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Impact of fetal alcohol spectrum disorder on families
  1. Natalie Lynette Phillips1,2,
  2. Marcel David Zimmet1,2,
  3. Amy Phu1,2,
  4. Meenakshi Rattan3,
  5. Yvonne Zurynski1,2,
  6. Elizabeth J Elliott1,2
  1. 1 Faculty of Medicine and Health, Specialty of Child and Adolescent Health, The University of Sydney, Sydney, New South Wales, Australia
  2. 2 Australian Paediatric Surveillance Unit, Kids Research Institute, Sydney Children's Hospitals Network, Westmead, New South Wales, Australia
  3. 3 Department of Psychological Medicine, Sydney Children's Hospitals Network, Westmead, New South Wales, Australia
  1. Correspondence to Professor Elizabeth J Elliott, Faculty of Medicine and Health, Specialty of Child and Adolescent Health, The University of Sydney, Sydney, NSW 2006, Australia; elizabeth.elliott{at}


Objective To evaluate the impact of fetal alcohol spectrum disorder (FASD) on child and family functioning.

Design Prospective survey.

Setting Multidisciplinary FASD assessment service.

Patients Caregivers of 35 children with FASD.

Main outcome measures Child-health-related functioning (Royal Alexandra Hospital for Children Measure of Function (MOF)), family impact (Impact on Family (IOF) Scale), impact on siblings and caregiver stress.

Results Most caregivers were foster carers (74%). Children with FASD (median age 8.7 years; 54% male) were a median of 7.0 years at diagnosis. Regarding child-health-related functioning, 43% reported moderate, severe or major problems in at least one area on the MOF. IOF was moderate (60%) or high (34%). Poorer child-health-related functioning was associated with greater impact on family. Unaffected siblings received less parental attention and displayed anger or frustration about the affected child’s needs. Caregivers reported frequent and high levels of stress.

Conclusions FASD impacts children’s health, and function of the family and unaffected siblings. These novel findings highlight the need for family-oriented service development.

  • paediatrics
  • child health
  • adolescent health

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  • Twitter @Dr_NLPhillips, @YvonneZurynski, @ProfEElliott

  • Contributors EJE, YZ, MDZ and NLP were responsible for the conceptualisation of the study, and with AP and MR, developed the questionnaire. NLP was responsible for data collection and performed the statistical analyses. NLP, MDZ and EJE wrote the manuscript. All authors contributed to interpretation of the study findings and revision and final approval of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.