We are excited to share the news that an article was published in the journal Military Medicine on “Mapping the Fetal Alcohol Spectrum Disorder Continuum of Care Across the Military Health System.”  This in-depth article is the product of an intensive data collection and analysis process conducted by leading experts at the Uniformed Services University of the Health Sciences (USUHS).  FASD United is proud to partner with the USUHS team on a four-year, federally-funded health services research initiative on FASD in the U.S. Department of Defense Military Health System (MHS).

The team of Ilse Rivera, Elizabeth H Lee, Zoe Solomon, and Tracey P Koehlmoos took a deep dive into understanding what the U.S. Military Health System (MHS), which treats nearly 1 million children, is doing to address prenatal alcohol exposure (PAE), and FASD.  The USUHS team conducted a detailed environmental scan looking at “clinical guidelines, services, programs, educational resources, and policies.”  Data was gathered from literature reviews and input from professionals and individuals with living experience of FASD.

The review process found several resources that addressed alcohol use before and during pregnancy.  While these prevention resources are important, it is critical to support the people that are living with FASD.  Recognizing the gaps in this area, the article finds “the absence of any resource specifically targeting FASD beyond the prevention of [alcohol use] in pregnancy”. Specifically, the authors “did not find any MHS-specific resources that address diagnosis and management of FASD” and “were unable to locate any MHS materials specific to FASD screening, diagnosis, or case management over the life course.”

A key take-away conclusion from the article is the need for more specialized support for FASD.  “Findings suggest opportunities to raise awareness, educate providers, and improve guidelines, policies, and practices in the MHS.”  Moving forward, the authors point out that, “identifying gaps in FASD care delivery can lead to programmatic and policy changes within the MHS to improve the quality of care given to military families.”  The authors developed an “FASD continuum of care framework” to present data and to serve as a tool to better serve those affected. 

While the gaps in care specific to FASD are significant, the article outlines a path towards improvement.  “Existing policies and programs that aid military families supporting a family member with a neurodevelopmental disability may be an appropriate place to begin.”

In addition to the article’s direct implications for the Military Health System, the knowledge gained from this project can make a big difference to families well beyond this system.  Promisingly, the article states, “A successful care plan to address FASD within the military can serve as a model for civilian health systems.”

We greatly appreciate our partnership with USUHS and are grateful for their work at a series of workshops on FASD in the US Military Healthcare System on September 18^th as part of FASD Impact Week.  The workshops featured an interactive working session on family supports and interventions for people with FASD.  Leading FASD researcher Heather Carmichael Olson gave a keynote presentation.  An emotional highlight of the workshop was a living experience family panel moderated by Jennifer Wisdahl, FASD United Chief Operating Officer.  The panel featured Kathy White and Aubrey Page, who both shared their experiences of navigating FASD within the military and its health system.  Aubrey and Kathy talked about the challenges of a lack of recognition of FASD and a military culture that often encourages alcohol use. 

For additional context, take a look at the workshop report published in the journal BMC Proceedings in August 2024 on the FASD research initiative in the Military Health System.  This report summarizes the 2023 Workshop on FASD Prevention and Clinical Guidelines Research that was hosted by USUHS in conjunction with FASD United.