'Opening a box you can't contain or put the lid on'. Assessing and supporting children and young people with probable or diagnosed Fetal Alcohol Spectrum Disorder (FASD): The experience of clinicians working within CAMHS.

  • Yasmin Tanfield

Student thesis: Doctoral Thesis


Background: Prenatal alcohol exposure (PAE) can have profound impacts on the fetus and can result in an individual receiving a diagnosis of Fetal Alcohol Spectrum Disorder (FASD) due to physical, behavioural and cognitive difficulties (Mukherjee et al., 2006). These difficulties often present similar to neurodevelopmental diagnoses and can result in secondary difficulties, particularly when a child’s needs are not met. Literature suggests that healthcare professionals lack knowledge and understanding of FASD (McCormack et al., 2022). As a result, children and young people often get misdiagnosed or the diagnosis of FASD is missed (Chasnoff et al., 2015). Child and Adolescent Mental Health Services (CAMHS) are involved in the diagnosis of neurodevelopmental disorders, therefore due to high rates of comorbidities, the awareness of FASD within these services needs to be understood.

Method: A constructivist grounded theory, focussing on generating a comprehensive theory exploring the barriers and facilitators clinicians experience when assessing and supporting children and young people with probable or diagnosed FASD within CAMHS. A sample of 12 clinicians working into CAMHS, including nurses, psychologists and psychiatrists were interviewed following purposive and theoretical sampling. Interviews were transcribed and analysed using techniques of initial, focussed, theoretical coding and constant comparative analysis. These techniques were utilised to aid the generation of an end theory and model.

Findings: The end theory captures the barriers and faciliatory factors clinicians working in CAMHS experience when assessing and supporting children and young people with probable or diagnosed FASD. A box analogy was used to portray the four categories that emerged from the data; ‘Unable to Open the Box’, ‘Things that Help Open the Box’, ‘Asking Others About the Box’ and ‘Making the box Easier to Open in Future’.

Conclusion: The grounded theory supports and adds to the existing literature by displaying the barriers and facilitators professionals face around FASD. This theory provides new insights into CAMHS clinicians experiences, highlighting clinical implications within this area. ASSESSING AND SUPPORTING FASD IN CAMHS 3

Tentative recommendations for future research are provided in the hope of continued research exploring FASD to help children and young people get their needs appropriately understood and supported.
Date of Award13 Sept 2023
Original languageEnglish
Awarding Institution
  • Teesside University
SupervisorKathy Burrows (Supervisor), Megan Middlemiss (Supervisor) & Ash Summers (Supervisor)

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