3. Increase in first-past screening referrals.

Long-Term Outcomes

1. Increase in detection of FASD in rural and remote communities. 

2. Increase in appropriate referrals to specialist services for treatment.


Health Literacy


Number of Parents participated in community engagement

FASD Screening


Number of Children Screened for FASD

FASD Treatment


Number of children referred to CICADA for diagnoses


15 Apr 2024


Social Impact



Julia Faulkner, Manager Rural and Remote Health Initiatives (0451 816 827)

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