James P Fitzpatrick1, Jane Latimer2, Heather Carmichael Olson3, Maureen Carter4, June Oscar5, Barbara R Lucas6, Robyn Doney7, Claire Salter8, Julianne Try9, Genevieve Hawkes10, Emily Fitzpatrick11, Marmingee Hand12, Rochelle E Watkins13, Tracey W Tsang14, Carol Bower15, Manuela L Ferreira16, John Boulton17, Elizabeth J Elliott18. 1. Discipline of Paediatrics and Child Health, Sydney Medical School, University of Sydney, Australia; Telethon Kids Institute, The University of Western Australia, Perth, Australia. Electronic address: james.fitzpatrick@telethonkids.org.au. 2. The George Institute for Global Health, Sydney Medical School, University of Sydney, Australia. Electronic address: jlatimer@georgeinstitute.org.au. 3. The University of Washington School of Medicine, Seattle, Washington, USA; Seattle Children's Research Institute, Seattle, Washington, USA. Electronic address: heather.carmichael_olson@seattlechildrens.org. 4. Nindilingarri Cultural Health Services, Fitzroy Crossing, Australia. Electronic address: maureen.carter@nindilingarri.org.au. 5. Marninwarntikura Women's Resource Centre, Fitzroy Crossing, Australia; University of Notre Dame, Broome, Australia. Electronic address: june.oscar9@gmail.com. 6. Discipline of Paediatrics and Child Health, Sydney Medical School, University of Sydney, Australia; The George Institute for Global Health, Sydney Medical School, University of Sydney, Australia. Electronic address: blucas@georgeinstitute.org.au. 7. School of Public Health, Curtin University, Perth, Australia. Electronic address: robyndoney@gmail.com. 8. Derby Allied Health Service, Western Australian Country Health Services, Derby, Australia. Electronic address: ce_salter@bigpond.com. 9. Department of Education and Early Childhood Development, Government of Victoria, Australia. Electronic address: juliannectry@gmail.com. 10. Derby Allied Health Service, Western Australian Country Health Services, Derby, Australia. Electronic address: gen.hawkes@gmail.com. 11. Discipline of Paediatrics and Child Health, Sydney Medical School, University of Sydney, Australia. Electronic address: emilyfitzp@gmail.com. 12. University of Notre Dame, Broome, Australia. Electronic address: marmingee.hand@det.wa.edu.au. 13. Telethon Kids Institute, The University of Western Australia, Perth, Australia. Electronic address: rochelle.watkins@telethonkids.org.au. 14. Discipline of Paediatrics and Child Health, Sydney Medical School, University of Sydney, Australia. Electronic address: tracey.tsang@sydney.edu.au. 15. Telethon Kids Institute, The University of Western Australia, Perth, Australia. Electronic address: carol.bower@telethonkids.org.au. 16. The George Institute for Global Health, Sydney Medical School, University of Sydney, Australia. Electronic address: mferreira@georgeinstitute.org.au. 17. Telethon Kids Institute, The University of Western Australia, Perth, Australia. Electronic address: john.boulton10@bigpond.com. 18. Discipline of Paediatrics and Child Health, Sydney Medical School, University of Sydney, Australia; The George Institute for Global Health, Sydney Medical School, University of Sydney, Australia. Electronic address: elizabeth.elliott@health.nsw.gov.au.
Abstract
BACKGROUND: Despite multiple risk factors for neurodevelopmental vulnerability, few studies have assessed neurodevelopmental performance of Australian Aboriginal children. An important risk factor for neurodevelopmental vulnerability is prenatal alcohol exposure (PAE), which places children at risk for Fetal Alcohol Spectrum Disorder (FASD). AIMS: This study assesses neurodevelopment outcomes in a population of Australian Aboriginal children with and without PAE. METHODS AND PROCEDURES: Children born in 2002/2003, and living in the Fitzroy Valley, Western Australia between April 2010 and November 2011, were eligible (N=134). Sociodemographic and antenatal data, including PAE, were collected by interview with 127/134 (95%) consenting parents/caregivers. Maternal/child medical records were reviewed. Neurodevelopment was assessed by clinicians blinded to PAE in 108/134 (81%) children and diagnoses on the FASD spectrum were assigned. OUTCOMES AND RESULTS: Neurodevelopmental disorder was documented in 34/108 children (314.8 per 1000). Any diagnosis on the FASD spectrum was made in 21/108 (194.4 per 1000) children (95% CI=131.0-279.0). CONCLUSIONS AND IMPLICATIONS: Neurodevelopmental impairment with or without PAE is highly prevalent among children in the Fitzroy Valley. Rates of diagnoses on the FASD spectrum are among the highest worldwide. Early intervention services are needed to support developmentally vulnerable children in remote communities.
BACKGROUND: Despite multiple risk factors for neurodevelopmental vulnerability, few studies have assessed neurodevelopmental performance of Australian Aboriginal children. An important risk factor for neurodevelopmental vulnerability is prenatal alcohol exposure (PAE), which places children at risk for Fetal Alcohol Spectrum Disorder (FASD). AIMS: This study assesses neurodevelopment outcomes in a population of Australian Aboriginal children with and without PAE. METHODS AND PROCEDURES: Children born in 2002/2003, and living in the Fitzroy Valley, Western Australia between April 2010 and November 2011, were eligible (N=134). Sociodemographic and antenatal data, including PAE, were collected by interview with 127/134 (95%) consenting parents/caregivers. Maternal/child medical records were reviewed. Neurodevelopment was assessed by clinicians blinded to PAE in 108/134 (81%) children and diagnoses on the FASD spectrum were assigned. OUTCOMES AND RESULTS:Neurodevelopmental disorder was documented in 34/108 children (314.8 per 1000). Any diagnosis on the FASD spectrum was made in 21/108 (194.4 per 1000) children (95% CI=131.0-279.0). CONCLUSIONS AND IMPLICATIONS: Neurodevelopmental impairment with or without PAE is highly prevalent among children in the Fitzroy Valley. Rates of diagnoses on the FASD spectrum are among the highest worldwide. Early intervention services are needed to support developmentally vulnerable children in remote communities.
Authors: Hayley M Passmore; Raewyn C Mutch; Rochelle Watkins; Sharyn Burns; Guy Hall; James Urquhart; Jonathan Carapetis; Carol Bower Journal: Psychiatr Psychol Law Date: 2020-08-04
Authors: A Finlay-Jones; M Symons; W Tsang; R Mullan; H Jones; A McKenzie; L Cannon; B Birda; N Reynolds; P Sargent; H Gailes; D Mayers; E J Elliott; C Bower Journal: Int J Popul Data Sci Date: 2020-12-10
Authors: Emily F M Fitzpatrick; Maureen Carter; June Oscar; Tom Lawford; Alexandra L C Martiniuk; Heather A D'Antoine; Elizabeth J Elliott Journal: BMJ Open Date: 2017-12-28 Impact factor: 2.692
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Authors: Tracey W Tsang; Zoe Laing-Aiken; Jane Latimer; James Fitzpatrick; June Oscar; Maureen Carter; Elizabeth J Elliott Journal: BMJ Paediatr Open Date: 2017-09-11