Why Child Protection Keeps Missing Prenatal Alcohol Brain Injury
Recently, I had the privilege of speaking to William “Liam” Curran, a ‘pracademic’ with international standing in the area of prenatal alcohol-induced brain injury. It was a very important part of the jigsaw I am building with The Secure Start Podcast, where I am endeavouring to offer a ‘reservoir of knowledge’ about child protection, out-of-home care, and related endeavours. If you enjoy the episode, please like it and share in your network.
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More about William Curran:
William (Liam) Curran, Ph.D., M.Sc., LCSW, is a licensed clinical social worker originally from Ireland and currently based in Providence. Registered with the Rhode Island Department of Health, Liam brings extensive experience across multiple areas of child and family social work. Over the past 15 years, he has developed a strong focus on supporting caregivers and professionals working with individuals affected by Fetal Alcohol Spectrum Disorders (FASD). His work centers on the identification, assessment, and practical response to suspected cases of prenatal alcohol exposure, with a particular emphasis on translating complex knowledge into real-world social work practice. Liam is a published author and an established educator, having delivered international training and professional development on FASD to social workers, caregivers, and multidisciplinary teams. His approach is grounded in the social model of disability, highlighting the lived experiences of individuals and families navigating often unrecognized neurodevelopmental challenges.
In addition to his clinical work conducting neurodevelopmental assessments for children and youth with or spectated FASD, Liam serves as an adjunct professor in the School of Social Work at Simmons University, where he teaches both BSW and MSW students and advocates for bridging the gap between theory and practice.
More about the podcast episode:
Fetal Alcohol Spectrum Disorder (FASD) sits at the intersection of public health, child protection and everyday parenting, yet it is still widely misunderstood. Alcohol is a teratogen, and when it crosses the placenta the foetus cannot metabolise it like an adult can. The result can be lifelong neurodevelopmental disability that shows up as challenges with sleep, sensory processing, learning and impulse control. The conversation also highlights a key public message for pregnancy health: no amount of alcohol is risk-free, and mixed cultural messaging keeps families and professionals trapped in uncertainty about what is “safe”.
A major thread is the difference between visible Fetal Alcohol Syndrome and the far more common hidden presentation, NDPAE (Neurodevelopmental Disorder Associated With Prenatal Alcohol Exposure), which appears in DSM-5. NDPAE often has no sentinel facial features, so the disability is missed and children are labelled as “troublesome” rather than recognised as having an acquired brain-based impairment. Because the neurocognitive and neurobehavioural profile often becomes clearer around ages 8 to 16, systems need accurate prenatal alcohol exposure history years earlier. When antenatal services do not routinely document alcohol use, later diagnosis pathways stall and children in foster care experience placement disruption, school exclusion and escalating risk.
The episode challenges the idea that diagnosis alone is the solution. Families are often promised that a formal FASD diagnosis will open services, but without a trained allied health and social work workforce, the same barriers remain after diagnosis. Misdiagnosis is a recurring harm, particularly ADHD diagnoses layered on top of complex presentations, sometimes alongside heavy medication without a coherent formulation. The practical consequence is that children are pushed around systems rather than supported with a needs-led plan focused on adaptive functioning and executive functioning, the two most consistently documented problem areas in the FASD research literature.
A practical alternative is a structured screening pathway that builds evidence before chasing a label. Liam Curran’s five-step model starts with genetic screening to rule out other neurodevelopmental conditions that can mimic FASD presentations, then moves through behavioural, adaptive and executive functioning assessments (including tools such as the Vineland), before bringing stakeholders together to interpret the “jigsaw” and plan supports. This approach aims to help child welfare teams “see the unseen”, reduce costly and delayed diagnostic bottlenecks, and create clearer communication between clinicians and child protection so diagnoses like NDPAE do not disappear in paperwork. The broader prevention message is equally concrete: improve professional competency training, strengthen documentation in pregnancy care, and nudge culture early through school-based health education so fewer children enter the system carrying preventable disability.
Chapters:
0:00 Cold Open On Hidden Harm
2:34 Welcome And Meet Liam Curran
6:45 How A Case Changed His Work
15:14 FASD Basics And NDPAE Explained
27:21 The Evidence Problem In Diagnosis
30:29 A Five-Step Screening Pathway
39:52 Misdiagnosis And Service Dead Ends
57:01 Culture, Prevention, And True Prevalence
1:02:27 Supporting Parents With Lifelong Disability
1:06:28 Training That Builds Real Competence
1:15:56 Where To Get Capture Invisibility
Links:
Patreon: https://www.patreon.com/c/TheSecureStartPodcast
William’s Linked In: linkedin.com/in/william-curran-48a9b0337
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Transcript:
Colby 0:00
Welcome to the Secure Start podcast brought to you by the Secure Start Aura apps, supporting trauma-informed care and practice at home and in school.
Welcome And Meet Liam Curran
William 0:17
Child welfare system is fearful of the cost of fetal alcohol. And I think that is because they’re listening to the wrong narratives. The fetus isn’t developed strong enough to deal with alcohol. And this is where the harm comes in. These kids are seen as just bad kids, troublesome kids, you know. And then, of course, we use the labels of trauma in early childhood or um ADHD, whatever. We will do everything to avoid acknowledging that this could be a brain impairment that was sustained in neutral. NDPAE, on the other hand, is a completely invisible um impairment. It’s where the alcohol has disrupted the brain wiring of the fetus in neutral. I think the problem for our child welfare system is we’re the system is picking up probably 99.9% of the invisible NDPAE. It’s 85% or 90% of all individuals impacted will have a hidden brain impairment. And those kids are the ones that are really falling through the gaps at the moment. The neurobehavioral and neurocognitive presentations really don’t start developing from until 8, 9, 10, 11. In the five-step screening, I do the genetic screen first, I do a behavioral screen second, I do an adaptive screening third, I do an executive screening fourth, and then fifth, we come together and we talk about it. The vast majority of our allied health and social work system are not getting the professional education. They don’t quite know what they’re dealing with. And so it’s easier to shut it down, it’s easier to dismiss it than to actually deal with it. This is what often happens to these kids. They get pushed around the system, they get diagnosed, they get medicated. These kids unfortunately do. Because of the invisibility again, they get misdiagnosed.
Colby 2:34
Welcome to the Secure Start podcast. I’m Colby Pierce, and joining me for this episode is a powerful expert voice in the field of fetal alcohol spectrum disorders. Before I introduce my guests, I’d just like to acknowledge the traditional custodians of the lands I’m coming to you from, the Ghana people of the Adelaide Plains, and acknowledge the continuing connection the living Ghana people feel to land, waters, culture, and community. I’d also like to pay my respects to their elders, past, present, and emerging. My guest this episode is William Curran, also known as Liam Curran. William is a licensed clinical social worker originally from Ireland, currently based in Providence in the USA. Registered with the Rhode Island Department of Health, William brings extensive experience across multiple areas of child and family social work. Over the past 15 years, he has developed a strong focus on supporting caregivers and professionals working with individuals affected by fetal alcohol spectrum disorders. His work centres on the identification, assessment, and practical response to suspected cases of prenatal alcohol exposure with a particular emphasis on translating complex knowledge into real-world social work practice. William is a published author and an established educator, having delivered international training and professional development on FASD to social workers, caregivers, and multidisciplinary teams. His approach is grounded in the social model of disability, highlighting the lived experiences of individuals and families navigating often unrecognized neurodevelopmental challenges. In addition to his clinical work conducting neurodevelopmental assessments for children and youth with or suspected FASD, William serves as an adjunct professor in the School of Social Work at Simmons University, where he teaches both Bachelor of Social Work and Master of Social Work students, and advocates for bridging the gap between theory and practice. When not working, William enjoys time in his local community, often found with a coffee in hand at Coffee Exchange, one of his favourite spots. So welcome to the podcast, William. Before we go any further, I’m going to try to remember to address you as Liam for the remainder of our conversation. You’re a man of more than one name, and that’s useful for our listeners to know. But I have you perhaps explain why that is the case and also why that is useful for our listeners.
William 5:52
Yeah, thank you. Thank you, Colby, and thank you for having me on the podcast. Yes, the Leam William thing is a little challenging. Leem is the Gaelic of William, and I was Leam all the time and growing up, but I was baptized William and my passport was William. And then I moved to America, and because of the American immigration stuff, you have to be kind of Dutch race and cross your T’s. So I have to be William. And indeed, I have publications under William and I have publications under Liam. And some people are confused by that. But Liam is very much for caregivers, William is for professionals. Aye, aye.
How A Case Changed His Work
Colby 6:29
Well, I thought it was it was very important to get that out of the way because as you say, we’ve probably got a mixed audience anyway of caregivers and professionals. Well, in fact, I know that we do, uh, but also that you’ve written under both names, so it’s important to kind of connect those up. Yeah. Sure. So uh from my knowledge of you, one of your great areas of work and and um focus of your work has been fetal alcohol spectrum disorders, um, including in a child protection context. And I’m just wondering about how you became interested in it. And indeed, what is fetal alcohol? What are, I should say, fetal alcohol spectrum disorders?
FASD Basics And NDPAE Explained
William 7:13
Yeah, I guess firstly, maybe how I got involved, um, it was accidental. Um many, many years ago, I was a principal social worker in practice, and I had a very complex case of drug and alcohol child, a pre-birth risk assessment case of pre-birth um of drug and alcohol. And in that process with case conference and stuff, there was an obsceney professional who gave her view, and I remember being very struck by it because she talked about the internal world of the child, the internal world. And that struck me because I think as social work, we’re trained on the external world, we’re trained on the toxic trio of domestic violence, of addiction, of mental health, of all of these factors that impact child development. But we were not trained really on that whole pre-birth stage of life and what could be going wrong. And that was the trigger for me. Um, it wasn’t long after that I went back to Ireland and I went into Trinity College and I did a master’s in Trinity. And the question I asked in that master’s was if drug and alcohol use in pregnancy was a child welfare concern. Um that ended up getting taken up by the Society Knowledge in Ireland, and this is where my life changed. I was just doing a master’s and thinking life is good, and got my master’s, but then the Society for Knowledge in Ireland picked up on this on my, and it was part published in a book in Ireland, part of my thesis. Um, but then my name kind of got associated with the issue. So I kept going and I did a number of other things, and I published in community care in the UK and blah, blah, blah. Then in 2014, I co-authored a book with a foster parent in the UK. And again, that book is called Understanding Fetal Alcoholic Spectrum Disorders, a guide for parents, carers, and professionals. And that was launched in Dublin by one member of the Irish Senate um in 2013, I think it was now launched. It has done amazingly well around the world. I’m kind of really because I wrote it very much with an Irish kind of vision on it, but uh it’s done well. Um and I suppose then after that I was kind of at a loss, what do I do next? And so my partner decided to come to Canada to do medical residency, and I decided to come and I applied to the university and for a PhD, and uh I wasn’t hopeful, but lo and behold, they accepted me. Um then not just that, but they gave me a three-year fellowship, which I didn’t even ask for, which I I know for many PhDers out there they’d be kind of scrolling at the screen now that say that I got it without even asking. But um I I think again it was for something that I wrote in the in the in for for the PhD that they were just so kind of taken with it, what I wrote. But at that stage, I suppose I was about 10 years into the fetal alcohol space. My knowledge base had developed by that. So that is the journey. Um, I suppose after PhD, there isn’t anywhere else to go. Um, you know, um, I I was I’m not a postdoc type of person, I’ve always seen myself more as a practitioner than an academic, but I am now in the academics field of of teaching at the university, and that’s where I kind of spend my main time, but I continue to do the feet like all work on the side as well, and it’s kind of complicated, but you know, so but that’s how I got into it. Um, it was accidental, it was just doing that master’s in Trinity College in Dublin um back then. Um but I I I guess it it it Ireland, I’m gonna talk about, has real challenges in this subject, and and so I didn’t maybe understand the level of interest there would be in what I’d wrote, put it that way. And and so suddenly I was I was an expert in something that I wasn’t quite sure to do. Oh, I left it out piece because in the middle of all that I went to the US here from Ireland and I became a CDC certified educator of fetal alcohol. They were running a program, and so and I trained that throughout Europe. I did CPD. Did CPD work in Australia continuing professional development? I did I did CPD training in in Ireland, in the UK, in Europe, with social workers for fetal alcohol, etc. etc. Um, am I talking too much now? No, no, no, you’re doing fine. Yeah. No, but I often reflect back on those CPD days, and I can say to you, Colby, full days, train six hours. Many of the delegates would uh would evaluate the days at me as needing two days. And it kind of says how complex this issue is in social care and in social work. Um, it is massively, massively complex when you look at it or you go through it in a professional context and take in all the caveats that are involved. Um, I had a module on how you talk to a birth mom around fetal alcohol. You know, that was a whole module in the training, and so um, yeah, it it kind of but I do look back as well, Colby, and think you know, I trained those social workers, full days trainings, blah blah blah, but they went out into a system that wasn’t really acknowledging fetal alcohol. And kind of the training in that respect, I kind of reflect and think went into a vacuum. It didn’t, you know, but at the same time, I know I remember my last training was 26 social workers with 24 female and two male, which is kind of typical of this profession. Um and they were so so grateful for the for the information that I gave them. And I remember them saying, I’m taking this back to the office, I’m taking this, you know, and blah blah blah. So um social work definitely, in my experience and subsequent years of talking about social work, they definitely want this sort of education. But I do think there is a potential difficulty in that the corporate parent is not necessarily on board with that. And I think the issue there for the corporate parent in the child welfare system is that the child welfare system is fearful of the cost of fetal alcohol, and I think that is because they’re listening to the wrong narratives, they’re listening to a diagnostic narrative, and I’m saying that unfortunately the child welfare system cannot diagnose all the suspected cases of fetal alcohol, they can’t do it, and so that diagnostic kind of narrative is very overpowering in the fetal alcohol space. Um, and uh as we go through, I want to talk about that in the sense that there is some real challenges in that diagnostic narrative that we need to talk about in terms of how child welfare addresses this issue. Yeah.
Colby 15:14
Yeah. Well perhaps why don’t we why don’t we just move there and talk a little bit about um the narrative that exists around fetal alcohol spectrum disorders? And perhaps uh if you for our um you know the uh full diversity of audience of this podcast, if you can perhaps just for such a complex disorder uh uh group of disorders, perhaps just give us a little bit of a an insight into what they are and then some of that uh those complexities that exist around uh FASD.
William 15:48
Yeah. I think obviously fetal alcohol um harm has been, I think the difficulty we have now, Colby, we we have 58 years of empirical research. Yeah, we shouldn’t be here trying to decide what this is about. But I I wonder where the black hole is of where this 58 years of research has gone, because it’s not seem, it does not seem to connect uh in any sort of societal level of what and to prevent this. But fetal alcohol harm is obviously caused by alcohol use during pregnancy. Alcohol is a teratogen. It is kind of acknowledged that as a teratogen, it travels through the umbilical cord into the fetus. The fetus isn’t developed strong enough to deal with alcohol. Um all the adult listeners of this will understand that a few glasses or a few beers and your head starts to pound or whatever. Um, a fetus can’t deal with the alcohol, and this is where the harm comes in. Now, the the the two main conditions under the umbrella are fetal alcohol syndrome, and there’s a number of other ones, but I’ll go with what I’m saying now is NDPAE, neurodevelopment disorder from prenatal alcohol exposure. Those are the two that are the primary focuses in society at the minute. And I say that because number of the assessments that I’m picking up under my model that I’m doing, lots of the kids are coming with NDPAE. They’re not coming with an FSD diagnosis, they’re coming with the diagnosis under the under the umbrella term. What’s the difference between them? What’s the what’s the difference?
Colby 17:39
Yeah.
William 17:39
Well, well, between fetal alcohol syndrome, fetal alcohol strength syndrome has clinical guidelines, but there’s only about 10 to 15 percent of any live births will be fetal alcohol syndrome. It’s the it’s the heavy end of alcohol use in pregnancy. And where the child will have what they know as senital features or feet or facial dysmorphia, so they have slight alterations in in the face. Again, I suppose I want to clarify when training talks about those facial features are clinical measurements. And what I mean is that you don’t just look at someone and say, ah, they’ve got fetal alcohol because their facial features are different to someone else. Yeah, the met the actual features have to be have to meet clinical guidelines in terms of the measurement. That’s the international classification of diseases in 9 and 10. Those guidelines are in there. NDPAE, on the other hand, is a completely invisible um impairment. It’s where the alcohol has disrupted the brain wiring of the fetus in neutral. And what I’ll say in terms of the presentation of these under the FSD umbrella is that it’s from mild to severe. So you get some mild impairment where the individual can really do quite well in society, but they have little little supports, etc. I think the problem for our child welfare system is we’re the system is picking up probably 99.9% of the invisible NDPAE type injury in this population.
Colby 19:31
Yeah, in terms of picking up, you mean that they’re coming in to child welfare system.
William 19:36
Yeah. Yes. And why do they come in to the child welfare system? Because NDPAE or the FSDE umbrella term, the neurobehavioral presentation is is quite noticeable. Um, these kids have a lot of problems with impulsivity. Um, they have a lot of problems with with you know diet, they have a lot of problems with sleep, they have a lot of problems with sensory processing. So, you know, they they tend to not do well in the classroom, and um, they often get expelled and thrown out of the classroom, etc., etc. They tend, I mean, the research is there, and this is the problem with me as an educator now. I’m just talking about what research is out there, and the research clearly shows that there’s a high level of placement disruption in foster care because these kids go in, but their neurobehavioral, neurocognitive presentation doesn’t fit. And so the the behaviors, etc. etc., is that the placement ultimately breaks down and these children move within the system. Um but again I’m saying it’s it’s it’s it’s the 90, well, I said I said 10 to 15, so it’s 85% or 90% of all individuals impacted will have a hidden brain impairment concept, and those kids are the ones that are really falling through the gaps at the moment. I say that because feet logical syndrome because it’s visible and because there’s a clinical diagnosis, those kids can do okay. In fact, I was when I was being trained at CDC, I had an adoptive parent in the pro in the program, and she had one of one one feet logical syndrome, one feet logical um hidden. And she said that she said the kid he gets and society recognizes, etc. etc. So they do okay. It’s this 85-90 percent of hidden that enters our systems that we just don’t see, we don’t understand. Um and I suppose this is comes back to the William piece because my doctoral study is a painful, pain. Read because as a grounded theorist, I kind of did grind down and I did a deep dive in child welfare in the context of uh fetal alcohol. And unfortunately, my thesis has a number of child fatalities in the system, and they’re all linked to fetal alcohol. Um what I will say is that these fatalities, whether it’s Canada, whether I’ve I one of them was in Australia, et cetera, et cetera. The society is a little bit more open on the issue of fetal alcohol in those places. And so that the link of fetal alcohol is in the coroner’s report and in the kind of the narrative that the public health coroners talk. But again, Colby, what I’ll say is those coroner reports clearly, clearly say that their recommendations to child welfare systems and to the child welfare system has to kind of grasp this issue. Um I worry that there’s many cultures, including my own, in Ireland and the UK, where child fatalities are happening in the system, but fetal alcohol will never get laid would will never get be the label applied. But I remember reading the recent one from my own culture, and there were five kids that was undefined as to what happened in terms of their fatality. Um and you would have no problem in from my perspective, as someone that’s very informed in this area, that those kids would probably clearly fall into that bracket. But again, the kids that are impulsive, the mental health, the addiction, all of these issues that with teenagers, this again is where it’s totally not been understood that it’s the brain and it’s the brain issue that’s that that’s presenting. Um these kids are seen as just bad kids, troublesome kids, you know, and then of course we use the labels of trauma in early childhood or um ADHD, whatever. We we will do everything to avoid acknowledging that this could be a brain impairment that was sustained in neutral. Um and I kind of question why we have funded 58 years of research? Why do why why why fund it if we’re not going to acknowledge it? Um and I suppose, like you know, from my work in Europe with the foster parents, with the adoptive parents, I I co-delivered education with birth moms. And so, you know, I I’m very aware that birth moms, the vast majority, if not all, no, no birth mom decides that she’s going to do this to her child.
Colby 25:04
No.
William 25:05
But she she does perhaps drink because of the mixed messages that are in society. Because unfortunately, Colby, you will get people saying, ah, sure, it’s okay to have one or two. Or sure, it’s okay in the third trimester. Actually, the third trimester is the highest risk for the brain impairment because of the brain, the wiring is is is falling into place in that final stage, and that’s where the alcohol comes in and it damages some of that synapsis connections that are happening in the brain.
Colby 25:41
So the key message there is really no alcohol, the baby just can’t tell it, can’t do anything with the alcohol, can’t metabolize it, can’t cope with it, it has no, and so any alcohol during pregnancy is going to impact. Um you were saying, if I can just clarify a couple of things, you were saying, I think, if I understood you correctly, that um perhaps 90% of the uh of uh the undiagnosed fetal alcohol spectrum disorders are in uh come into uh child protection. Yes. So that’s that’s that’s the 90%. There’s you were also saying that of of the totality of children with fetal alcohol effects, you could say, or impacts fetal alcohol fetal alcohol exposure, about 15% get diagnosed, and and they’re probably diagnosed in part because of the um morphological features of their face, which probably is what draws people’s attention. But one of the big stumbling blocks to go progressing any further than that is establishing whether there has been um it’s at least in my context uh here in Australia, establishing whether there has been prenatal alcohol exposure. So if they if they can’t, if if the the doctors can’t establish pre prenatal alcohol exposure, then the assessment process stops there. It doesn’t go any further.
A Five-Step Screening Pathway
William 27:21
Um yeah, there’s a number of issues there in this. Um firstly, you’re right in a sense that we don’t routinely collect that that that data in in postnatal or prenatal stages. Um we although the that the the mother may be coming in for prenatal checks, etc. etc. in her pregnancy, we just don’t ask the questions. We don’t, you know. Now it’s interesting because when I was doing the work in Europe, the AGIO, which is the alcohol industry in Europe, it actually funded the training of 10,000 midwives in the UK simply for the fact that they would document alcohol use in pregnancy. Because the other issue, Colby, is that the neurobehavioral and neurocognitive presentations really don’t start developing from until 8, 9, 10, 11. And so what I’m saying is that you want that record from 10 years earlier in order to diagnose um now when they’re 10, 11, 12. Um that’s that’s again a major issue because you know your Australian guidelines were published in 2025, um, May 2025, the new guidelines. Um I hear a lot of see a lot of social media posts, oh, we have diagnostic, we can get diagnosed now. We get about the problem, Colby, is that I’ve read them, I’ve read those guidelines, they come back to the same same issue, and the guideline clearly says that in order to diagnose hidden um brain impairment, you need to have evidence of prenatal alcohol exposure. Yeah, and so are three senatal features, which is coming back to the fetal alcohol syndrome and the ICD 9 and 10, because the hidden does not have the senatal features, so but it says you have to have the prenatal alcohol exposure evidence, and that is that is a major issue in the system because to quote a senior child welfare system uh uh child welfare officer, he said that they’re they were having rogue diagnoses. In other words, children are getting diagnosed uh without that confirmation, and that is not helpful either, because the potential is for that their diagnosis is wrong. Um you cannot assume, even if you take the mom from the bar stool in the bar to the maternity hospital, you cannot assume that it’s fetal alcohol. You just can’t do that. There is a mechanism and there’s a clear way to determine if this is fetal alcohol or not, and that maybe kind of brings me into why I published the five-step model. I don’t know if you want to ask me about that.
Colby 30:31
Well, I was going to say, you know, because I’ve seen it in my own clinical practice, I’ve seen that there are children who um I would say they they may not have all three sentinel features, uh, but they definitely have one or two. And you you would think um the only thing that is stopping that it progressing into a further assessment and potentially a diagnosis, and then with the diagnosis, significant um resources are mobilised to support the young person and and the people who are looking after them. The only thing that stops that process dead in its tracks is the uh lack of evidence of prenatal alcohol exposure. And I guess I’m thinking about in child protection, I’m thinking about well, what proportion of mums uh in whose children come into the system even go to an have antenatal care? Um so I I I think it it does we are coming, I guess, to what you just said is that well, how do we we’ve got say 85% of of of young people who have likely got some sort of alcohol related impairment, prenatal alcohol exposure impairment, who are not being diagnosed. What what is the what are the consequences? What’s the the fallout of that and and what do you propose that we we do to um to to facilitate or to ensure better practice in relation to those young people?
William 32:16
Yeah. Well obviously that in my doctoral study I probably read 20,000, 30,000 papers over the four years. I just kept reading. Um I’m saying to you there’s 58 years of it there. There’s a lot of lot of repetition in in in in the research that’s coming out. Um the good empirical stuff that stuff that’s done under strong ethical guidelines that tends to get lost in the narrative, and so we don’t necessarily acknowledge the good stuff that’s in the literature base. Um but I suppose in in that literature, for me, there was a number of things. One is that adaptive and executive functioning are the two most written about aspects of fetal alcohol in all of that literature, it continually pops up in the thing. So there’s adaptive and executive functioning. There’s obviously a behavioral issue. Um, but then interestingly, at the time I was doing the work in the UK with the foster and adoptive parents, the only national diagnostic clinic in the UK was run by a guy called Dr. Raj Mukhaj. And Raj would not see a child before the age of eight because he would argue that the developmental stage that you can’t really measure that piece earlier, that you have to wait until the child gets into some sort of self-directive type functioning to measure. And the second thing that he had as a criteria is that you needed to get a genetic screen. Now you might be thinking, what’s genetics got to do with fetal alcohol? Well, it has nothing to do with fetal alcohol, but we have in the region of 60 neurodevelopment conditions that would many of them would actually look like fetal alcohol presentation. Um we have like just recently at the last two or three years, we have a new one added to that, and it was Menck’s syndrome. Menck’s syndrome or Menck’s disease is a copper deficiency in pregnancy. The child, the child will actually develop very similar to fetal alcohol. They will have um neurological impact, they will have behavior, they will have whatever. Um they have very, very finely tinned hair in Menx syndrome. That’s one of the more obvious features, but a lot of it is again an internal brain uh impairment piece. Now, Menck’s syndrome was just added as a panel to the genetic codes, I think about three, four years ago. Um, I’ve seen it already in one of my assessments here that I’ve done. Um the reason that the genetic component of the five-step screening program that I brought forward is to rule out all of these other conditions because of the risk of misdiagnosing. We have the research that these kids are being misdiagnosed full stop. Uh, Chasnoff and colleagues in in Chicago here did it. Um so it is about ruling out all of these other, so it’s about trying to slim down the pathway of understanding what is this neurobehavioral thing we’re seeing. Because if you can remove 60 potentials, then you’re left with now, ADHD still doesn’t have a genetic panel, so you’re still left with that quandary between the two. But again, there’s there’s ways of again, under professional guidance, there’s a ways of teasing out whether this is fetal icon or not. Now, in in the five-step screening, I do the genetic screen first, I do a behavioral screen second, I do an adaptive screen in third, I do an executive screen in fourth, and then fifth, we come together and we talk about it. That’s the kind of the panel. Now, I’m gonna be honest on this podcast, there’s some pushback on it because I’ve put diagnosis and is step six. And some people are saying you can’t do that in the fetal alcohol world. My simple argument here is are you kind of diagnose first, ask questions later, or are you ask questions first, diagnose later? Um, we are we are, I don’t know where Australia, but here in the US now, we are diagnosing children way too quickly on across the board with everything. We’re not asking the questions, we’re not asking, um, we’re not seeking any of the answers. Um quite a lot of the pressure on the system to diagnose is is coming from parents that are stressed out, working, etc. They want quick fixes for their children. And so the diagnosis is is primarily first in everything of children’s health. Um, and I’ve come along and said, no, no, no, let’s do this first and let’s then go to diagnosis. You you create an evidence-based pathway, and the clinician should be really happy that you would come in with the evidence of the assessments because it would make the clinician’s job much, much easier to be able to see those outcomes.
Colby 38:12
Are you suggesting, Liam, that we can diagnose uh a fetal alcohol um disorder, spectrum disorder without that uh without the knowing of fetal uh of prenatal alcohol exposure? Is that what you’re saying? If we follow a five this five-step process, then that will mean that we we can make diagnoses in circumstances where there is no evidence of the fetal of the prenatal exposure.
William 38:46
Yeah, I think what I’m coming to is that say under the vinyland, which is step three, vinyland will capture the nine domains that are the brain domains that are very, very common in in the fetal space, but in any child development state, the nine domains, the social, the kind of the play, the whatever. The vinyland will capture that and will show you where the child is at. And one of the can one of the ways that I think even the Australian guidelines are trying to work this is that they’re talking about three domains to where you see significant um deficits in in three of the domains. So, again, what I’m saying is you can diagnose it, but you’ve got to piece together the jigsaw piece first. You’ve got to get the evidence that it all makes sense. Um, you said there earlier, which kind of took me back, which was that you get a diagnosis and you open up all these services.
Colby 39:52
You do here.
William 39:53
I would say I would say, uh, Colby, that doesn’t happen. That does not happen. And I think many caregivers believe that they’re going to get the diagnosis, and then suddenly um nirvana, that all the services are going to happen. I’m saying, and I happily say on this podcast, if this if the trained professionals are not there prior to the diagnosis, they’re not there after the diagnosis either. And services, interestingly, I had a carer that got two different. She went to a service, they said they don’t deal with you need a diagnosis to get a service. She went away two years later, she got the diagnosis, she went back to the service, she said the criteria we don’t deal with fetal alcohol. Yeah. So this is what happens to caregivers quite a lot. And it’s all got to do with the fact that unfortunately, the vast majority of our allied health and social work system are not getting the professional education. They’re not, they don’t quite know what they’re dealing with. And so it’s easier to shut it down, it’s easier to dismiss it than to actually deal with it. And it leaves caregivers in a difficult place.
Colby 41:11
What are they being diagnosed with something else? And and potentially treatment is focusing on something else. I know you mentioned ADHD a little while ago.
William 41:21
Yeah. The most common misdnosis is ADHD. Yeah. And yes, you’re right, it’s misdiagnosed. I mean, again, I have a training session, and it was a social worker contacting me here in the US. And what I do now, if a social worker contacts me, I say, Can you send me through a bullet point of the child and any medications or diagnoses? He sent me through the kid had eight diagnoses and was on 10 medications, and he was looking for an assessment of fetal alcohol. And I went back to him and said, Why now? And he said, Oh, the medical profession suggested that might be a good idea to get a fetal alcohol assessment. This is what often happens to these kids. They get pushed around the system, they get diagnosed, they get medicated, and then somebody does the bright spark and think maybe this is fetal alcohol. And then they look for an assessment. Um I’m gonna be honest with you and the the listener is that I was worried about that kid. He’d already done, he’d already had two suicidal attempts. He was in a bad place. Yeah, but I would actually argue that the mismedication and the misdiagnosing was a strong part of that bad place, you know. And so these kids unfortunately do because of the invisibility again, they get misdiagnosed. I would encourage anyone to read the the Chasnov study of 2015, it clearly showed, and he did he study was again in foster and adoptive populations, and it showed the level of missed misdiagnoses and misdiagnoses that was in that population.
Colby 43:12
You’ve you’ve you’ve indicated that there would be a level of professional naivety, let’s put it that way, about um fetal alcohol spectrum disorders. Um do you think that there are other uh you’ve also you also mentioned a little bit earlier that this raise the specter of costs. Do you think there’s anything else that um gets in the way of us properly considering fetal alcohol spectrum disorders, particularly in a child protection space? And I guess there’s a couple of things that I’m thinking of particularly, which is um concerns about the message that uh Of how that alcohol exposure happened, and I’m referring to mothers. And also, I think with some of the young people I’ve known, um, I’ve been concerned about how they, you know, the message that they receive, not only in relation to their mothers, but the messages that they really receive in relation to how they look, particularly if they’ve got the sentinel features. Apart from the professional naivety, oh yeah, what what is getting in the way?
William 44:31
It it it depends. I I suppose like I write and I kind of talk about cultural sensitivity to addressing this issue. Now, I’m on a podcast with you, you’re in Australia, I’m in America, I’m from Ireland. I’m gonna say all those cultures are very, very different in how A they view alcohol, how they view maternal child health, you know, where that sits on the on the parameters of public health. So culture is a major, major challenge in it. And I think for my my own culture, we are we are globally known for our alcohol in you know culture. And we have unfortunately one of the highest alcohol rates in pregnancy at 82 percent. Yeah. Now that’s not me saying it, that is the epidemiologists who showed that level in Ireland. Yeah, now another study married with UK, and so they came up with 75% in the UK and Ireland of alcohol use in pregnancy. The latest one I’ve seen for Australia is quite good. You are at 28%, according to a study I seen. That’s good. However, Canada, when I was doing my PhD, was at 10.4 as a national alcohol rate in pregnancy, and the US was at 12.6. Now the US has gone up a little to 13.4 as a result of the pandemic. I think probably Canada’s gone up a little bit. All cultures have gone up a bit because the pandemic was clearly seen as a potential. Um, and again, a guy called Shear wrote in 2020 and he warned of the collateral damage of the pandemic. And we’re going to start seeing that collateral damage now because we’re six years out from that. Um, six, seven, eight, we’re gonna see an increase of children entering our child welfare system with this condition from that period. Um, so I I know that that answers your question in sense of culture, but I do think I do think there is cultures that have grabbed this and gone with. I I would give you Alberta in Canada. Um, it’s a population of 5.5 million. Colby, you’d be shocked to know they have 24 multidisciplinary assessment centers for fetal alcohol. Goodness. Yes. Why? Why? You might ask. In 1991, social workers and foster carers came together and they wrote to their elected MLA professional in in government in Alberta and said, and they both wrote their needs. So the foster care had a need, the social worker had a need, and they wrote it into the system and said, you know, that’s why Alberta has what it has today. And, you know, that’s one thing I say now. I was in I was in Queen’s University in Belfast lecturing last week, and I say, please, if you read the paper, think about advocating up the line, think about pushing this up the line. Because I do feel if you just read capture invisibility, the paper with the model in it, it’s just another paper of the 58 years of research. But if you do believe that the model has ability to address that vacuum that is in the middle between kids with identification and kids that haven’t because of their invisibility, I believe the model is really settled for those kids and it helps those kids. And I’ve seen that in the assessments I’ve done here in the US. And I think it’s another issue that’s happening in our services, Colby, and I don’t know about Australia, whatever, where the clinicians are diagnosing under the FSD umbrella, NDPAE, very common. And they’re just putting it on paperwork and it’s going back with the child into a system where the system doesn’t understand what NDPAE is. Yeah. Now, what I’m saying to the listener here, NDPAE is in the DSM 5, it’s 315.8, it’s clearly in there, and so why we don’t understand the these DSM 5 and why we don’t understand this diagnosis, I’m confused with that. As I am confused with the 58 years of research that we’ve not engaged with. Yeah. And I say I say to Colby, you know, the children being returned to the system without anyone knowing. I mean, that was a case um in Canada. Um Barbary and Chote, which are two social work professor professors in in Canada, they wrote a paper in, I think again was around 2015, and social um fetal alcohol spectrum disorders, a disability in need of social work education was the title. But it was the actual paper was about where a child had been diagnosed, returned to the system. Nobody in the system knew he had the diagnosis. And then what happened was that in an impulsive act, he attacked another child with a piece of wood and actually killed the other child. Both of them were in foster care. But the the inquiry that came out of it and the reports that came out of it clearly demonstrated that the child was returned to the system, but nobody knew about it. Nobody knew about the diagnosis. And I think unfortunately, that is happening all too often. And I don’t know, like I would like to see the systems, especially child welfare systems, you know, that there should be some mechanism by which if a clinician is making those diagnoses that they’re informing the child welfare system, that this diagnosis has been handed down and this child will need XYZ. That would be a simple communication between the two systems. Um, but again, it’s fallen into the fact that these kids are in the system, they’re misunderstood, they’re not understood, and they’re coming into very negative trajectories. And again, I say to people, please do not read my doctoral study if you’re sensitive, because it it does have some heavy stuff in there.
Colby 51:21
Oh I I like to think about people’s blind spots in my practice, and it there’s clearly, I think what you’re saying, uh, there’s a degree of naivety, and and maybe um maybe there’s not the support in child welfare uh authorities to um to to access training. But I I think alcohol alcohol use, I was surprised by some of those figures that you mentioned earlier by how low uh maternal alcohol consumption is in many of our uh Western countries. Um I I would have dare say that it was higher than that. Um frightening.
William 52:04
I think what call what I’d say Colby is that at the end of the day, Australia is a big country, so you get variations across the country, and like in Canada, I said 10.4, but within the various provinces in Canada, I was in Quebec uh doing my PhD, and it was 27.6 in in Quebec, but it was 5.4 on Prince Edward Island, which is another part of the Canadian system. So the same with Australia, you’ll get you’ll get wide variations within that figure.
Colby 52:38
Yeah, but but alcohol is is very much or alcohol use is very much part of the social fabric, I I would say. And um and I wonder if I wonder I I do wonder if part of the problem is that the idea that any alcohol consumption during pregnancy it can be doing harm to your unborn child is just so confronting that that also creates this blind spot around even even in professional circles, around properly looking at the contribution of prenatal alcohol exposure um in the presentations of the children we’re seeing.
William 53:25
Yeah. But I think obviously, you know, A the levels of alcohol use and pregnancy over here in North America are are are way down, but there’s so much public education. I mean, if you go in a bar in the US, you will probably see the sign behind the bar man. You will, you know, there’s lots of education around, and public health both in the US and in Canada have done really good jobs on that. Um I think it’s it’s it’s a constant it’s a constant um education piece in the system.
Colby 54:05
Yeah.
William 54:05
But I think I think at the same time, you know, when I was doing my first, when I was doing my masters back way then, and that question I was dealing with that question of drug and alcohol use. I remember one of my colleagues in in the in in the hot in the I was on the floor with public health, and she talked about that she wouldn’t eat cheese when she was pregnant. So it was one of it’s one of those ironies that we have these healthy pregnancy messages that seem to really do go into culture and go into them well, but we just will not speak against alcohol. And I kind of say, like, you know, that I said to you there, I don’t know, you know, DiAgio, which is the major alcohol supplier in Europe, it funded 10,000 midwives training in the UK back in the 90s. Um with with with the acknowledgement, no acknowledgement of their of their role, but they did that funding because the funding was about ensuring that the documentation of prenatal was on the records. Um, but again, if if the Agio can do that in one, now there’s a lot of debate in the in the fetal alcohol space that you don’t take money from the alcohol industry for the fetal alcohol you know narrative. I’m saying I’m I would quite happy take the money from the Agio if I can help to prevent and uh etc. etc. And I think it’s a win-win for the alcohol industry because what they would lose in revenue from a pregnant woman not drinking during her pregnancy, they’re going to win heavily by their public health approach to fetal alcohol, you know? Yeah, and I think certainly in some in the European cultures, there needs to be some creative ways of of addressing the issue because we have very high rates. Now, in my in my thesis, I talk about uh second level education, that we have SPHE programs in in school, and I would like to see, even if it’s only a leaflet, go into that pack of health promotion pieces in the school, because I think adolescent brains are much easier to kind of get a message into than once the individual gets older, it’s harder to get the message in, you know. So if we started with children and young people in the education system, just to get in a leaflet, just to get in, it’s not it’s not doing a full education on it, it’s it’s just subtly getting the messages into culture because you have to nudge the culture when you have high rates of alcohol use in that way.
Colby 57:01
Yeah, yeah. You talked about the rates. I don’t know if this is a um a fair or or question to ask at this time, but um you talked about the rates of of drinking or alcohol use during pregnancy. What do you think is the true population prevalence of uh fetal alcohol spectrum disorders?
William 57:28
Again, I suppose, like you know, there’s a there’s a significant body of research um done in the social world by social workers like me, um, and and talking about that prevalence rate. So, you know, that um there in the in in in in Australia, you have a you have an excellent um educator, Prue Walker, um, and she’s done she’s done amazing work showing how um these children are turning up in the child protection system. I think it was one in five or two or five of the system that was impacted. Um I think again, prevalence studies have to be linked to the work of the epidemiologists in in the culture. Because if I I gave you different stats there for Canada, for blah, for Ireland, for England, so obviously different stats are going to have different prevalence rates. The Canadian prevalence rate uh is 16.9 percent. Again, if that’s predicated against a 10.4 national average of alcohol use in pregnancy, so 16.9 from that. The UK has done a couple of studies, they are around 30% of what of the child welfare system. Now, again, I come back to the fact that you know I do a little model when I was in Queen’s University uh last week, I did a little breakdown of how you can get to. So that breakdown brought me to 1% of the population in Northern Ireland has some aspect of impairment from fetal alcohol. Now you might say, well, 1%, that’s good, but it’s 1% of, I can’t remember now what the population was, the statistic that I did in Northern Ireland, but it’s about 2 million people, whatever. Um so 1% is quite an in a big population. I think the problem is that these kids then are turning up in the child welfare system in a higher percentage of that because of their neurobehavioral and neurocognitive displays, um, they’re coming into the system because parents can’t cope, etc.
Colby 59:54
Um, I wonder that’s very common themselves.
William 59:57
And it’s it’s eight, eight onwards, eight, I think eight to sixteen is the most obvious signs of fetal alcohol in terms of the neurobehavioral and neurocognitive representations.
Colby 1:00:12
You know, while you’re talking about that and you bring up the parents again or brought up the parents again, um, I was thinking about the I wonder, I wonder if anyone is wondering about the prevalence of fetal alcohol issues in the the parents of the children that are coming into the system. Because you talked about poor executive functioning, impulsivity, um, low adaptive functioning. That sounds a lot like a lot of uh the parents of children that are coming into the system today.
William 1:00:49
Yeah, and I thank you for pointing out obviously that fiddlage impairment is a lifelong disability. That brain impairment can’t be fixed um by medication or anything. It’s it it the the neurons in the brain have been burned off by the alcohol. So you’re right in a sense that it’s lifelong. I’m struggling as you were talking to remember the name, but I can’t pull the name on my head at the moment. But a colleague of mine who’s a social worker in Canada, again, she works specifically with mothers who have fetal alcohol spectrum disorders. But what she’s shown in her research, and I’m so annoyed, I can’t think of her name. Um, she’s shown that mothers are able to parent their children effectively with with with not big resources, but with resources, they’re able to parent the child. Yeah, and this is my worry again in the systems that we are removing these children too quickly because oh, it’s fetal alcohol. We need to get them out, we need to get them out. When actually a small investment in helping and supporting the parent can significantly turn that around, or again, applying the five-step model of assessment for the child or whatever, doing these little uh what I call biopsychosocial type interventions in the family can keep the child in the home.
Colby 1:02:27
Um yeah, and I think there’s a broader message around family support and family intervention to prevent placement. Um you what do you in terms of um I referred to it as naivety, um, but what do you what sort of training do you think our um professionals who work with children and young people in but in health and um welfare sectors, what what sort of training do you think is uh do they need to be more across this issue?
William 1:03:02
Yeah, well, I I think I said to you earlier that like you know, I I trained with the CDC, and so under that model, there’s six, seven modules within that training. Um the whole concept of the biology of risk, of understanding why fetal alcohol happens, et cetera, et cetera. Um I guess what I’m saying ultimately is that social workers, social care, allied health should try and advocate themselves for professional education. We have a lot of awareness education. I mean, I don’t know in Australia, but here in the US, there’s a lot of awareness education. It doesn’t necessarily not you you have to be careful by who’s behind the awareness education because I’m saying the University of Google graduates a lot of people. And so, you know, you can go to Google, you can download, you can download my paper, and you can become an expert. No, it doesn’t work that way. This is a massively, massively complex area of practice, and so I would be encouraging the professionals to know that there is a training um framework, a professional training framework is in the in in this in in the narrative, um, and that they need to be the ones to speak up for it. Because unfortunately, the system is not going to give it to them unless they advocate themselves that they need it. Yeah. And so definitely, definitely that there’s a there’s a an issue between a professional narrative and a I suppose I would yeah, well, I I was talking to uh a professional. Well, he was he was in more in public health, but he was looking at the system from from again, it was Northern Ireland, Northern Ireland’s been very engaged with me in this, and and he said at the end of it, he said, it’s so nice to have a qualified narrative on this, and I think that’s the difference. You can get an unqualified narrative. There’s a lot of people, and I don’t dismiss them. There’s a lot of people on the platform with mild diagnoses that are saying this is FST, this is what you know, this is what we deal with, blah blah blah. That mild diagnosis does not look like anything that the more severe diagnoses that are affecting the child welfare system are encountering. And so again, it can give a kind of a confused narrative in society about this disability. And if the one thing that I’m saying is that this is mild to severe, moderate to severe is affecting the child welfare system. Each one of these kids will have their own unique neurobehavioral neuro. Cognitive presentation. There’s no one easy fix. There’s no holy grail that will solve the problem. You have to assess each of these kids individually. Find out what’s their strengths, what’s their evidence, what’s what’s what are they missing? What’s the deficits? And then plan your intervention. So but yeah, I told you.
Colby 1:06:28
Well, it’s fascinating. I think there needs to be awareness. Um, but how would you make a distinction? I’m sure you do. How what would be the distinction between say awareness training? And you know, and this podcast is not necessarily training, but it’s about uh making you know increasing awareness. What would you between that and say professional competency training in relation to the issue of um FASD?
William 1:06:55
I think I suppose like at the end of the day, yes, I I I’ve done that program with the CDC, so that kind of gives me some level of credibility in the field. But I do think that it’s reasonable for any professional or caregiver out there that if they’re listening to an FSD narrative, that they just look at the individual that’s given the narrative and have they researched this? Have they published in this field? Have they spent time truly understanding all the different caveats that are in this discussion? Um that probably can differentiate very quickly between what is a professional narrative to what is a kind of University of Google generated narrative. Um so I think professionals need to be very careful of you know that awareness education will not give them skill or skill-based interventions. Um, my training, what I’ve done in the past, what I continue to do where social workers contact with me, I give the I have a practice bulletin, it’s three pages. I give them that first and and ask them to think about it and how they work that through in their teams. And the practice bulletin is very much about trying to see, well, trying to see the unseen. That’s what the bulletin is about. Because you have to try and see the unseen in this context. Um so I think I think the problem is that society or even child welfare system, because this is invisible, that that means that they don’t have to deal with it. But I think corporate child welfare systems know they are passing these kids out to foster homes, to adoptive homes, the residential child care homes, the alternative care homes. They know that these kids are in the system. So it’s not good enough to say, well, it’s invisible, we don’t have to deal with it. And I think that is probably the most telling thing of my publication in 2023 because the title is Capture Invisibility, and it really was for child welfare system, because I think trying to dodge the issue because it’s invisible, well, I’m sorry, there’s now a publication that says you can capture it. And so I’m throwing down the gauntlet to child welfare to say, you know, because again, it was so easy to perhaps say this kid will not meet the criteria for diagnosis, therefore he won’t get a diagnosis. Um but then what do you do with that kid? That’s what capture and invisibility is about. It’s about assessing those kids and giving them, you know. But I will say again, Colby, capture invisibility kind of rattles has is rattling the narrative a little bit because the tools within it are tried and tested tools. When I talk Vineland, you not you know vinyland, you’ve heard of it. The DREF, I don’t know if you’ve heard much in the U in Australia, but again, I’m saying because they’re not necessarily FSD-specific tools, people are thinking, oh, well, they they don’t have value in the FSD world. I come back to the fact that every child, regardless of their condition, if it’s an executive or adaptive functioning, those tools capture them. Yeah. And it does not matter whether it’s fetal alcohol, whether it’s ADHD, whether it’s autism, whether it’s Asperger’s, whatever, those tools still capture where the child is at in their development.
Colby 1:11:01
Yeah.
William 1:11:01
And that is what’s important for the for the for the discourse in in fetal alcohol, is meeting the needs rather than just hanging everything on a diagnosis and then not getting that and leaving the child to drift. That is that is what’s happening.
Colby 1:11:18
Yeah, and I think that’s a really powerful message is that we need to be um turning our minds to or maintaining our minds on meeting the needs of these children, not just waiting for a diagnosis or not or them not um there not being a diagnosis, and then what do we do here? And it you know, and that’s a message that should go down should be um accepted in child protection circles very easily because it’s a message that is is used um um quite a lot around considering what lies behind the behavior, considering the those the needs of the children and and um and how we should be meeting them.
Where To Get Capture Invisibility
William 1:12:09
Yeah. No, I you know, I think obviously that that I again say that the model the model in caption invisibility, it came from social workers’ data. It it came from the front line of child welfare and child protection. It was social workers that spoke and they overwhelmingly acknowledged in the data that they wanted a pathway, that when these kids are presenting at the moment, many social workers just do not know where to turn because you’re going from A to Z with diagnosis. Yeah, and and the diagnosis is costly. Again, I don’t know in Australia, but in the U in Canada it’s $4,400. In the UK, the last I heard was $3,000 sterling. I’m saying that you can up you can apply that model for around $1,000. All the assessment pieces. Yeah. Now I get a number of families coming to me after the diagnosis to do these assessments. And I’m thinking, wait a minute, why didn’t you come before the diagnosis? Yeah, because somebody is making a lot of money here. And it’s not the family, and it’s not this the child welfare system. Um so I’m saying, you know, I’m clearly saying that the model came from data, it came from practitioners on the front line, it it really was for the child welfare system. I do think that they can operate that model in-house rather than contracting out everything, that they could do that in-house. And it’s interesting because I think it was Dr. James Fitzpatrick in Australia on the back of a coroner’s report of a kid in Australia, and he noted that he noted again about about developmental screening tools, and he noted that professionals could be trained in one or two days um to do these assessments, etc. etc. And that’s what I would love if a child welfare came to me and said, Listen, will you come and train on your development screening tools? I would love to go in and train um and and and show them and show them how they work. Um I used what I use the Pearson Clinical. I don’t know if you use that Pearson Clinical, but I use Pearson Clinical. Pearson Clinical then has a it’s called acute global. It’s an another platform where all my assessments are generated on on virtually, if you like. Yeah, yeah. So I did an assessment there not so long ago, and the carer was in the UK, and I can do the assessments from my living room here. Um the printout of those assessments would be exactly the same if I was sitting with the carer in the UA because it’s this it’s the Pearson clinical process that analyzes the data and gives the kind of the the markers within this within the the report. But I think I think also what’s kind of interesting, I suppose, like you know, this is where I worry that maybe people will take the assessment or do it. I I do a two to three page plain English report on the back of the assessments, and I do that from an FSD-informed narrative so that I’m helping whether it’s the caregiver or a professional to say this is what the assessment is saying, this is what the deficits are, this is what the strengths are, this is what we need to do concept, you know. Um but anyway, I talk a lot.
Colby 1:15:56
Fascinating. Well, I mean, I could there’s there’s so many more questions I could ask, but um, we both um have other uh other duties today, and uh, but it’s been a fascinating conversation, Liam or William, depending on uh who you are and where you are. But yeah, thank you very much for coming on the podcast and um contributing to our little well, it’s getting bigger, reservoir of knowledge that um for um for practitioners, um probably um specifically working in child and family welfare and social care, um, but perhaps even more broadly as well uh in terms of public health professionals who who interface uh not only with FASTE but also with with the child uh welfare sector. Yeah. So thank you very much for coming on.
William 1:16:49
No, I I thank you as well. Again, I I’m I’m pleased to be able to do this podcast that has that social care child protection angle. Uh you know, because that’s where I think my research, and that’s where I want my research to to resonate in in that space. Um I I would say very briefly, I’m very shocked that say the paper captioned invisibility. I’m looking at it on the internet and people are charging crazy money for it. I don’t get any of that money, but organization is charging. I I want to say to anyone that wants to read it, look me up on LinkedIn. I’m William Kern on Will with LinkedIn, send me a message and I can I can we can work from there, you know?
Colby 1:17:31
Yeah, so so you yes, I I was going to um ask about accessing that, but I’ll put your LinkedIn link uh on in the descriptions of the podcast. Sure. Uh good so far. All right, well, thanks again.
Disclaimer:
Information reported by guests of this podcast is assumed to be accurate as stated. Podcast owner Colby Pearce is not responsible for any error of facts presented by podcast guests. In addition, unless otherwise specified, opinions expressed by guests of this podcast may not reflect those of the podcast owner, Colby Pearce. Finally, all references to case examples are anonymised to the extent that the actual case could not be identified, or are fictional but based on real-life examples for illustrative purposes, or have client consent to talk about in an educative context.
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