Prevalence and profile of Neurodevelopment and Fetal Alcohol Spectrum Disorder (FASD) amongst Australian Aboriginal children living in remote communities

James P Fitzpatrick; Jane Latimer; Heather Carmichael Olson; Maureen Carter; June Oscar; Barbara R Lucas; Robyn Doney; Claire Salter; Julianne Try; Genevieve Hawkes; Emily Fitzpatrick; Marmingee Hand; Rochelle E Watkins; Tracey W Tsang; Carol Bower; Manuela L Ferreira; John Boulton; Elizabeth J Elliott

doi:10.1016/j.ridd.2017.04.001

Prevalence and profile of Neurodevelopment and Fetal Alcohol Spectrum Disorder (FASD) amongst Australian Aboriginal children living in remote communities

Res Dev Disabil. 2017 Jun:65:114-126. doi: 10.1016/j.ridd.2017.04.001. Epub 2017 May 9.

Authors

James P Fitzpatrick¹, Jane Latimer², Heather Carmichael Olson³, Maureen Carter⁴, June Oscar⁵, Barbara R Lucas⁶, Robyn Doney⁷, Claire Salter⁸, Julianne Try⁹, Genevieve Hawkes¹⁰, Emily Fitzpatrick¹¹, Marmingee Hand¹², Rochelle E Watkins¹³, Tracey W Tsang¹⁴, Carol Bower¹⁵, Manuela L Ferreira¹⁶, John Boulton¹⁷, Elizabeth J Elliott¹⁸

Affiliations

¹ Discipline of Paediatrics and Child Health, Sydney Medical School, University of Sydney, Australia; Telethon Kids Institute, The University of Western Australia, Perth, Australia. Electronic address: james.fitzpatrick@telethonkids.org.au.
² The George Institute for Global Health, Sydney Medical School, University of Sydney, Australia. Electronic address: jlatimer@georgeinstitute.org.au.
³ The University of Washington School of Medicine, Seattle, Washington, USA; Seattle Children's Research Institute, Seattle, Washington, USA. Electronic address: heather.carmichael_olson@seattlechildrens.org.
⁴ Nindilingarri Cultural Health Services, Fitzroy Crossing, Australia. Electronic address: maureen.carter@nindilingarri.org.au.
⁵ Marninwarntikura Women's Resource Centre, Fitzroy Crossing, Australia; University of Notre Dame, Broome, Australia. Electronic address: june.oscar9@gmail.com.
⁶ Discipline of Paediatrics and Child Health, Sydney Medical School, University of Sydney, Australia; The George Institute for Global Health, Sydney Medical School, University of Sydney, Australia. Electronic address: blucas@georgeinstitute.org.au.
⁷ School of Public Health, Curtin University, Perth, Australia. Electronic address: robyndoney@gmail.com.
⁸ Derby Allied Health Service, Western Australian Country Health Services, Derby, Australia. Electronic address: ce_salter@bigpond.com.
⁹ Department of Education and Early Childhood Development, Government of Victoria, Australia. Electronic address: juliannectry@gmail.com.
¹⁰ Derby Allied Health Service, Western Australian Country Health Services, Derby, Australia. Electronic address: gen.hawkes@gmail.com.
¹¹ Discipline of Paediatrics and Child Health, Sydney Medical School, University of Sydney, Australia. Electronic address: emilyfitzp@gmail.com.
¹² University of Notre Dame, Broome, Australia. Electronic address: marmingee.hand@det.wa.edu.au.
¹³ Telethon Kids Institute, The University of Western Australia, Perth, Australia. Electronic address: rochelle.watkins@telethonkids.org.au.
¹⁴ Discipline of Paediatrics and Child Health, Sydney Medical School, University of Sydney, Australia. Electronic address: tracey.tsang@sydney.edu.au.
¹⁵ Telethon Kids Institute, The University of Western Australia, Perth, Australia. Electronic address: carol.bower@telethonkids.org.au.
¹⁶ The George Institute for Global Health, Sydney Medical School, University of Sydney, Australia. Electronic address: mferreira@georgeinstitute.org.au.
¹⁷ Telethon Kids Institute, The University of Western Australia, Perth, Australia. Electronic address: john.boulton10@bigpond.com.
¹⁸ Discipline of Paediatrics and Child Health, Sydney Medical School, University of Sydney, Australia; The George Institute for Global Health, Sydney Medical School, University of Sydney, Australia. Electronic address: elizabeth.elliott@health.nsw.gov.au.

PMID: 28499185
DOI: 10.1016/j.ridd.2017.04.001

Abstract

Background: Despite multiple risk factors for neurodevelopmental vulnerability, few studies have assessed neurodevelopmental performance of Australian Aboriginal children. An important risk factor for neurodevelopmental vulnerability is prenatal alcohol exposure (PAE), which places children at risk for Fetal Alcohol Spectrum Disorder (FASD).

Aims: This study assesses neurodevelopment outcomes in a population of Australian Aboriginal children with and without PAE.

Methods and procedures: Children born in 2002/2003, and living in the Fitzroy Valley, Western Australia between April 2010 and November 2011, were eligible (N=134). Sociodemographic and antenatal data, including PAE, were collected by interview with 127/134 (95%) consenting parents/caregivers. Maternal/child medical records were reviewed. Neurodevelopment was assessed by clinicians blinded to PAE in 108/134 (81%) children and diagnoses on the FASD spectrum were assigned.

Outcomes and results: Neurodevelopmental disorder was documented in 34/108 children (314.8 per 1000). Any diagnosis on the FASD spectrum was made in 21/108 (194.4 per 1000) children (95% CI=131.0-279.0).

Conclusions and implications: Neurodevelopmental impairment with or without PAE is highly prevalent among children in the Fitzroy Valley. Rates of diagnoses on the FASD spectrum are among the highest worldwide. Early intervention services are needed to support developmentally vulnerable children in remote communities.

Keywords: Australian Aboriginal; Child development; Fetal Alcohol Spectrum Disorder (FASD); Fetal Alcohol Syndrome (FAS); Prenatal alcohol exposure.

MeSH terms

Child
Child Development*
Demography
Female
Fetal Alcohol Spectrum Disorders* / diagnosis
Fetal Alcohol Spectrum Disorders* / ethnology
Humans
Male
Native Hawaiian or Other Pacific Islander / statistics & numerical data
Needs Assessment
Nervous System / growth & development
Neurologic Examination / methods
Neurologic Examination / statistics & numerical data
Pregnancy
Prenatal Exposure Delayed Effects / diagnosis
Prenatal Exposure Delayed Effects / epidemiology
Prenatal Exposure Delayed Effects / prevention & control
Socioeconomic Factors
Western Australia / epidemiology