Fetal Alcohol Spectrum Disorder Awareness, Knowledge, and Practice Among Australian Occupational Therapists: A Cross-Sectional Survey

Laine Chilman; Daniel Meloncelli; Alison Houghton; Asmita Mudholkar; Catherine Hilly

doi:10.1111/1440-1630.70118

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Fetal Alcohol Spectrum Disorder Awareness, Knowledge, and Practice Among Australian Occupational Therapists: A Cross-Sectional Survey

Journal article

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Fetal Alcohol Spectrum Disorder Awareness, Knowledge, and Practice Among Australian Occupational Therapists: A Cross-Sectional Survey

Laine Chilman, Daniel Meloncelli, Alison Houghton, Asmita Mudholkar and Catherine Hilly

Australian Occupational Therapy Journal, Vol.73(4), pp.1-18

2026

DOI: https://doi.org/10.1111/1440-1630.70118

PMCID: PMC13483264

PMID: 42610651

Appears in UniSC Supported Open Access Outputs

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Abstract

allied health

clinical reasoning

fetal alcohol effects

fetal alcohol syndrome

PAE

Introduction Fetal Alcohol Spectrum Disorder (FASD) describes a spectrum of birth defects and developmental disabilities resulting from prenatal alcohol exposure. With a prevalence rate of 3.64%, developing an FASD-informed occupational therapy workforce is essential across all practice contexts. Since the Australian diagnostic guidelines were introduced in 2016 and updated in 2025, awareness has grown. This study aimed to explore Australian occupational therapists' awareness, knowledge, and practice regarding FASD. Method A cross-sectional survey of 90 occupational therapists assessed knowledge, awareness, and confidence regarding FASD via a 22-item online questionnaire. Chi-square tests examined associations between key variables; effect sizes were estimated using Cramér's V. Inductive content analysis was performed on open-ended responses. Consumer and Community Involvement The survey was designed for occupational therapists practising in Australia to obtain information on current practice contexts and was piloted by occupational therapists working with the FASD community. Results Despite 93.3% agreeing FASD knowledge is important, confidence and preparedness were markedly low. Only 26.7% had completed professional development, 37.8% reported easy access to reliable information, and 66.7% were unprepared to discuss FASD concerns. Professional development was strongly associated with confidence in recognising FASD (66.7% vs. 12.1%, P < 0.001, V = 0.517) and confidence working with adolescents and children. Clinical experience showed a categorical threshold effect: 40.7% with experience reported confidence in recognising FASD versus 0% without. Access to reliable information was a significant predictor of preparedness (58.8% vs. 17.9%, P = 0.008). Qualitative findings highlighted an absence of FASD-specific guidance, with occupational therapists drawing on frameworks and knowledge from other diagnoses. Conclusion This study indicates a need for occupational therapy-specific FASD research and practice guidance. Access to reliable information and professional development is critical to building workforce confidence and preparedness in FASD recognition and management.

Details

Title: Fetal Alcohol Spectrum Disorder Awareness, Knowledge, and Practice Among Australian Occupational Therapists: A Cross-Sectional Survey
Authors: Laine Chilman (Corresponding Author) - University of the Sunshine Coast
Daniel Meloncelli - University of the Sunshine Coast
Alison Houghton - University of the Sunshine Coast
Asmita Mudholkar - La Trobe University
Catherine Hilly - Australian Catholic University
Publication details: Australian Occupational Therapy Journal, Vol.73(4), pp.1-18
Publisher: John Wiley & Sons, Inc.
Date published: 2026
DOI: 10.1111/1440-1630.70118
ISSN: 1440-1630
PMID: 42610651; PMC13483264
Copyright note: © 2026 The Author(s). Australian Occupational Therapy Journal published by John Wiley & Sons Australia, Ltd on behalf of Occupational Therapy Australia. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Data Availability: The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.
Grant note: This research received funding from the University of the Sunshine Coast, School of Health honours student programme.
Organisation Unit: Healthy Ageing Research Cluster; School of Health; School of Health - Occupational Therapy
Language: English
Record Identifier: 991254373702621
Output Type: Journal article

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