Fetal alcohol spectrum disorders: Current issues in awareness, prevention and intervention
How common are fetal alcohol spectrum disorders?
It is difficult to estimate the prevalence of FASD. The true incidence and prevalence of FASD in Australia is currently unknown, as children are not routinely screened for FASD in infancy or childhood (Burns, Elliot et al., 2012; House of Representatives Standing Committee on Social Policy and Legal Affairs, 2012). Available figures are likely to underestimate the true incidence of FASD (Burns, Breen, Bower, O'Leary, & Elliot, 2013). Estimates for FAS (at the more severe end of the spectrum of disorders) range from between 0.01 to 1.7 per 1,000 live births (Burns et al., 2013), although this may be higher among Indigenous communities where FAS has been recorded. The Foundation for Alcohol Research & Education (FARE) reports that among Indigenous Australians, the incidence of FAS may be as high as 1.87 to 4.7 per 1,000 births (Burns et al., 2013). It has been suggested that as many as 2% of all Australian babies may be born with some form of FASD (House of Representatives Standing Committee on Social Policy and Legal Affairs, 2012).
Attempts to establish estimates are hampered by many factors, including incomplete or inconsistent information regarding the maternal history of alcohol use, lack of awareness of FASD among professionals, lack of specialised diagnostic and support services, and fear of stigmatising the mother. There may also be a reluctance to provide a formal diagnosis or label for the child brought about by an absence of background information, the perceived stigma attached to diagnosis and the absence of appropriate follow-up services (Elliott, Payne, Haan, & Bower, 2006; Payne et al., 2005). There is a need to establish agreed methods for the assessment of maternal alcohol consumption and for screening populations, particularly in high-risk communities, that are suitable for use in Australian settings. This will build the capacity to accurately assess the prevalence of FASD in Australian populations into the future (Burns, Elliot et al., 2012; Burns et al., 2013; Watkins et al., 2013).