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Hewlett N, Hayes L, Williams R, Hamilton S, Holland L, Gall A, Doyle M, Goldsbury S, Boaden N, Reid N. Development of an Australian FASD Indigenous Framework: Aboriginal Healing-Informed and Strengths-Based Ways of Knowing, Being and Doing. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20065215. [PMID: 36982125 PMCID: PMC10049125 DOI: 10.3390/ijerph20065215] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 03/09/2023] [Accepted: 03/14/2023] [Indexed: 05/27/2023]
Abstract
Aboriginal culture intuitively embodies and interconnects the threads of life that are known to be intrinsic to human wellbeing: connection. Therefore, Aboriginal wisdom and practices are inherently strengths-based and healing-informed. Underpinned by an Indigenist research methodology, this article presents findings from a collaboration of Aboriginal and non-Aboriginal peoples to develop an Australian Fetal Alcohol Spectrum Disorder (FASD) Indigenous Framework during 2021 to 2023. The FASD Indigenous Framework unfolds the changes that non-Aboriginal clinicians and Aboriginal peoples each need to make in their respective ways of knowing, being and doing in order to facilitate access to healing-informed, strengths-based and culturally responsive FASD knowledge, assessment, diagnosis and support services among Aboriginal peoples. Drawing on the Aboriginal practices of yarning and Dadirri, written and oral knowledges were gathered. These knowledges were mapped against Aboriginal cultural responsiveness and wellbeing frameworks and collaboratively and iteratively reflected upon throughout. This article brings together Aboriginal wisdom (strengths-based, healing-informed approaches grounded in holistic and integrated support) and Western wisdom (biomedicine and therapeutic models) in relation to FASD. From a place of still awareness (Dadirri), both forms of wisdom were drawn upon to create Australia's first FASD Indigenous Framework, a new practice in the assessment and diagnosis of FASD, which offers immense benefit to equity, justice, support and healing for Aboriginal families with a lived experience of FASD.
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Affiliation(s)
- Nicole Hewlett
- Child Health Research Centre, The University of Queensland, Brisbane, QLD 4072, Australia
| | - Lorian Hayes
- Child Health Research Centre, The University of Queensland, Brisbane, QLD 4072, Australia
| | - Robyn Williams
- Curtin Medical School, Curtin University, Perth, WA 6000, Australia
| | - Sharynne Hamilton
- Faculty of Health, School of Nursing and Midwifery, University of Technology Sydney, Ultimo, NSW 2007, Australia
| | - Lorelle Holland
- Child Health Research Centre, The University of Queensland, Brisbane, QLD 4072, Australia
- School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, QLD 4072, Australia
| | - Alana Gall
- National Centre for Naturopathic Medicine, Faculty of Health, Southern Cross University, Lismore, NSW 2480, Australia
| | - Michael Doyle
- Faculty of Medicine and Health, University of New South Wales, Sydney, NSW 2052, Australia
| | - Sarah Goldsbury
- Māori/Indigenous Health Innovation, University of Otago Christchurch, Christchurch 8013, New Zealand
| | - Nirosha Boaden
- Faculty of Social Work, The University of New South Wales, Sydney, NSW 2052, Australia
| | - Natasha Reid
- Child Health Research Centre, The University of Queensland, Brisbane, QLD 4072, Australia
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Morton Ninomiya ME, Almomani Y, Dunbar Winsor K, Burns N, Harding KD, Ropson M, Chaves D, Wolfson L. Supporting pregnant and parenting women who use alcohol during pregnancy: A scoping review of trauma-informed approaches. WOMEN'S HEALTH (LONDON, ENGLAND) 2023; 19:17455057221148304. [PMID: 36744547 PMCID: PMC9905036 DOI: 10.1177/17455057221148304] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Alcohol is legalized and used for a variety of reasons, including socially or as self-medication for trauma in the absence of accessible and safe supports. Trauma-informed approaches can help address the root causes of alcohol use, as well as the stigma around women's alcohol use during pregnancy. However, it is unclear how these approaches are used in contexts where pregnant and/or parenting women access care. Our objective was to synthesize existing literature and identify promising trauma-informed approaches to working with pregnant and/or parenting women who use alcohol. A multidisciplinary team of scholars with complementary expertise worked collaboratively to conduct a rigorous scoping review. All screening, extraction, and analysis was independently conducted by at least two authors before any differences were discussed and resolved through team consensus. The Joanna Briggs Institute method was used to map existing evidence from peer-reviewed articles found in PubMed, CINAHL, PsycINFO, Social Work Abstracts, and Web of Science. Data were extracted to describe study demographics, articulate trauma-informed principles in practice, and gather practice recommendations. Thirty-six studies, mostly from the United States and Canada, were included for analysis. Studies reported on findings of trauma-informed practice in different models of care, including live-in treatment centers, case coordination/management, integrated and wraparound supports, and outreach-for pregnant women, mothers, or both. We report on how the following four principles of trauma-informed practices were applied and articulated in the included studies: (1) trauma awareness; (2) safety and trustworthiness; (3) choice, collaboration, and connection; and (4) strengths-based approach and skill building. This review advances and highlights the importance of understanding trauma and applying trauma-informed practice and principles to better support women who use alcohol to reduce the risk of alcohol-exposed pregnancies. Relationships and trust are central to trauma-informed care. Moreover, when applying trauma-informed practices with pregnant and parenting women who use alcohol, we must consider the unique stigma attached to alcohol use.
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Affiliation(s)
- Melody E Morton Ninomiya
- Department of Health Sciences, Wilfrid Laurier University, Waterloo, ON, Canada,Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, London, ON, Canada,School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada,Melody E Morton Ninomiya, Department of Health Sciences, Wilfrid Laurier University, Rm. BA0546, 75 University Avenue West, Waterloo, ON N2L 3C5, Canada.
| | - Yasmeen Almomani
- Department of Health Sciences, Wilfrid Laurier University, Waterloo, ON, Canada
| | | | - Nicole Burns
- Department of Health Sciences, Wilfrid Laurier University, Waterloo, ON, Canada
| | - Kelly D Harding
- Canada Fetal Alcohol Spectrum Disorder Research Network, Vancouver, BC, Canada,School of Liberal Arts, Laurentian University, Sudbury, ON, Canada
| | - Megan Ropson
- Memorial University, St. John’s, NL, Canada,Labrador-Grenfell Health, Happy Valley-Goose Bay, NL, Canada
| | - Debbie Chaves
- Library, Wilfrid Laurier University, Waterloo, ON, Canada
| | - Lindsay Wolfson
- Canada Fetal Alcohol Spectrum Disorder Research Network, Vancouver, BC, Canada,Centre of Excellence for Women’s Health, Vancouver, BC, Canada
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Fletcher T, Mullan B, Finlay-Jones A. Perceptions of two different alcohol use behaviours in pregnancy: an application of the prototype/willingness model. Health Psychol Behav Med 2022; 10:1071-1085. [PMID: 36388869 PMCID: PMC9645282 DOI: 10.1080/21642850.2022.2143362] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Objective: This study explored whether exposure to either an ‘ambiguous consumption’ prototype (no amount of alcohol specified) or a ‘small consumption’ prototype (‘small’ amount of alcohol specified) had an impact on prototype perceptions of, and willingness to use, small amounts of alcohol during pregnancy. Method: Participants were 140 women living in the UK, aged 20–45 years old, of whom 92% had previously been, or intended to become, pregnant. Participants completed measures to assess how favourably they viewed alcohol use in pregnancy, how similar they felt to those who would use alcohol in pregnancy and how responsible they perceived those who would use alcohol in pregnancy to be. Participant’s own willingness to use small amounts of alcohol during pregnancy was also assessed. Results: Having at least one child was positively correlated with being willing to accept an alcoholic drink while pregnant for those exposed to the ‘ambiguous consumption’ prototype only. Although perceptions of favourability, similarity and responsibility were consistently higher for those exposed to a ‘small consumption’ condition, there were no differences in willingness to drink according to exposure. Conclusion: This research suggests that women’s perceptions of those who drink alcohol while pregnant differ according to the amount of alcohol that they perceive as typical. This may have implications for how alcohol use in pregnancy is portrayed in public health messaging, particularly regarding the level of acceptance that may be associated with low to moderate alcohol use.
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Affiliation(s)
- Tess Fletcher
- FASD Research Australia Centre for Research Excellence, Telethon Kids Institute, Nedlands, Australia
- Enable Institute, Curtin University, Perth, Australia
- School of Population Health, Curtin University, Perth, Australia
| | | | - Amy Finlay-Jones
- FASD Research Australia Centre for Research Excellence, Telethon Kids Institute, Nedlands, Australia
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Mattson JT, Thorne JC, Kover ST. [Formula: see text]Parental interaction style, child engagement, and emerging executive function in fetal alcohol spectrum disorders (FASD). Child Neuropsychol 2022; 28:853-877. [PMID: 34978272 PMCID: PMC10686097 DOI: 10.1080/09297049.2021.2023122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 12/19/2021] [Indexed: 10/19/2022]
Abstract
Children with fetal alcohol spectrum disorders (FASD) are known to experience cognitive and neurobehavioral difficulties, including in areas of executive function and social skills development. Interventions for these challenges have focused on a number of areas, including parent-based training. Despite the general consensus that specific parenting styles consistent with an "authoritative" - warm but firm - parenting approach may influence behavioral self-regulation, it is not known what specific parental interaction styles are associated with child engagement and emerging executive function in this population. The current study used an observation-based behavioral coding scheme during parent-child play interactions and associated parent report-based executive function measures in children with FASD. Here, we demonstrate that parental interaction styles with increased responsive/child-oriented behavior and parental affect are associated with higher levels of child play engagement, while parental interaction that has increased achievement-orientation is associated with higher levels of emerging executive function in children with FASD. These findings help inform future studies on behavioral targets in parent-based training programs and highlight the importance of considering certain parental interaction styles during parent-child play.
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Affiliation(s)
- Julia T. Mattson
- Department of Pediatrics, University of Washington, Seattle, Washington
| | - John C. Thorne
- Department of Speech & Hearing Sciences, University of Washington, Seattle, Washington
| | - Sara T. Kover
- Department of Speech & Hearing Sciences, University of Washington, Seattle, Washington
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Brown J, Jonason A, Asp E, McGinn V, Carter MN, Spiller V, Jozan A. Fetal alcohol spectrum disorder and confabulation in psycholegal settings: A beginner's guide for criminal justice, forensic mental health, and legal interviewers. BEHAVIORAL SCIENCES & THE LAW 2022; 40:46-86. [PMID: 34689366 DOI: 10.1002/bsl.2540] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 09/30/2021] [Accepted: 10/03/2021] [Indexed: 06/13/2023]
Abstract
Fetal alcohol spectrum disorders (FASD) are neurodevelopmental/neurobehavioral conditions caused by prenatal alcohol exposure (PAE). Impairments caused by PAE contribute to the over-representation of individuals with FASD in the United States juvenile and adult criminal justice systems. These same impairments can equally impact on individuals with FASD who are witnesses to or victims of crime who also have to navigate the complexities of the criminal justice system. Difficulties include increased susceptibility to confabulation throughout the legal process that, in turn, can contribute to increased rates of poor outcomes including false confessions and wrongful convictions. Individuals with FASD are particularity at risk of confabulation when they are subjected to tactics, such as stressful and anxiety-provoking situations, threats, and leading, suggestive, or coercive questioning. Many professionals in the forensic context are unfamiliar with FASD or related confabulation risk and may unintentionally utilize tactics that intensify impacts of pre-existing impairment. This article serves as a beginner's guide for professionals working in criminal justice settings by (a) providing research-based overviews of FASD and confabulation, (b) describing how FASD may lead to confabulation, and (c) suggesting ways that professionals can modify protocols when interacting with individuals with FASD. Suggestions in this article hold the potential to decrease the risk of confabulation in the criminal justice system and decrease problematic outcomes, such as false confessions and wrongful convictions among individuals with FASD.
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Affiliation(s)
- Jerrod Brown
- Pathways Counseling Center, Inc., St. Paul, Minnesota, USA
- Concordia University, St. Paul, Minnesota, USA
- American Institute for the Advancement of Forensic Studies, St. Paul, Minnesota, USA
| | - Alec Jonason
- Department of Psychology, Hamline University, St. Paul, Minnesota, USA
- Wesley & Lorene Artz Cognitive Neuroscience Research Center, Hamline University, St. Paul, Minnesota, USA
| | - Erik Asp
- Department of Psychology, Hamline University, St. Paul, Minnesota, USA
- Wesley & Lorene Artz Cognitive Neuroscience Research Center, Hamline University, St. Paul, Minnesota, USA
- Department of Neurology, University of Iowa, Iowa City, Iowa, USA
| | - Valerie McGinn
- The FASD Centre, Auckland, New Zealand
- School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Megan N Carter
- University of Washington, Seattle, Washington, USA
- Department of Social and Health Services, Special Commitment Center, Steilacoom, Washington, USA
| | | | - Amy Jozan
- American Institute for the Advancement of Forensic Studies, St. Paul, Minnesota, USA
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Schölin L, Heenan M. "No Alcohol, No Risk. #FASD"- Twitter Activity on Alcohol and Pregnancy among Australian Organizations. Subst Use Misuse 2022; 57:2021-2030. [PMID: 36259782 DOI: 10.1080/10826084.2022.2083170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Objective: Research has suggested that information communicated by public health and industry-funded organizations differ, as organizations linked to industry have tended to downplay risks with alcohol more broadly and pregnancy specifically. There is limited knowledge of how alcohol use in pregnancy and associated risks are communicated on social media in Australia. This study set out to describe communication of health risks associated with alcohol use during pregnancy on Twitter by Australian-based organizations and stakeholders. Methods: We searched for "alcohol" and "pregnancy", "pregnant", or "FASD" on Twitter accounts belonging to potentially relevant organizations, of which 17 had tweeted on the topic. Content analysis was undertaken on all tweets and summarized under eight themes. Results: A total of 347 tweets were identified, posted between 2010 and 2019 mainly by public health and disability nongovernmental organizations. Tweets generally focused on FASD, but other potential consequences of maternal alcohol use were infrequently mentioned and tended to be generic. We found infrequent mentions of direct advice around alcohol use during pregnancy and official guidelines. Overall, tweets reflected ongoing policy debates in Australia - including alcohol warning labeling, disability policy and increased activity was seen particularly before the second parliamentary inquiry into FASD. Conclusions: The limited number of tweets from relevant organizations over a nine-year period suggests focus has been on FASD while less discussion of alcohol use during pregnancy was evident. We identified an opportunity for more and consistent communication of trusted national health guidance.
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Affiliation(s)
- Lisa Schölin
- Centre for Pesticide Suicide Prevention, Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | - Maddie Heenan
- The George Institute for Global Health, Newtown, Australia
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Cook M, Leggat G, Pennay A. Change Over Time in Australian Newspaper Reporting of Drinking During Pregnancy: A Content Analysis (2000-2017). Alcohol Alcohol 2021; 55:690-697. [PMID: 32676647 DOI: 10.1093/alcalc/agaa072] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 06/18/2020] [Accepted: 06/23/2020] [Indexed: 11/12/2022] Open
Abstract
AIMS This paper analyses the content of news media messages on drinking during pregnancy in Australia over an 18-year period to understand whether and how the nature of messages communicated to women has changed over time. METHODS Factiva was used to search Australian newspapers from 2000 to 2017, resulting in a sample of 1394 articles from the 18 major national and state-based newspapers. Content analysis of articles was undertaken, and Poisson regression analysis was used to assess changes over time. RESULTS The largest number of articles on drinking during pregnancy was published in 2007. Themes that significantly increased over time included Harms to the Child (from 0.97% in 2008 to 29.69% in 2015) and Prevention Initiatives (from 0% in 2005 to 12.50% in 2017). Articles endorsing women not consuming alcohol during pregnancy significantly increased over time (from 20.69% in 2001 to 53.78% in 2013), matched by a decreasing trend in the proportion of articles presenting mixed advice (from 15.93% in 2009 to 0% in 2017). The largest number of articles adopted no position in relation to women's consumption. CONCLUSIONS A stronger abstinence message during pregnancy has been communicated through Australian newspaper media over time. The mixed messaging and large number of articles not endorsing a position on consumption may reflect the inconclusiveness of the evidence on harms from low to moderate levels of alcohol consumption during pregnancy. Opportunities remain for researchers to work with public health advocates to disseminate balanced messages based on evidence-based research.
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Affiliation(s)
- Megan Cook
- Centre for Alcohol Policy Research, La Trobe University, Plenty Rd & Kingsbury Dr Bundoora, Victoria 3086, Australia
| | - Geoffrey Leggat
- Centre for Alcohol Policy Research, La Trobe University, Plenty Rd & Kingsbury Dr Bundoora, Victoria 3086, Australia
| | - Amy Pennay
- Centre for Alcohol Policy Research, La Trobe University, Plenty Rd & Kingsbury Dr Bundoora, Victoria 3086, Australia
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Choate P, Badry D. Stigma as a dominant discourse in fetal alcohol spectrum disorder. ADVANCES IN DUAL DIAGNOSIS 2019. [DOI: 10.1108/add-05-2018-0005] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeThe purpose of this paper is to conduct a scoping review of the literature to explore the many ways stigma affects people with FASD and to highlight the disciplines and places where discourse on FASD and stigma is taking place.Design/methodology/approachSearches were conducted in PubMed, ERIC, Family & Society Studies Worldwide, Families Studies Abstracts and Google Scholar between 2008 and 2018. Search terms focused on stigma, shame and the connection to FASD with a view to looking across social and medical science literature.FindingsSearches identified 39 full text manuscripts, 13 of which were included in the scoping review. Stigma toward people with FASD exists in multiple professional forums across disciplines. The relationship between mother’s use of alcohol and the lasting impact on the child is a focus in the articles identified from a public health perspective. The review showed there was limited cross-disciplinary discussion evident. In total 13 articles were selected for inclusion in this review.Research limitations/implicationsNegative discourses predominate with little attention being paid to possible areas of success as well as cases of lower FASD impacts. There is a significant void in work focusing on positive outcomes for people with FASD. Such discourse would support a better understanding of pathways to more positive outcomes.Originality/valueThis paper highlights the issue of FASD and stigma through identification of relevant literature and expands the conversation to offer insights into the challenging terrain that individuals with FASD must navigate. The issue of stigma is not linked only to individuals with FASD but also their support systems. It is critical to recognize the multiple attributions of stigma to FASD in order to effectively take up conversations across and between disciplines to promote new discourses focused on de-stigmatization.
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Latuskie KA, Leibson T, Andrews NCZ, Motz M, Pepler DJ, Ito S. Substance Use in Pregnancy Among Vulnerable Women Seeking Addiction and Parenting Support. Int J Ment Health Addict 2018. [DOI: 10.1007/s11469-018-0005-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Gibbs A, Sherwood K. Putting Fetal Alcohol Spectrum Disorder (FASD) on the Map in New Zealand: A Review of Health, Social, Political, Justice and Cultural Developments. PSYCHIATRY, PSYCHOLOGY, AND LAW : AN INTERDISCIPLINARY JOURNAL OF THE AUSTRALIAN AND NEW ZEALAND ASSOCIATION OF PSYCHIATRY, PSYCHOLOGY AND LAW 2017; 24:825-842. [PMID: 31983993 PMCID: PMC6818225 DOI: 10.1080/13218719.2017.1315784] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The damaging effects of alcohol intake have long been recognised as an issue for New Zealand society since the introduction of alcohol by early settlers. In the mid-1990s, New Zealand began to acknowledge the distinct set of impairments that result from prenatal alcohol exposure that is now known as fetal alcohol spectrum disorder (FASD), which affects all facets of an individual's life, including having individual impairments as well as secondary disabilities arising from those impairments. In New Zealand, a collaborative, multidisciplinary and multiagency approach has been necessary in order to offer the best support for individuals and families who are living with FASD. In this article, the developments within New Zealand's health, justice, social and cultural sectors are traced and the work of many individual trailblazers who have put FASD on the map is acknowledged. The story of putting FASD on the map in New Zealand is one of determination, hope and opportunity, as well as recognition that there is still a long way to go.
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Affiliation(s)
- Anita Gibbs
- Department of Sociology, Gender and Social Work, University of Otago, Dunedin, New Zealand
| | - Kesia Sherwood
- Department of Sociology, Gender and Social Work, University of Otago, Dunedin, New Zealand
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Corrigan PW, Lara JL, Shah BB, Mitchell KT, Simmes D, Jones KL. The Public Stigma of Birth Mothers of Children with Fetal Alcohol Spectrum Disorders. Alcohol Clin Exp Res 2017; 41:1166-1173. [DOI: 10.1111/acer.13381] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Accepted: 03/20/2017] [Indexed: 11/29/2022]
Affiliation(s)
| | | | | | - Kathleen T. Mitchell
- National Organization on Fetal Alcohol Syndrome (NOFAS); Washington District of Columbia
| | - Diana Simmes
- Department of Pediatrics; University of California, San Diego; La Jolla California
| | - Kenneth L. Jones
- Department of Pediatrics; University of California, San Diego; La Jolla California
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