byResearch Society on Alcohol

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The authors of a recent study have recommended improvements to commonly used assessments of health care and social service providers' attitudes about prenatal alcohol exposure and fetal alcohol spectrum disorders. The recommendations follow a thorough evaluation of assessments that had not previously been psychometrically validated and represent a first step toward establishing reliable and valid measures to assess attitudes toward these conditions. More accurately understanding providers' attitudes can help identify training needs and effectiveness in order to improve the diagnosis and treatment of prenatal alcohol exposure and its consequences.

Fetal alcohol spectrum disorder, or FASD, is a set of conditions marked by often significant physical, behavioral, and cognitive challenges, resulting from prenatal exposure to alcohol. Early evaluation and diagnosis of prenatal alcohol exposure and FASD can improve outcomes for those affected, yet opportunities for assessment and intervention are often missed by health care and other service providers who may hold biases about prenatal alcohol exposure or lack understanding or confidence in their ability to address it.

Providers who have undergone tailored training designed to improve diagnosis and treatment by increasing their understanding of PAE and FASD have reported greater empathy and confidence following the training; however, there have not been standardized assessments that quantitatively measure changes in their attitudes.

The paper, nowpublishedinAlcohol, Clinical and Experimental Research, aimed to evaluate two assessments, one that measures attitudes about alcohol use during pregnancy, the "Alcohol and Pregnancy Measure," and another, the "Knowledge and Attitudes Regarding FASD Measure." For the study, almost 1,800 Scottish health care and social services workers completed both measures, each of which asked participants to rate how certain statements about FASD or prenatal alcohol use align with their beliefs, and answered knowledge questions about key facts about FASD.

An analysis revealed that the assessments partially measure what they are designed to measure. Certain issues were identified that may compromise the reliability of the assessments, specifically, a lack of set comparison measures and inconsistency at the subfactor level, with less than acceptable consistency for subfactors such as stigma toward FASD and support for prenatal alcohol exposure.

The study authors recommend that a new measure be developed in conjunction with people with lived experience with FASD who can identify the attitudes and biases they encounter to inform the assessment questions.

More information Ruth H. Brown et al, Dual psychometric evaluation of measures assessing attitudes toward prenatal alcohol exposure and fetal alcohol spectrum disorder, Alcohol, Clinical and Experimental Research (2026). DOI: 10.1111/acer.70239