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FASD awareness in the child and family sector: ACWA conference

Imagine being a child who struggles to make sense of the world, facing challenges that others don’t see. This is the reality for many children living with Fetal Alcohol Spectrum Disorder (FASD), one of the most common developmental disorders in Australia. Yet, the majority of children are not diagnosed, leaving many unaware of their difficulties.

In June 2024, I had the opportunity to present a poster at the Association of Children’s Welfare Agencies (ACWA) conference in Sydney, focusing on how child and family welfare workers can play a vital role in supporting children with FASD and their families. In this blog post, I’ll provide a snapshot of some key aspects of FASD and highlight the important role our workforce can play in improving outcomes.

Key Facts and Statistics

It’s estimated that 1% of people globally are affected by FASD – some estimates are even higher, at 2-5%.

Australia has one of the highest rates of alcohol consumption in pregnancy in the world.

  • 35% of pregnancies and 55% of unplanned pregnancies were alcohol-exposed in 2020 [4].
  • Despite these high rates, only 7% of pregnancies had documented alcohol use in antenatal records in 2021 [5].

FASD is a critical issue for child and family welfare services

Parental alcohol use is a key factor in children entering the child protection system, and going into out-of-home-care (OOHC).

  • 63% of pre-birth reports to child protection identified parental alcohol use [6].
  • In 15% of these reports, alcohol was consumed in pregnancy.
  • Children prenatally exposed to alcohol are 4 times more likely to enter care than their peers [7].
  • Researchers estimate FASD affects 25-31% of children in care [8].

Data from three Australian FASD diagnostic clinics indicates that children in OOHC represent between 60-78% of all children assessed. [10,11,12]. Yet diagnosis is often missed.

Children and young people with FASD are at risk of adverse outcomes

FASD is a neurodevelopmental condition with impairments that affect an individual’s learning, behaviour and development, and the effects are lifelong. Many people with FASD have difficulties in self-regulation, impulsivity and attention, as well as cognitive and learning difficulties. They are at higher risk than peers for adverse outcomes including

  • Mental health issues
  • Alcohol and drug issues
  • Involvement in the justice system
  • Disengagement from education.

Most people with FASD have also experienced early life trauma.

The Importance of Early Diagnosis

Early diagnosis of FASD can significantly reduce risks and improve the quality of life for affected individuals. Children with FASD benefit from:

  • Early identification, assessment, and diagnosis
  • Positive role models and mentors
  • Targeted therapies such as speech, occupational therapy, and psychology
  • Caregiver education and support
  • Medical care and pharmacotherapies
  • Sensory supports and adapting environments
  • Adapted learning environments and teaching methods

Being FASD-informed

People working in the child and family service system need to have an understanding of some key concepts including:

  • The imporance of understanding behaviour as a symptom of neuro-developmental impairment
  • We need to change our expectations, our approach and the environment round the person rather than expecting the person with FASD to change
  • We need to take a strength based approach and work within the family’s cultural framework.

FASD-informed practice … means a solid grounding in knowledge on FASD from a family systems perspective and engagement in trauma-informed practice while building supportive relationships with families and communities. (Bagley, K and Badry, D. 2019)

5 actions we can take to Improve Outcomes for people with FASD.

Here are five actions that child and family services workers can take to improve outcomes for people with FASD:

1. Ask the question – did you use alcohol during the pregnancy?

Screening for prenatal alcohol exposure can be done in a sensitive and culturally safe way. Make this part of standard practice, and document it.

2. Make referrals for developmental assessments

Be familiar with FASD indicators and refer for speech, motor skills and cognitive/neuropsychology assessments when there are concerns. Dysregulated behaviour can be attributed to trauma but may also have a developmental basis.

3. Educate yourself about FASD

Explore online training modules and webinars to understand the range of impacts and effective interventions – there are many examples on the FASD Hub and NOFASD Australia.

4. Seek out voices of lived experience

Listen to stories from birth parents, individuals with FASD, First Nations people, and carers to understand the diversity of experiences.

5. Identify gaps in services and programs

Consider how your programs could be more inclusive and responsive to individuals with FASD. Ensure staff have access to necessary resources and training.

You can download a copy of the poster presentation here.

Understanding and addressing FASD requires a community effort. By being informed, supportive, and proactive, we can make a significant difference in the lives of individuals affected by FASD.