Knowledge Gaps: FASD

The NCCAH is responding to the concern of First Nations, Inuit and Métis communities about fetal alcohol syndrome and fetal alcohol spectrum disorder among Aboriginal peoples.

Two NCCAH reports that review published literature on the subject shed light on issues concerning the prevalence of the syndrome, and illuminate gaps in knowledge about the disorder. FAS and FASD are terms that encompass a range of outcomes linked by maternal consumption of alcohol during pregnancy.  

Perceptions of Prevalence

The first NCCAH report, released in 2009, concludes that the true extent of FAS and FASD in Aboriginal and non-Aboriginal populations is not known. Despite a widespread perception that the disorders are more prevalent in Canadian Aboriginal children than among non-Aboriginal children, report author Mike Pacey found that published studies are too methodologically diverse to provide a basis for Aboriginal-specific rates.

Moreover, some of the Canadian Aboriginal-specific published studies focus on higher-risk communities, which may in fact promote a perception of higher prevalence in the Aboriginal population.

The NCCAH study, notes that “substantial discord” exists between the estimates available in the epidemiological literature on prevalence, and the experiential knowledge of many Aboriginal communities who feel FAS and FASD is a critical public health issue. The report highlighted the importance of reconciling these perceptions through research that addresses these methodological challenges, and that examines the critical relationship between the social and economic environment of mothers and children and the prevalence of FASD.

Setting a Direction for Future Research

Two related studies have been completed since the release of this report. A study identifying knowledge gaps in FAS/FASD research from a life course perspective can help prioritize future research and improve understanding of how to address FAS/FASD in Aboriginal communities.

The second report is a systematic review of community-based interventions for children and adolescents with attention deficit hyperactivity disorder (ADHD) and their families. ADHD is a condition that is often co-morbid in Aboriginal children diagnosed with FAS/FASD. Both reports are scheduled for release in the summer of 2010.

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