Fetal Alcohol Spectrum Disorder Awareness, Knowledge, and Practice Among Australian Occupational Therapists: A Cross-Sectional Survey.

INTRODUCTION: Fetal Alcohol Spectrum Disorder (FASD) describes a spectrum of birth defects and developmental disabilities resulting from prenatal alcohol exposure. With a prevalence rate of 3.64%, developing an FASD-informed occupational therapy workforce is essential across all practice contexts. Since the Australian diagnostic guidelines were introduced in 2016 and updated in 2025, awareness has grown. This study aimed to explore Australian occupational therapists' awareness, knowledge, and practice regarding FASD. METHOD: A cross-sectional survey of 90 occupational therapists assessed knowledge, awareness, and confidence regarding FASD via a 22-item online questionnaire. Chi-square tests examined associations between key variables; effect sizes were estimated using Cramér's V. Inductive content analysis was performed on open-ended responses. CONSUMER AND COMMUNITY INVOLVEMENT: The survey was designed for occupational therapists practising in Australia to obtain information on current practice contexts and was piloted by occupational therapists working with the FASD community. RESULTS: Despite 93.3% agreeing FASD knowledge is important, confidence and preparedness were markedly low. Only 26.7% had completed professional development, 37.8% reported easy access to reliable information, and 66.7% were unprepared to discuss FASD concerns. Professional development was strongly associated with confidence in recognising FASD (66.7% vs. 12.1%, P < 0.001, V = 0.517) and confidence working with adolescents and children. Clinical experience showed a categorical threshold effect: 40.7% with experience reported confidence in recognising FASD versus 0% without. Access to reliable information was a significant predictor of preparedness (58.8% vs. 17.9%, P = 0.008). Qualitative findings highlighted an absence of FASD-specific guidance, with occupational therapists drawing on frameworks and knowledge from other diagnoses. CONCLUSION: This study indicates a need for occupational therapy-specific FASD research and practice guidance. Access to reliable information and professional development is critical to building workforce confidence and preparedness in FASD recognition and management.