Knowledge, attitudes, and practices of fetal alcohol spectrum disorder in health, justice, and education professionals: A systematic review.
Doctors, teachers, and police rarely know the real FASD criteria, so bring the rules to them.
01Research in Context
What this study did
The team hunted every survey that asked doctors, teachers, police, or other helpers what they know about fetal alcohol spectrum disorder (FASD). They found 58 studies from 11 countries and pooled the answers.
Each survey was checked for how well it covered the actual diagnostic rules: growth problems, face features, brain signs, and confirmed mom drank. They also noted who got training and who did not.
What they found
Most professionals had heard of FASD, but fewer than half could list the real diagnostic criteria. Doctors scored highest; justice staff scored lowest.
Only one in four said they had ever received FASD-specific training. The rest wanted it, but courses are rare.
How this fits with other research
Lim et al. (2022) looked at screening tools the same year. Their work shows the tests exist, yet accuracy is shaky. Together the two reviews reveal a double gap: helpers do not know the rules, and the quick tests they grab are weak.
Reid et al. (2021) ran a one-day co-design workshop in rural Australia. Knowledge and attitudes rose right away. The new review says such short boosts are needed everywhere because baseline knowledge is so poor.
Cruz-Montecinos et al. (2024) followed parents who learned PBS strategies after diagnosis. They kept using the tools months later. The review shows most professionals never learn these skills, so parent training fills a vacuum that services should already cover.
Why it matters
If you assess, teach, or support anyone with FASD, assume the team knows less than it admits. Build a five-minute crash card with the four diagnostic criteria and hand it to doctors, teachers, and court staff before the meeting starts. Push your agency to host a live workshop or webinar this quarter; the review shows even brief training lifts scores. Track who still confuses FASD with ADHD or oppositional defiance and offer them the Huey screening review so they pick a tool that actually works.
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02At a glance
03Original abstract
BACKGROUND AND AIMS: Fetal alcohol spectrum disorder (FASD) is one of the most common forms of developmental disability, and yet, anecdotally, is poorly understood by both the public and professionals across health, justice, education, and social services. This review aims to understand the knowledge, attitudes, and practices of professionals who work across a range of sectors - specifically health, education and justice - where they may encounter people with FASD, their families and caregivers. METHOD: We conducted a systematic search for research using surveys or questionnaires to address knowledge, and attitudes of professionals in health, education, and justice with regards to FASD between 1990 and 2021. Our search consisted of electronic databases (APA PsychInfo, CINAHL, EMBASE, Medline, PubMed, and PAIS Index) and grey literature sources. RESULTS: Our search yielded 971 results, of which 58 were relevant. The studies surveyed professionals from health (n = 35), education (n = 10), justice (n = 8), social services (n = 1), and multiple settings (n = 4). Most studies were conducted in North America. The areas surveyed included knowledge of FASD, attitudes towards people with FASD, experience with FASD, practices towards people with FASD, and education and training needs. CONCLUSIONS: Knowledge, attitudes, and practices towards FASD have been surveyed extensively in healthcare professionals over the last 30 years, but less so with those working in justice and education sectors. Findings from surveys suggest that although most professionals had some knowledge of the effects of FASD, their knowledge of the specific criteria of Fetal Alcohol Syndrome (FAS) and FASD is poor across most professional groups, including most health professionals. Our review highlights the need to provide training and information across sectors ongoing surveillance to determine where gaps in knowledge are and what resources are needed. WHAT THIS PAPER ADDS: This study is the first to systematically synthesize knowledge, attitudes, and practices toward FASD across different sectors. Poor knowledge and insufficient training were common. Knowledge, attitudes, and practices about FASD have been surveyed extensively in the healthcare setting, but surveys are more limited outside of this setting. Continuous surveillance is needed to identify and respond to knowledge gaps and changes in practice.
Research in developmental disabilities, 2022 · doi:10.1016/j.ridd.2022.104354