Health professionals’ views and experiences of Fetal Alcohol Spectrum Disorder (FASD): “If we’re not thinking FASD, we’re not assessing it, we’re not diagnosing it”

BACKGROUND: Low diagnostic rates of Fetal Alcohol Spectrum Disorder (FASD) persist in the United Kingdom. This qualitative study explored clinicians' views about the FASD diagnostic process, post-diagnostic supports and disability identity formation. METHOD: Twenty-five clinicians across NHS Scotland were interviewed online about: FASD knowledge and training; clinical practice; facilitators and barriers in FASD practice; and diagnostic impact on young people's self and disability identity. Data were analysed using reflexive thematic analysis. RESULTS: Clinician views and compassionate practice were framed by their training, professional role, and service type. In the FASD diagnostic process, clinicians valued their role in supporting people's self-understanding and access to supports. Diagnostic practice was impacted by ethical concerns for the biological parent/child relationship and broaching FASD and disability. CONCLUSION: Multidisciplinary and neurodevelopmental assessment services can support complexity in FASD practice. Clinician roles in diagnostic practice can contribute to positive experiences of diagnosis, disability, and identity for young people.