Clinical Conversations: Fetal Alcohol Syndrome – A Practical Approach for GPs | Part one

Clinical Conversations: Fetal Alcohol Syndrome – A Practical Approach for GPs | Part one


Fetal alcohol spectrum disorder (FASD) is an underdiagnosed condition that should be suspected in patients with neurodevelopmental delay, learning difficulties and in some cases, specific facial features.

Those who have been in the justice system are also at high risk, based on research by A/Prof. Carmela Pestell and her colleagues. She has been involved with FASD for decades and wants to increase awareness of this condition. Early diagnosis and intervention gives the best chance of a productive life for the person with FASD.

This is part one of this series. Read Part 2 >>

Practice points

• Epidemiological data from similar countries to Australia suggest that FASD likely to affect between 2% and 5% of the population.
• It occurs in all socioeconomic backgrounds but the prevalence is ten to forty times higher in certain high risk groups, such as children that are involved in the justice system or in child protection.
• It is not known if there is a safe level of alcohol use in pregnancy but certainly there’s a dose dependent relationship.
• FASD has three sentinel facial features, a short palpebral fissure length, a smooth philtrum and a thin upper lip. However, facial features only occur in a small proportion of cases, which contributes to the under-diagnosis of this condition. There also needs to be significant impairment in at least three neurodevelopmental domains, according to Australian Diagnostic Guidelines.
• We should not shaming mothers, because people obviously drink for a lot of reasons and often, it’s because they’ve been misinformed.

A/Prof. Carmela Pestell is a clinician, lecturer and researcher who is based at the Robin Winkler Clinic in the School of Psychological Sciences at the University of Western Australia. She has worked as a clinical psychologist and neuropsychologist for more than twenty years. Dr Pestell was the lead neuropsychologist on the Banksia Hill Detention Centre Study that investigated the prevalence ...

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