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J FAS Int 2005;3:e2 - Jan. 2005
Approaches of Canadian Providers to the Diagnosis of Fetal Alcohol Spectrum Disorders

Margaret Clarke, Suzanne C Tough, Matt Hicks, Sterling Clarren


Background
A better understanding of the attitudes and knowledge of providers towards diagnosis of fetal alcohol spectrum disorders (FASD) will assist in the development of appropriate supports and interventions.

Objective
To determine approaches of providers to the diagnosis of FASD.

Methods
Between October 2001 and May 2002, a survey was mailed to a national random sample of paediatricians, psychiatrists, obstetricians and gynaecologists, family physicians, and midwives in Canada, who were current members of professional organisations (N=5361).

Results
The overall response rate was 41.3%. Over 90% of providers agreed that a diagnosis of fetal alcohol syndrome (FAS) can change things for affected children and 75% agreed making a diagnosis is within their scope of practice. The most noted barrier to diagnosis was lack of training (56.4%). The most common sources of FAS information were medical journals (76.4%), medical school (63.6%), and Continuing Medical Education (CME) seminars (50.9%). Approximately 60% of providers correctly identified the combination of growth, brain and facial abnormalities as providing the most accurate diagnosis of FAS. Over 60% of providers identified emotional disorders, disrupted school experience, addictions and legal problems as long term outcomes associated with FAS. There were significant differences (p≤0.001) across provider group with regard to scope of practice, barriers to diagnosis, source of knowledge, diagnostic knowledge, and understanding of long term outcomes.

Discussion
Providers have identified lack of training as a barrier to diagnosis of FAS. Thus, there are potential opportunities for provider training to improve the probability of diagnosis for affected children.

Key Words: fetal alcohol spectrum disorders; fetal alcohol syndrome; diagnosis; physician?s practice patterns; professional practice; knowledge; education

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