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Background: The Canadian fetal alcohol spectrum disorder (FASD) diagnostic guideline provides clinicians with the process and procedure to reach an accurate diagnosis. However, organisational structure, culture, and resource utilisation vary. The objectives of this study were to identify the key challenges and strengths of successful FASD diagnostic clinics. Method: Qualitative interviews were conducted with 12 key informants from 10 clinics representing different regions, populations served, and clinic structures. Data analysis was performed using iterative thematic inquiry. Results: Three themes related to challenges and four themes related to strengths were identified. Human resources were identified as both a challenge and strength. Additional challenges were diagnostic capacity and system level support. Additional strengths were clinic adaptability, relational connections, and culturally responsive approaches. Conclusions: FASD clinics are more alike than not in their approach to assessment and diagnosis. Some clinics are facing similar challenges that others have overcome, supporting the need for mentorship and consistent operating standards. [ABSTRACT FROM AUTHOR]

Introduction: There is significant symptom overlap between fetal alcohol spectrum disorder (FASD), which results from prenatal alcohol exposure (PAE), and autism spectrum disorder (ASD). There is also limited research regarding the comorbidity of these disorders. Method: Thirty-nine individuals with ASD and PAE (ASD+PAE) aged 3 to 30 years were matched for age, sex, and IQ to 78 individuals with PAE-only and compared on demographics, comorbid conditions, and 9 domains of neurodevelopmental function. Results: The ASD+PAE group were significantly more likely to have deficits in motor and daily living skills. They also had a greater number of impaired neurodevelopmental domains overall. They were diagnosed with ADHD more often and reported more sensory sensitivities, self-regulation difficulties, and social skills deficits. Conclusions: Overall, the ASD+PAE group had a more complex and severe presentation of symptoms. The relationship between ASD, FASD, and PAE as well as the value of providing an ASD diagnosis in the context of PAE are discussed. [ABSTRACT FROM AUTHOR]