{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T02:02:28Z","timestamp":1771207348511,"version":"3.50.1"},"reference-count":25,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T00:00:00Z","timestamp":1764201600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T00:00:00Z","timestamp":1764201600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Drug and Alcohol Review"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>\n                      International guidelines for diagnosing fetal alcohol spectrum disorder (FASD) differ regarding the required level of prenatal alcohol exposure (PAE). The\n                      <jats:italic>Australian Guidelines for Assessment and Diagnosis of Fetal Alcohol Spectrum Disorder<\/jats:italic>\n                      (2025) introduce a minimum PAE threshold, unlike the 2016 Guide to FASD Diagnosis, which allowed for diagnosis at any exposure level. This retrospective case review evaluates whether applying the minimum PAE threshold would alter diagnostic outcomes for individuals previously assessed for FASD at a specialist neurodevelopmental clinic in Queensland.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Records of 81 individuals assessed between February 2019 and May 2024 were reviewed. PAE information was re\u2010categorised according to the 2025 guideline thresholds. Diagnostic outcomes were then compared to original assessments.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>All individuals previously diagnosed with FASD without three sentinel facial features had PAE in at least the moderate\u2013high range, thereby meeting the minimum PAE threshold. Those identified as \u2018at risk of FASD\u2019 were also found to have at least moderate\u2013high PAE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion and Conclusions<\/jats:title>\n                    <jats:p>Concerns have been raised that introducing a minimum PAE threshold could reduce FASD diagnoses. However, this study shows that applying the 2025 criteria retrospectively did not alter diagnostic outcomes for this specific cohort. These findings suggest the updated guidelines may not significantly impact diagnosis rates in similar specialist clinical settings. Further research is needed to assess the broader implications across other service delivery contexts.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dar.70082","type":"journal-article","created":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T00:25:33Z","timestamp":1764289533000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Application of a Minimum Prenatal Alcohol Exposure Threshold for Diagnosis of Fetal Alcohol Spectrum Disorder: A Retrospective Chart Review"],"prefix":"10.1111","volume":"45","author":[{"given":"Eleanor","family":"Robinson","sequence":"first","affiliation":[{"name":"Child Development Service, Queensland Health  Gold Coast Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen","family":"Liddle","sequence":"additional","affiliation":[{"name":"Queensland Children's Hospital, Queensland Health  Brisbane Australia"},{"name":"Child Health Research Centre The University of Queensland  Brisbane Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Khari","family":"Garavelis","sequence":"additional","affiliation":[{"name":"Child Health Research Centre The University of Queensland  Brisbane Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chelsea","family":"Vanderpeet","sequence":"additional","affiliation":[{"name":"Child Health Research Centre The University of Queensland  Brisbane Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-2261-5336","authenticated-orcid":false,"given":"Jennifer","family":"McAuliffe","sequence":"additional","affiliation":[{"name":"Child Development Service, Queensland Health  Brisbane Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9813-5613","authenticated-orcid":false,"given":"Natasha","family":"Reid","sequence":"additional","affiliation":[{"name":"Child Health Research Centre The University of Queensland  Brisbane Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,11,27]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"Australian Guidelines Development Group \u201cAustralian Clinical Practice Guidelines for the Assessment and Diagnosis of Fetal Alcohol Spectrum Disorder \u201d2025."},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-024-03656-w"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41380-018-0095-4"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.141593"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2017-019605"},{"key":"e_1_2_11_7_1","volume-title":"Children and Young People Exposed Prenatally to Alcohol: A National Clinical Guideline","author":"Healthcare Improvement Scotland ib, Scottish Intercollegiate Guidelines Network ib","year":"2019"},{"key":"e_1_2_11_8_1","volume-title":"Fetal Alcohol Spectrum Disorders (FASD): Systematic Reviews of Prevention, Diagnosis and Management","author":"Ministry of Health","year":"2013"},{"key":"e_1_2_11_9_1","first-page":"1","article-title":"Guidelines for Identifying and Referring Persons With Fetal Alcohol Syndrome","volume":"54","author":"Bertrand J.","year":"2005","journal-title":"Morbidity and Mortality Weekly Report: Recommendations and Reports"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2015-4256"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2013-0066"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/add.14598"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/dar.14082"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph192013144"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/acer.70040"},{"key":"e_1_2_11_16_1","volume-title":"Report to the Australian Government Department of Health: Australian Guide to the Diagnosis of Fetal Alcohol Spectrum Disorder (FASD)","author":"Bower C.","year":"2016"},{"key":"e_1_2_11_17_1","article-title":"Validation of the Fetal Alcohol Spectrum Disorder (FASD) 4\u2010Digit Diagnostic Code","volume":"20","author":"Astley S. 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