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A summary of the new Australian Guidelines for Assessment and Diagnosis of Fetal Alcohol Spectrum Disorder has been published in the Medical Journal of Australia.
The guidelines were released in May 2025 as an update to the 2016 Guide. They were developed through extensive stakeholder consultation, a comprehensive review of empirical evidence and the application of a novel Grading of Recommendations, Development and Evaluation (GRADE)-based approach for developing evidence-based diagnostic criteria.
Recommendations
The guidelines include 11 GRADE-based recommendations, forming the core of the diagnostic criteria, and 11 lived experience statements, supporting client-centred assessment approaches. The guidelines also feature 40 good practice statements and 18 implementation considerations, tools and tips as practical resources and supports for practitioners.
A table outlining the recommendations can be viewed here.
Changes in management as a result of the guidelines
Key changes in the new guidelines include:
- A minimum prenatal alcohol exposure threshold for diagnosis to support more precise identification of fetal alcohol spectrum disorder (FASD);
- The assessment of neurodevelopmental impairments and functioning has been refined, including detailed advice for practitioners seeking to identify clinically significant impairments;
- Inclusion/exclusion of neurodevelopmental domains as part of the assessment; and
- Revisions to some of the content of the included neurodevelopmental domains.
Changes have also been made with attention to the needs of First Nations Australians and people from other culturally and linguistically diverse backgrounds. The guidelines advocate for the use of shared decision-making approaches, promoting collaboration between practitioners, individuals attending for assessment and their support network. Importantly, the guidelines will enable an accessible, holistic and flexible assessment process, supporting timely and accurate assessment and diagnosis of FASD in Australia. The rigorous development process also provides practitioners with confidence in the guidelines, promoting increased uptake of assessment and diagnostic practices, and informing international diagnostic criteria and guidelines.
Read the guideline summary in the Medical Journal of Australia here.
Access the full guidelines here.
Annika Howells is the sub-editor of the MJA’s InSight+.
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