Fetal Alcohol Spectrum Disorder (FASD)

Child Development Service

Useful Management Information

  • Children who are experiencing symptoms associated with a history of trauma may also be appropriate for parallel treatment and engagement with other services such as Child and Youth Mental Health Service (CYMHS ) or Evolve Therapeutic Services
  • If there has been a recent change in placement for children in out of home care; consideration will be made regarding the timing of specialised FASD assessment, as deferring to allow for adjustment period may be appropriate before formal assessment.
  • GP to consider whether a referral for a medical speciality (e.g. Paediatrician, Neurologist) would be a more appropriate initial action
  • GP to consider if the child has seen a Child Health Nurse for assessment and general development strategies
  • Delay across multiple developmental domains is more likely to be associated with significant impairment and require Paediatric review
  • To support classification of the severity of the child’s behaviour or cognition:
    • Moderate-Severe concerns suggestive of Category 2 may include:
      • Standard scores in the clinically elevated range on standardised questionnaires assessing behavioural, emotional or social concerns
      • Standard scores on formal cognitive / intellectual assessment measures being ranked as clinically impaired (i.e., < 10th percentile) for the developmental area/s being tested
    • Mild concerns suggestive of Category 3 may include:
      • Standard scores in the borderline range on standardised questionnaires assessing behavioural, emotional or social concerns
      • Standard scores on formal assessment measures being ranked in the borderline range (i.e., 10th – 16th percentile) for the developmental area/s being tested

Clinician Resources

Patient Resources

Minimum Referral Criteria

Does your patient meet the minimum referral criteria?
Category 1 (appointment within 30 calendar days)
  • Child in out of home care, known to Child Safety Services where there is an imminent threat of breakdown of current foster placement due to the complexity of the child's developmental concerns
  • Child with facial dysmorphology characterised by 3 sentinel facial features and microcephaly
  • Child who presents with abnormalities on neurological examination or neuroimaging and severe functional deficits
  • Child under 12 months residing in the Gold Coast catchment who presents with significant global developmental delay
Category 2 (appointment within 90 calendar days)
  • Child at imminent risk of losing existing resources / or not able to access appropriate external resources (i.e., ECEI / NDIS) without diagnostic assessment
  • Child demonstrating evidence of moderate-severe developmental delay, behaviour or cognitive problems across three or more domains suggestive of FASD (i.e., motor, communication, learning, memory, attention, executive function, and social, emotional or adaptive functioning) that are impacting on their day to day functioning or participation
  • Specialist FASD diagnostic assessment requested for a child (presenting with symptoms and behaviours associated with FASD) who has had difficulty engaging in assessment or responding to recognised therapies / interventions provided by an external service
  • Child with neurodevelopmental concerns who is
    • in out of home care
    • at risk of entering the child protection system
    • in the care of a biological parent or relative with some supports in place that are insufficient to support the child and family’s immediate needs
  • Child who is at low-moderate risk of harm to themselves, others, property, and/or animals
  • Child who is involved with the police and/or justice system
  • Child who meets one or more of the Education Adjustment Program (EAP) verifiable categories or Child who is on an Individual Learning Plan / learning on an adjusted curriculum below their year level
  • School-aged child with recent change in behaviour that has resulted in them entering or progressing up the Queensland Education “One School” tier system for behaviour management
  • Child who is at risk of expulsion or has experienced repeated suspensions or who is presenting with reduced access or engagement at childcare / school due to behaviour or developmental concerns.
Category 3 (appointment within 365 calendar days)
  • Children with confirmed Prenatal Alcohol Exposure (PAE) requiring diagnostic clarification who are linked in with a service (ECEI / NDIS or private therapist) and are in a stable care environment
  • Children with symptoms and behaviours associated with FASD that have responded to recognised therapies / interventions to such a level that their symptoms and behaviours are well managed and supported

If your patient does not meet the minimum referral criteria

  • Assessment and management information may be found on a range of conditions at HealthPathways
  • If the patient does not meet the criteria for referral but the referring practitioner believes the patient requires specialist review, a clinical override may be requested:
    • Please explain why (e.g. warning signs or symptoms, clinical modifiers, uncertain about diagnosis, etc.)
  • Please note that your referral may not be accepted or may be redirected to another service

Essential Referral Information

  • As specified in key criteria, evidence of prenatal alcohol exposure is required (i.e., directly reported, witnessed or documented in formal records), including details regarding frequency, duration and quantity of consumption. Where possible the AUDIT-C should be completed to characterise alcohol exposure during the target pregnancy.
  • Sufficient screening of symptoms or behaviours of concern. This may include developmental status, mental health status, behaviour and/or social wellbeing
  • If school-based behaviours are the primary reason for the referral, provide a letter from the school outlining behaviours of concern.
  • Specify what medical investigations, if any, have been requested or completed (e.g., laboratory tests, medical imaging). Please attach copies of results where available. Please provide a reason when investigations are clinically indicated, but not yet completed.
  • Medical history including:
    • Information regarding adverse events during pregnancy or birth
    • Details regarding relevant medical events
  • Provide evidence and source of current diagnoses (e.g., Intellectual Disability, Attention Deficit Hyperactivity Disorder, Autism Spectrum Disorder, Anxiety, Post-traumatic Stress Disorder, Reactive Attachment Disorder etc.)
  • Specify what assessments, if any, have been completed by external service providers (i.e., Allied Health Practitioners, Department of Education). Please provide a summary of findings or attach copies of reports where available.

Additional Referral Information

Highly desirable information – may change triage category

  • Copies of reports from the school which include information and comments pertaining to:
    • Academic achievement and engagement with schoolwork (e.g., Age/Grade equivalents)
    • Behavioural and emotional wellbeing, and social engagement with peers
    • Details regarding suspensions or expulsions
    • Details regarding school attendance (i.e., days missed, school refusal)
  • Details regarding care history for children in out of home care
  • Details of exposure to early childhood adverse events (i.e., type of trauma, length of exposure, mode – directly experienced or witnessed) and referrals made to address this concern

Desirable information- will assist at consultation

  • Please provide copies of the following documents:
    • Any correspondence from support services involved (e.g., Child Safety Services case manager, Family and Child Connect service, Intensive Family Support service, After-Care service)
    • Current Child Protection Order
Last updated 7 December 2021

Send Referrals To

Smart Referrals

Preferred Method
About Smart Referrals

Secure Web Transfer

Send to: Gold Coast Child Community Health MO Account: GQ4215000TL HL EDI: qldcomch

Internal Referrals


(07) 5687 4497


Gold Coast University Hospital
1 Hospital Boulevard
Southport QLD 4215


(07) 5687 9141

Related HealthPathways

No directly related pathways found

Service Availability

Dr Francoise Butel
Medical Director Children's Community Health


Gold Coast University Hospital
Southport Health Precinct
Palm Beach Community Health Centre
Helensvale Community Health Centre
Upper Coomera Child Health
Early Years Centre Coomera Springs
Norfolk Village State School Health & Education Hub

If you would like to send a named referral, please address it to the specialist listed above, who will allocate a suitably qualified specialist to see the patient. Alternatively, you can view a full list of our specialists.

Child Safety

If you have a reason to suspect a child in Queensland is experiencing harm, or is at risk of experiencing harm, contact Department of Children, Youth Justice and Multicultural Services . Please consider if mandatory reporting applies.

Gold Coast Health - For Clinicians
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