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Literature Review

A systematic review of literature published worldwide (including government, other websites and reports) was undertaken. Information from other countries on screening and diagnostic tests, procedures and guidelines was considered for their suitability for use in Australia.

Delphi Process         

A formal consensus method (Delphi Process) was used to enable a wide range of knowledge and experience to be synthesised and brought together to meet the project aim to develop an instrument that can be used to improve the identification and/or diagnosis of FASD in Australia.   

Participants in the Delphi process included:

  • Medical practitioners - paediatricians, neonatologists, general practitioners, geneticists, obstetricians, psychiatrists
  • Nurses - clinical, midwives, maternal and child health, practitioners
  • Clinical  Psychologists
  • Occupational Therapists
  • Speech Pathologists
  • Physiotherapists
  • Aboriginal HealthWorkers
  • Social Workers  

The Delphi process was administered as an on-line questionnaire over two rounds.  It was designed so that participants could easily complete the questionnaire in a number of sessions. Participants were recruited via invitations to peak medical colleges and societies, recommendations by members of the Steering Group and through the website and newsletter. 139 health professionals participated in the Delphi process.

Community and Consumer Workshops

To ensure that consumers and the community could be actively engaged in this project outside the formal Delphi process, we used small discussion groups and a 'world café' process to explore questions about alcohol and pregnancy.  This process was called a 'Community Conversation'. Community Conversations were held in Perth (December 2010) and Cairns (February 2011). 32 women particpated the community conversations.

The purpose of the alcohol and pregnancy community conversation was to provide input to the Steering Group for use when developing the screening and diagnostic instrument. The community voice aimed to gather information from consumers and the community who are not as well informed about FASD in a manner that was non-judgemental. It was particularly important when the Steering Group was considering questions that maybe asked of women as part of the screening tool. The Community Conversation was an important foundation for meaningful and inclusive consumer and community participation. 

Read a summary of the Community Conversations

Consensus Development Workshop

The second stage of the formal consensus process used a consensus development workshop to review the outcomes of the literature review, the Delphi process and community conversations. The FASD Collaboration applied these findings to the development of the final diagnostic instrument.

Read more about the workshop outcomes


Clinician and Consumer Subgroups

Following the workshop a subgroup of paediatricians and medical practitioners reviewed the workshop outcomes related to diagnosis and constructed the final instrument. A three-member consumer subgroup was formed to review the workshop outcomes related to consumer resources and develop the final consumer resources for inclusion in the diagnostic instrument. 

If you have any questions related to this page, please email the FASD Hub team or call 08 6319 1824.

Who conducted this research?

This research was conducted by the Australian FASD Collaboration. The Collaboration:

  • national group of highly qualified and experienced professionals and community members
  • dedicated to the prevention, diagnosis and care of children with a Fetal Alcohol Spectrum Disorder
  • track record for conduct and dissemination of research (including research in Indigenous communities), health professional and community education, advocacy and policy development about alcohol use in pregnancy and FASD

Lead Investigators

  • Winthrop Research  Professor Carol Bower, Telethon Kids Institute, The University of Western Australia
  • Professor Elizabeth  Elliott AM,  University of Sydney and the Children's Hospital at Westmead

Senior Consultants

  • Dr Lucinda Burns, Nationa Drug and Alcohol Research  Centre, University of NSW
  • Ms Maureen Carter, Nindilingarri Cultural Health Services, Fitzroy Crossing WA
  • Ms Heather D'Antoine, Menzies School of Health Research, Charles Darwin University
  • Dr James Fitzpatrick, The George Institute for Global Health, University of Sydney 
  • Assoc Prof Jane  Halliday, Murdoch      Childrens Research Institute, University of Melbourne
  • Ms Lorian Hayes, Centre for Chronic Disease, University of Queensland
  • Assoc Prof Jane Latimer, George Institute for Global Health, University of Sydney
  • Ms Anne Mckenzie, Telethon Kids Institute and School of Population Health, The University of Western Australia
  • Ms Sue Miers AM, National Organisation for Fetal Alcohol Spectrum Disorders Australia
  • Dr Raewyn Mutch, Telethon Kids Institute , The University of Western Australia and Child and Adolescent Health Service WA      Department of Health
  • Dr Colleen O'Leary, Centre for Population Health Research Curtin University and Telethon KIds Institute
  • Dr Jan Payne, Telethon Kids Institute , The University of Western Australia
  • Dr Elizabeth Peadon, Children's Hospital at Westmead
  • Ms Anne Russell, Russell Family Fetal Alcohol Disorders Association
  • Dr Amanda Wilkins, Telethon Kids Institute , The University of Western Australia and Child and Adolescent Health Service WA      Department of Health

Project Team

  • Ms Heather Jones, Telethon Kids Institute,  The University of Western Australia
  • Dr Rochelle Watkins, Telethon Kids Institute, The University of Western Australia


Final Report and Summary Report

  1. A two-volume final report was submitted to the Commonwealth Department of Health and Ageing in May 2012. Volume 1/Volume 2
  2. Read the Summary Report


  1. Rochelle E Watkins, Elizabeth J Elliott, Amanda Wilkins, Jane Latimer, Jane Halliday, James P Fitzpatrick, Raewyn C Mutch, Colleen M O'Leary, Lucinda Burns, Anne McKenzie, Heather M Jones, Janet M Payne, Heather D'Antoine, Sue Miers, Elizabeth Russell, Lorian Hayes, Maureen Carter, Carol Bower. Fetal alcohol spectrum disorder: development of consensus referral criteria for specialist diagnostic assessment in Australia. BMC Pediatrics 2014, 14:178
  2. Watkins RE, Elliott EJ, Wilkins A, Mutch RC, Fitzpatrick JP, Payne JM, O'Leary CM, Jones HM, Latimer J, Hayes L, Halliday J, D'Antoine H, Miers S, Russell E, Burns L, McKenzie A, Peadon E, Carter M, Bower C. Recommendations from a consensus development workshop on the diagnosis of fetal alcohol spectrum disorders in Australia. BMC Pediatr. 2013, 13:156.
  3. Jones HM, McKenzie A, Miers S, Russell E, Watkins RE, Payne JM, Hayes L, Carter M, D'Antoine HA, Latimer J, Wilkins A, Mutch R, Burns L, Fitzpatrick J, Halliday J, O'Leary CM, Peadon E, Elliott EJ, Bower C. Involving consumers and the community in the development of a diagnostic instrument for Fetal Alcohol Spectrum Disorders in Australia. BMC Health Research Policy and Systems 2013, 11:26
  4. Watkins E Rochelle, Elliott J Elizabeth, Halliday  Jane, O'Leary M Colleen, D'Antoine  Heather, Russell  Elizabeth, Hayes  Lorian, Peadon  Elizabeth, Wilkins  Amanda, Jones M Heather, et al: A modified Delphi study of screening for fetal alcohol spectrum disorders in Australia. BMC Pediatr. 2013, 13:13.
  5. Watkins RE, Elliott EJ, Mutch RC, Latimer J, Wilkins A, Payne JM, Jones HM, Miers S, Peadon E, McKenzie A, D'Antoine HA, Russell E, Fitzpatrick J, O'Leary CM, Halliday J, Hayes L, Burns L, Carter M, Bower C. Health professionals' perceptions about the adoption of existing guidelines for the diagnosis of fetal alcohol spectrum disorders in Australia. BMC Pediatr. 2012 Jun 14;12(1):69.
  6. Watkins RE, Elliott EJ, Mutch RC, Payne JM, Jones HM, Latimer J, Russell E, Fitzpatrick JP, Hayes L, Burns L, Halliday J, D'Antoine HA, Wilkins A, Peadon E, Miers S, Carter M, O'Leary CM, McKenzie A, Bower C. Consensus diagnostic criteria for fetal alcohol spectrum disorders in Australia: a modified Delphi study. BMJ Open. 2012 Oct 25;2(5)

Pilot and implement the diagnostic instrument (Australian Guide to the diagnosis of FASD)

The Commonwealth Department of Health and Ageing awarded a contract to the Telethon Kids Institute and the University fo Sydney to pilot and implement a diagnostic instrument for FASD in Australia 

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The project was funded by the Commonwealth Department of Health and Ageing. The research was conducted between August 2010 and May 2012.


Dissemmination and evaluation of the Australian Guide to the diagnosis of FASD and eLearning modules

This project aimed to increse awareness and use of the Australian Guide and provide education for clinicians.

The project was funded by the Australian Government Department of Health . The work was conducted in 2018 and 2019.

Read more