{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T04:00:43Z","timestamp":1790308843858,"version":"4.1.0"},"reference-count":72,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:00:00Z","timestamp":1788998400000},"content-version":"vor","delay-in-days":9,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"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":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Issues<\/jats:title>\n                    <jats:p>Fetal alcohol spectrum disorder (FASD) is a prevalent yet widely underdiagnosed neurodevelopmental condition resulting from prenatal alcohol exposure (PAE). FASD has profound lifelong implications for affected individuals, their caregivers and society. Active case ascertainment is the gold standard for estimating FASD prevalence, but methodological variability limits comparability across studies. This review aims to systematically evaluate the methodologies and reporting practices of school\u2010based FASD prevalence studies, with the goal of identifying best practices and informing standardised approaches to enhance the validity, reproducibility and policy relevance of future research.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Approach<\/jats:title>\n                    <jats:p>A systematic review was conducted to examine the methods, measures, strengths and limitations of school\u2010based FASD prevalence studies. Five databases were searched using key terms associated with FASD prevalence in school settings. Identified studies were screened and data were extracted and analysed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key Findings<\/jats:title>\n                    <jats:p>The 29 included studies revealed variability in case definitions, diagnostic frameworks, tools and measures. Most studies employed active case ascertainment designs. Non\u2010participation rates and details on community engagement or co\u2010creation activities were often underreported. PAE assessment predominantly relied on maternal self\u2010report.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Implications<\/jats:title>\n                    <jats:p>Despite a shared goal of identifying FASD, methodological variability across studies may limit the comparability of outcomes. A lack of robust prevalence data impedes adequate funding for prevention, diagnosis and support services.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Establishing a universally accepted case definition and diagnostic guidelines for FASD is essential. Reporting of community engagement and involvement of individuals with lived experience should become standard practice and the development of objective measures for PAE identification is increasingly necessary.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dar.70233","type":"journal-article","created":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T07:23:52Z","timestamp":1789025032000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Fetal Alcohol Spectrum Disorder Prevalence Studies in School Settings: A Global Systematic Review of Methods, Measures, Strengths and Limitations"],"prefix":"10.1111","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3898-4194","authenticated-orcid":false,"given":"Robyn","family":"McCarthy","sequence":"first","affiliation":[{"name":"School of Health and Society University of Salford  Salford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"Pink","sequence":"additional","affiliation":[{"name":"Centre for Digital Innovations in Health &amp; Social Care University of Bradford  Bradford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leana","family":"Olivier","sequence":"additional","affiliation":[{"name":"Foundation for Alcohol Related Research  Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4812-2328","authenticated-orcid":false,"given":"David","family":"Gilbert","sequence":"additional","affiliation":[{"name":"School of Health and Society University of Salford  Salford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2171-928X","authenticated-orcid":false,"given":"Raja","family":"Mukherjee","sequence":"additional","affiliation":[{"name":"School of Health and Society University of Salford  Salford UK"},{"name":"Surrey and Borders Partnership NHS Foundation Trust  Redhill UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6435-8050","authenticated-orcid":false,"given":"Penny A.","family":"Cook","sequence":"additional","affiliation":[{"name":"School of Health and Society University of Salford  Salford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,10]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214\u2010109X(17)30021\u20109"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41575\u2010022\u201000688\u20106"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh\u20102019\u2010001958"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/17579139241296479"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.5972"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1017\/S2040174424000369"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dhjo.2024.101684"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2015\u20104256"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s11689\u2010024\u201009537\u2010w"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja2.70159"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.141593"},{"key":"e_1_2_11_13_1","volume-title":"Children and Young People Exposed Prenatally to Alcohol","author":"Scottish Intercollegiate Guidelines Network (SIGN)","year":"2019"},{"key":"e_1_2_11_14_1","volume-title":"Whakakotahitanga\/Unity: The FASD Diagnostic Guidelines for Aotearoa (New Zealand) 2024","author":"Crawford A.","year":"2024"},{"issue":"3","key":"e_1_2_11_15_1","article-title":"Validation of the Fetal Alcohol Spectrum Disorder (FASD) 4\u2010Digit Diagnostic Code","volume":"20","author":"Astley S. 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