Toward professionalization of diagnosis, prevention and treatment of Fetal Alcohol Spectrum Disorder
Background: Since first publications in Poland on the “alcohol-induced fetal damage” (about twenty years ago), the problem has been mostly acknowledged by adoptive and foster parents and representatives of social services. They initiated various activities to improve diagnosis, prevention and to develop strategies of intervention and care. For almost two decades, medical professionals have been playing rather marginal role in the area of Fetal Alcohol Spectrum Disorders (FASD) in Poland.
Objective: Growing research evidence and development of new diagnostic and patients support methods (especially in North America) indicated the need for professionalization of this area also in Poland. Increasing the engagement of medical professionals in FASD diagnosis, prevention and treatment, became one of the priorities for the State Agency for Prevention of Alcohol Related Problems.
Methods: In accordance with the social development strategy, the process of increasing medical professionals activities in the area of FASD, may be described in several steps from getting started (activating a small group of catalysts, assessing how ready the society is to begin the process, inviting diverse stakeholders to get involved); getting organized (learning about FASD, organizing workgroups); gathering evidence (reviewing national data, identifying barriers, gaps and resources); creating, implementing and evaluating an action plan.
Results: Until now, key achievements include: assessment of the prevalence of FASD among children at school age in the population-based survey; publication (in cooperation with the Polish Society of Gynecologists and Obstetricians) of recommendations to prevent alcohol use by pregnant and/or planning pregnancy women; stimulation of research activities in the area of FASD, by offering research grants; multi-professional experts panel working on national guidelines for FASD diagnosis; established cooperation with leading clinical centers and medical professionals; ongoing dialog with NGO’s and public institutions active in the area of FASD; coming soon – opening of the first, within medical structures, rehabilitation center for children with FASD.
Conclusions: Although FASD is not recognized in international statistical classifications of treatment diseases, this neurodevelopmental disorder, is clearly a condition requiring medical diagnosis and treatment. Medical activities can be significantly supported, but not substituted by other professionals. At present, the key challenge in Poland is to involve medical professionals not losing the engagement of - much more experienced in work with children with FASD and their families – representatives of non-medical professions.