August 25, 2022

Why is FASD diagnosis important?

VicFAS - Dr Katrina Harris and Prue Walker, and support from Dr Ali Crichton and Dr Annette Connelly

What is FASD?

Fetal Alcohol Spectrum Disorder (FASD) is a term describing a range of life-long effects on a person due to prenatal alcohol exposure.1, 2

These effects range from mild to severe. This depends on the amount and frequency of drinking during pregnancy, and other factors like the parents’ nutrition and genetics.3

The main impacts of FASD are on a person’s learning, memory, behaviour and development.4

We’ve known for a long time that high levels of drinking during pregnancy can result in FASD.5 But we now know that even low levels of drinking during pregnancy can have an impact on a child’s development.6

You can read more about FASD prevention in our Mini Bulletin report.

International FASD Awareness Day

September 9 is International Fetal Alcohol Spectrum Disorder (FASD) Awareness Day. It’s a day to raise awareness about FASD and inspire positive change for those impacted. 

The day also highlights the importance of being alcohol-free during pregnancy to prevent FASD.

FASD is a community-wide issue that requires community support. You can find out more on the NoFASD Australia website.

Why is it important to identify children with FASD?

For people living with FASD, the impacts are lifelong.4

Being diagnosed is important because it means that the person affected, and their family, can be provided with support. Early diagnosis and support results in better social and physical health.4

It also means families can be provided with help to manage the challenges they might experience.

Why does FASD often go undiagnosed?

In Australia, FASD is under-recognised and often goes undiagnosed.7

FASD may also be more common than we previously thought or than is currently reported.8, 9

The reasons why include:

  • even low levels of drinking can impact development and may cause FASD6
  • capacity of service providers and capability of practitioners to diagnose it has been limited2
  • there’s a lot of stigma associated with FASD. Women don’t speak about drinking during pregnancy for fear of being judged. Clinicians also may not ask for fear of stigmatising the parent-to-be.10, 11

In 2020, the Australian Guide to the Diagnosis of FASD was updated to help define what’s needed for a FASD diagnosis.8

A diagnosis requires:

  • evidence of pre-natal alcohol exposure, and 
  • severe impairment in three or more areas of brain structure or function.8

Supporting diagnosis in Victoria

Until recently, clinics that diagnose FASD in Victoria were limited. This meant that families were either waiting a long time to access the services, or they had to travel interstate to receive a diagnosis. 

The Victorian Fetal Alcohol Service (VicFAS) is a state-wide service consisting of a team of clinical experts who:

  • help services diagnose and meet the needs of children (3-10yrs) with FASD
  • provide training to local clinicians so they can deliver diagnostic services in the future.

How is FASD assessed?

At VicFAS, children are referred to the service by their paediatrician. 

After a referral to VicFAS, the team gathers information about the child from a range of people, such as their doctor, school and family. 

Then VicFAS brings together a range of specialists to meet with the child and their family/carers to help support the assessment process. 

It is through this process that a formal diagnosis can be made, and information given about how to best support the child at home and at school.

Support can include:

  • helping families understand their child’s behaviours 
  • simplifying routines and providing structure and supervision 
  • referrals to the NDIS for speech therapy, occupational therapy or psychological supports
  • FASD education for parents, carers, teachers and professionals.

Supporting children across regional Victoria

To support families living in regional Victoria, VicFAS provides diagnostic services and training in regional areas. In January 2022, VicFAS received further Federal Government funding to expand these services to more regional areas over the next 3 years.12

Existing local health care providers are included in the diagnosis process. This helps the VicFAS team get to know each child better. It also gives existing health care providers a chance to learn about FASD diagnosis and support. 

VicFAS engages with paediatric community health teams who are keen to develop skills in this area. 

VicFAS also support regional community health teams to make FASD diagnosis through secondary consultation – providing advice, guidance and expertise remotely.

Want to know more about FASD diagnosis?

The FASD Hub provides current information about diagnosis, training and education, and supports for health professionals. It has a list of current training opportunities here and a directory of services.

If you would like further information about supporting children with FASD, you can find a summary on the Australian Institute of Family Studies website

There’s more information for parents/carers located on NOFASD

If you want to access diagnosis services for your child in Victoria, you can speak to your GP, and take a look at the VicFAS service


Pictured above, from left to right: Dr. Alison Crichton (VicFAS Clinical Coordinator and Senior Clinical Neuropsychologist), Natalie Huynh (Administrative Assistant), Prue Walker (VicFAS Service Coordinator), Dr. Katrina Harris (Developmental Paediatrician and VicFAS Lead), Maria Kouspos (Speech Pathologist).

This Insights article was prepared by the ADF with input from Dr Katrina Harris and Prue Walker, and support from Dr Ali Crichton (VicFAS Clinical Coordinator) and Dr Annette Connelly (VIcFAS Paediatrician). 

Dr Katrina Harris is a paediatrician, Head of Developmental and Community Paediatrics at Monash Children’s Hospital and of the recently established Victorian Fetal Alcohol Service (VicFAS). Dr Harris is a member of the National Fetal Alcohol Spectrum Disorder Advisory group, Adjunct Senior Lecturer at Monash University in Paediatrics, and national examiner for the Royal Australasian College of Physicians. She has worked in public hospital paediatric settings for over 20 years. Dr Harris works with children with neurodevelopmental differences - children with challenges in thinking, learning, behaviour, social and communication skills. 

Prue Walker is a social worker at the Victorian Fetal Alcohol Service (VicFAS) and provides FASD consultancy services to professionals and families. Prue’s background is in child protection and out of home care, in both Victoria and the Northern Territory. She undertook a Churchill Fellowship in 2009 investigating models of care for children with FASD in the US and Canada. Prue delivers workshops and training in relation to FASD, including assessment, prevention and case management. She provides FASD coaching to individuals and families and works as a mentor to adults with FASD with a focus on self-advocacy. Prue is a sessional teacher in Social Work at La Trobe University.

  1. Helgesson G, Bertilsson G, Domeij H, Fahlström G, Heintz E, Hjern A, et al. Ethical aspects of diagnosis and interventions for children with Fetal Alcohol Spectrum Disorder (FASD) and their families. BMC Medical Ethics [Internet]. 2018 [15.08.2022]; 19(1):[1-7 pp.]. Available from:
  2. McLean S.Fetal Alcohol Spectrum Disorder (FASD): An update on policy and practice in Australia. Southbank: Australian Institute of Family Studies, Australia CFC; 2022. Report No.: 978-1-76016-247-4.
  3. Kapur BM, Baber M. FASD: folic acid and formic acid—an unholy alliance in the alcohol abusing mother. Journal of Biochemistry and Cell Biology [Internet]. 2018 [15.08.2022]; 96(2):[189-97 pp.].
  4. FASD Hub. What is Fetal Alcohol Spectrum Disorder (FASD)? 2021 [16.08.2022].
  5. Jonsson E. Fetal Alcohol Spectrum Disorders (FASD): A Policy Perspective. Canadian Journal of Psychiatry [Internet]. 2019 [15.08.2022]; 64(3):[161-3 pp.].
  6. Halliday JL ME, Lewis S, Elliott EJ,  Amor DJ, O’Leary C, Donath S, Forster D, Nagle C, Craig JM, Anderson PJ. Alcohol consumption in a general antenatal population and child neurodevelopment at 2 years. Journal of Epidemiology and Community Health [Internet]. 2017 [15.08.2022]; 71(10):[990-8 pp.].
  7. Bower C, Watkins RE, Mutch RC, Marriott R, Freeman J, Kippin NR, et al.Fetal alcohol spectrum disorder and youth justice: a prevalence study among young people sentenced to detention in Western Australia. BMJ open [Internet]. 2018 [16.08.2022]; 8(2):[e019605 p.].
  8. Bower C, Elliot EJ. Australian Guide to the diagnosis of Fetal Alcohol Spectrum Disorder 2020 [16.08.2022].
  9. Commonwealth of Australia DoH. National Fetal Alcohol Spectrum Disorder Strategic Action Plan 2018 [15.08.2022].
  10. Shelton D, Reid N, Till H, Butel F, Moritz K. Responding to fetal alcohol spectrum disorder in Australia. Journal of Paediatrics and Child Health [Internet]. 2018 [16.08.2022]; 54(10):[1121-6 pp.].
  11. Corrigan PW, Shah BB, Lara JL, Mitchell KT, Simmes D, Jones KL. Addressing the public health concerns of Fetal Alcohol Spectrum Disorder: Impact of stigma and health literacy. Drug and alcohol dependence[Internet]. 2018 [16.08.2022]; 185:[266-70 pp.].
  12. Monash Health. Monash Children’s Hospital VicFAS program receives funding to further support regional communities 2022 [22.08.2022].

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