Open Access Research article

Recommendations from a consensus development workshop on the diagnosis of fetal alcohol spectrum disorders in Australia

Rochelle E Watkins1*, Elizabeth J Elliott234, Amanda Wilkins15, Raewyn C Mutch15, James P Fitzpatrick24, Janet M Payne1, Colleen M O’Leary16, Heather M Jones1, Jane Latimer4, Lorian Hayes7, Jane Halliday8, Heather D’Antoine9, Sue Miers10, Elizabeth Russell11, Lucinda Burns12, Anne McKenzie1, Elizabeth Peadon23, Maureen Carter13 and Carol Bower1

Author Affiliations

1 Telethon Institute for Child Health Research, Centre for Child Health Research, The University of Western Australia, P.O. Box 855, West Perth, WA 6872, Australia

2 Discipline of Paediatrics and Child Health, Sydney Medical School, University of Sydney, Sydney, Australia

3 The Children’s Hospital at Westmead, Sydney, Australia

4 The George Institute for Global Health, Sydney, Australia

5 Child and Adolescent Health Service, Department of Health Western Australia, Perth, Australia

6 Centre for Population Health Research, Curtin University, Perth, Australia

7 Centre for Chronic Disease, School of Medicine, University of Queensland, Brisbane, Australia

8 Public Health Genetics, Genetic Disorders, Murdoch Childrens Research Institute, Melbourne, Australia

9 Menzies School of Health Research, Charles Darwin University, Darwin, Australia

10 National Organisation for Fetal Alcohol Spectrum Disorders, Adelaide, Australia

11 Russell Family Fetal Alcohol Disorders Association, Cairns, Australia

12 National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia

13 Nindilingarri Cultural Health Services, Fitzroy Crossing, Australia

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BMC Pediatrics 2013, 13:156  doi:10.1186/1471-2431-13-156

Published: 2 October 2013



Fetal alcohol spectrum disorders (FASD) are underdiagnosed in Australia, and health professionals have endorsed the need for national guidelines for diagnosis. The aim of this study was to develop consensus recommendations for the diagnosis of FASD in Australia.


A panel of 13 health professionals, researchers, and consumer and community representatives with relevant expertise attended a 2-day consensus development workshop to review evidence on the screening and diagnosis of FASD obtained from a systematic literature review, a national survey of health professionals and community group discussions. The nominal group technique and facilitated discussion were used to review the evidence on screening and diagnosis, and to develop consensus recommendations for the diagnosis of FASD in Australia.


The use of population-based screening for FASD was not recommended. However, there was consensus support for the development of standard criteria for referral for specialist diagnostic assessment. Participants developed consensus recommendations for diagnostic categories, criteria and assessment methods, based on the adaption of elements from both the University of Washington 4-Digit Diagnostic Code and the Canadian guidelines for FASD diagnosis. Panel members also recommended the development of resources to: facilitate consistency in referral and diagnostic practices, including comprehensive clinical guidelines and assessment instruments; and to support individuals undergoing assessment and their parents or carers.


These consensus recommendations provide a foundation for the development of guidelines and other resources to promote consistency in the diagnosis of FASD in Australia. Guidelines for diagnosis will require review and evaluation in the Australian context prior to national implementation as well as periodic review to incorporate new knowledge.

Fetal alcohol spectrum disorder; Diagnosis; Consensus