Judith Adams (WA, Liberal Party) Share this | Link to this | Hansard source

I rise to speak on the important matter of foetal alcohol spectrum disorder. As a member of the Senate Select Committee on Regional and Remote Indigenous Communities, I have become very interested in the progress being made to reduce the incidence of foetal alcohol spectrum disorder. ‘Foetal alcohol spectrum disorder’ is used to describe a range of disabilities that occur as a direct result of prenatal alcohol exposure. These include physical, cognitive, behavioural and learning disabilities with lifelong implications. Diagnoses included in the foetal alcohol spectrum disorder are foetal alcohol syndrome, partial foetal alcohol syndrome, alcohol related birth defects and alcohol related neurodevelopmental disorder. Foetal alcohol syndrome is at the most severe end of the FASD framework. This syndrome has a number of abnormal characteristics which include low birth weight, deficiencies in growth, abnormal facial features, central nervous system problems, mental retardation and behavioural hyperactivity.

The Senate committee visited Fitzroy Crossing in Western Australia last year and, during a meeting with the women from the community, great concern was shown as to the number of children within the community with symptoms of foetal alcohol spectrum disorder. Grandmothers were trying to cope with hyperactive children who were uncontrollable at school and a number of families had decided to leave Fitzroy Crossing and relocate back to the outstations, where the children would not get into so much trouble. We met with two brave community women, June Oscar and Emily Carter, who between them had managed to restrict the sale of full-strength alcohol in Fitzroy Crossing in 2007. This had been a most successful initiative and after 12 months police were required to attend 28 per cent fewer alcohol related problems and there was a 36 per cent reduction in alcohol related emergency incidents at the local hospital.

Dr David Shepherd, senior doctor for Halls Creek Hospital, said in March last year:

We’ve got … mothers on the ward here now who are 13, 14-year-old mothers who are foetal alcohol syndrome kids and so they have learning difficulties and problems interacting with people and now they’ve got their own children and it is quite sad.

He talked about one mother on the ward who has the classic features of foetal alcohol syndrome holding her baby who also has foetal alcohol syndrome, and they are not able to interact with one another. This is a very, very sad state of affairs.

For too long, foetal alcohol syndrome has not received enough focus from professionals. Now, as the numbers increase, people are finally realising something must be done. In the Kimberley region of WA alone, the rate of foetal alcohol syndrome is as high as 8.5 per 1,000 live births. This rate is 100 times higher among Aboriginal children than among non-Aboriginal children. What is even more alarming is that this data is not reliable, as foetal alcohol syndrome is often underdiagnosed and under-reported. Dr Fiona Stanley, the head of the Telethon Institute for Child Health Research in Perth, suggested to a coronial inquiry into Aboriginal deaths that as many as one in four Indigenous children could have foetal alcohol syndrome.

I note that the West Australian of 27 January 2009 reported that Professor Stanley has recently been appointed to a new state government body designed to improve the lives of Aboriginals. She said her institute was ‘lobbying the federal government for funding for a national foetal alcohol study and strategy’. This is something that I have been following very closely in my estimates questions to the Department of Health and Ageing and FaHCSIA. I intend to keep going with it because it is a study that needs to be pushed. The Institute of Health and Welfare also were very interested in what I had to say and in my questions about how statistics could be obtained. At the Telethon Institute for Child Health Research a team working with Professor Carol Bower have been researching foetal alcohol syndrome since 2000, and I really look forward to the results of their study.

I want to showcase what has been happening in Western Australia through the state government. I congratulate my colleague the Hon. Robyn McSweeney, Minister for Child Protection, Community Services, Seniors and Volunteering and Women’s Interests, for the work her department has put into this issue. The WA government agencies are working collaboratively to reduce the incidence of foetal alcohol spectrum disorder. As they comment:

Many children do not live with their biological parents and as adults experience mental health problems, alcohol and drug problems, inappropriate sexual behaviour, unemployment, trouble with the law and imprisonment and very few live and work independently.

The department is nearing completion of a diagnosis and treatment protocol for the broad range of FASD as well as a specialised treatment clinic. Specialist staff in Child Development Services are using the most advanced and up-to-date FASD diagnostic and management techniques. They have also made good progress with ensuring that doctors and health workers are more aware of and comfortable with diagnosing foetal alcohol syndrome, which, as I have said before, is at the more severe end of the FASD spectrum. Research has indicated that only 12 per cent of professionals are able to list all four key features of foetal alcohol syndrome. The recent provision of improved alcohol and pregnancy education materials has resulted in a 20 per cent increase in foetal alcohol syndrome reports to the WA Birth Defects Registry.

A recently funded Healthway project is ‘Alcohol and Pregnancy—Health Promotion Messages That Work’. The outcomes of focus groups and interviews with women of child-rearing age will be used to develop a selection of messages about alcohol use and pregnancy. A survey will then test the cognitive and affective impact of the proposed messages. The goal is to identify the messages that most effectively increase the intentions of women of child-bearing age, pregnant women and women planning a pregnancy to reduce or abstain from alcohol during pregnancy. I know, just from talking to women, that some really do not understand that alcohol can have such a devastating effect on their baby. Those who are lucky enough to be able to attend antenatal classes are getting this message very strongly, but unfortunately those who live in the more remote areas of Australia are missing out. So it is definitely a huge issue and there is a need to do something with alcohol restrictions.

Since the very brave women in Fitzroy Crossing managed to have full-strength alcohol banned from their community, the community of Halls Creek, which is very close to them, recently introduced a ban. Once again, it was the women of the community who drove that ban. After just a month there has been an amazing reduction in the incidence of family violence and in the number of alcohol related incidents that the police have had to attend and that hospitals have had to deal with. There definitely is a problem, but it seems that finally the communities are getting on top of it. They chose to reduce the alcohol consumption because of the Fitzroy Crossing initiative. I know that June and Emily really did suffer in their community because they had been strong enough to stand up and make sure that the ban came into place.

Statistics from the Department for Child Protection reveal that in Halls Creek 26 out of 48 children have been cared for at the hostel since it opened in October 2007, and these children have shown effects of foetal alcohol syndrome. It really is a problem, but I do believe in positivism and I think the Western Australian Department for Child Protection are on the right track in working with other departments to try to resolve the problem.

Children affected by foetal alcohol syndrome have a limited capacity to benefit from mainstream teaching environments, due to poor self-regulation and aggressive and hyperactive behaviour. In Halls Creek and Fitzroy Crossing this was a huge problem because, if a child was not diagnosed with foetal alcohol syndrome, they were not able to have special tuition or have a teacher’s aide to help them. Not all children with the syndrome have the characteristic facial features, but they may still be very aggressive and hyperactive. So the fact that we are getting more paediatricians and social workers out into the communities is going to improve the situation. Hopefully we will have more antenatal classes and more support for teachers to help them cope with these children when they come to school.

I will conclude by speaking about alcohol and pregnancy statistics in Australia. Women of childbearing age in Australia are increasingly drinking alcohol at risky and high-risk levels. Only half of their pregnancies are planned. Many pregnancies may inadvertently be exposed to alcohol before a woman knows she is pregnant. Over a third of Australian women of childbearing age are unaware of the effects of alcohol consumption on the foetus. A quarter of Australian women would continue to drink alcohol during a future pregnancy. Health professionals are poorly informed about foetal alcohol spectrum disorder, and the majority do not ask or advise pregnant women about alcohol and pregnancy. The policy about alcohol use in pregnancy is inconsistent across Australia. These are things that I am very keen to follow up.

I would also like to quote some statistics from the Australian Institute of Health and Welfare. The percentage of Indigenous babies in major cities that are of low birth weight is 12.8 per cent versus 6.1 per cent for non-Indigenous babies; in inner regional areas, 12.1 per cent versus 6.2 per cent; in outer regional areas, 13 per cent versus 6.1 per cent; in remote areas, 14.7 per cent versus 5.7 per cent; and, in very remote areas, 13.6 per cent versus 5.7 per cent. These statistics show that there really is a problem for Indigenous women compared to their non-Indigenous counterparts. I may as well say that I will continue to push this issue. I am running out of time, so I would just say that I will be very happy to have more discussions with the Australian Institute of Health and Welfare, FaHCSIA and the Department of Health and Ageing regarding this issue and funding to go towards a project.