Barriers to diagnosis of fetal alcohol syndrome among medical and behavioral health professionals

Background: Fetal Alcohol Syndrome (FAS) is the leading preventable cause of developmental disabilities and yet it often goes undiagnosed by physicians. The purpose of this study is to examine the factors that contribute to medical and behavioral health providers not making a diagnosis of Fetal Alcohol Syndrome (FAS) and other related conditions.

Methods: A sample of 207 medical professionals (MPs; n=123) and behavioral health professionals (BHPs; n=84) from eight southeastern states participated in workshops. Participants were asked to fill out a 15-item survey regarding their knowledge, attitudes and beliefs and practice behaviors pertaining to Fetal Alcohol Syndrome (FAS) and other related conditions.

Results: There were differing responses between medical and behavioral health professionals regarding contributing factors for providers not making an FAS diagnosis. MPs reported confidentiality issues were the greatest contributor to non-diagnosis (89%), compared to only 11% of BHPs (P > .05). For BHPs, lack of specific training (32%) and lack of comfort (32%) were reported to be the greatest contributor to non-diagnosis.

Conclusions: Our findings suggest the issue of confidentially is a major contributor to MPs' non-diagnoses of fetal alcohol syndrome while BHPs are largely unaware of this. MPs also reported a lack of comfort. By increasing BHPs' awareness of confidentiality as an issue for providers, BHPs may be better prepared to assist MPs with these difficult discussions. Training in confidentiality issues would increase the number of those affected with FASDs to get the proper diagnosis and targeted services to meet their needs.