Clinical correlates of fetal alcohol spectrum disorder among diagnosed individuals in a rural diagnostic clinic.

BACKGROUND: Diagnosis of fetal alcohol spectrum disorder (FASD) is relevant for the reduction of long term adverse sequalae. However, the diagnostic guidelines require a multidisciplinary approach which may hinder access to diagnostic and management services. Most diagnostic clinics are located in urban areas. There is less emphasis on the operations, capacities, and outcomes from rural diagnostic clinics.

METHODS: Over a ten and half years of clinic operations to diagnose children and subsequently adults, all consenting adults provided answers to interviews, participated in measurements and other diagnostic procedures. Information was collected on their contact with mental health services. Comparison of the findings with those from other established clinics included variables relevant to outcome measures.

RESULTS: 375 individuals were referred, assessed and diagnosed according to the existing guidelines for FASD diagnosis. Alcohol-related neurodevelopmental disorder (ARND), which was closely associated with age, was the most prevalent FASD diagnosis. One third of those diagnosed had IQ above the average range and ADHD was the most relevant clinical correlate. The diagnostic clinic was able to complete diagnosis on potentially 37.5% of likely affected individuals.

CONCLUSION: FASD can be diagnosed in children and adults in a rural setting. ADHD and other mental disorders should be a focus for treatment in affected individuals especially adults. It is important to consider the impact of age on the outcome of FASD. To increase diagnostic capacity, clinic operations could be modelled similarly.