By Emma McDougall
Occupational Therapy: FASD Informed
When I graduated as an occupational therapist with Honours in 2016, I was passionate about working with children and families. I began my career in paediatrics, supporting children with a wide range of developmental differences, including Global Developmental Delay, Developmental Coordination Disorder, Attention Deficit Hyperactivity Disorder, Intellectual Disability, Autism, Sensory Processing Differences and Anxiety. Like many early career clinicians, I was learning every day, participating in professional development training, building skills, applying evidence-based frameworks, and aiming to work in a strength based, family‑centred way.
My early understanding of FASD
In 2018, I worked with my first client who had a confirmed diagnosis of FASD. Wanting to provide the best possible support, I attended a FASD conference through Gold Coast Health Service to expand my knowledge. I learned about evidence‑based strategies, including the Alert Program, and how these could support self‑regulation goals.
At the time, I believed this meant I was “FASD informed”.
Looking back, I now recognise that I had only a partial understanding. FASD is complex, lifelong, and experienced differently by each individual and family. As a young occupational therapist, I didn’t yet realise how much depth, nuance and flexibility FASD‑informed practice requires.
Knowing about FASD versus being FASD informed
As my career progressed, I continued working through a strengths‑based occupational therapy lens, using occupational therapy frameworks, alongside an understanding of sensory regulation principles. I “knew about” FASD and believed this sat alongside my broader paediatric practice.
In 2020, I began working with a teenager with FASD during a colleague’s maternity leave. The young person had significant emotional regulation challenges, among other goals. Once again, I approached this work believing I had the necessary knowledge.
What changed everything was the young person’s caregiver, a highly FASD‑informed parent and a determined advocate.
By listening carefully to the caregiver’s lived experience and knowledge, I began to understand how much more there was to learn. This experience reinforced that families are experts in their own children and that truly FASD‑informed practice cannot exist without genuine collaboration and respect for lived experience.
Learning through collaboration
As I shifted my approach and worked alongside the caregiver, my practice changed. I was able to adapt my occupational therapy knowledge more effectively, individualising my support to reflect the young person’s unique strengths, needs and profile, rather than relying on standard strategies.
Together, we made meaningful progress towards goals. Just as importantly, I felt more confident and more responsive as a clinician. This experience had a lasting impact on how I viewed FASD‑informed practice; not as a checklist of strategies, but as an ongoing process of listening, learning and adapting.
Deepening my knowledge
In 2024, I chose to undertake the Graduate Certificate in the Assessment and Diagnosis of FASD through the University of Western Australia (UWA). I enrolled in the course without having a specific career outcome in mind. I simply wanted to be truly FASD informed.
The course deepened my understanding of FASD from both research and assessment perspectives, building on my clinical experience and what I had learned from families. I also participated in the UWA student clinic, completing FASD assessments as part of a multidisciplinary team, an experience that reinforced the importance of collaboration and comprehensive and holistic understanding of clients.
Around this time, I became pregnant with my beautiful baby boy. As I began planning my return to work, I reflected on where I could best use my skills and knowledge. I reached out to NOFASD Australia because I saw this as a space where advocacy, education and lived experience come together, and where voices of people with FASD and their families are genuinely valued.
Reflections and a key message
Reflecting on my journey, the difference between “knowing about” FASD and being truly FASD informed is clear. It shows up in confidence, in relationships with families, and in the ability to support meaningful and sustainable change.
If you are a health professional working with someone with FASD, taking the time to become truly FASD informed matters. This includes undertaking quality training, engaging in reflective practice, and most importantly, listening to and valuing the expertise of people with lived experience.
Every person with FASD is different. When FASD‑informed knowledge is combined with genuine collaboration with individuals and families, that is where change happens.