title: Impairment of motor skills in children with fetal alcohol spectrum disorders in remote Australia: The Lililwan Project.
abstract: We aimed to characterise motor performance in predominantly Aboriginal children living in very remote Australia, where rates of prenatal alcohol exposure (PAE) are high. Motor performance was assessed, and the relationship between motor skills, fetal alcohol spectrum disorders (FASD) and PAE was explored.
  
  
  
  Motor performance was assessed using the Bruininks-Oseretsky Test of Motor Proficiency-Second Edition Complete Form, in a population-based study of children born in 2002 or 2003 living in the Fitzroy Valley, Western Australia. Composite scores ≥2SD (2nd percentile) and ≥1SD (16th percentile) below the mean were used respectively for FASD diagnosis and referral for treatment. FASD diagnoses were assigned using modified Canadian Guidelines.
  
  
  
  A total of 108 children (Aboriginal: 98.1%; male: 53%) with a mean age of 8.7 years was assessed. The cohort's mean total motor composite score (mean ± SD 47.2 ± 7.6) approached the Bruininks-Oseretsky Test of Motor Proficiency-Second Edition normative mean (50 ± 10). Motor performance was lower in children with FASD diagnosis than without (mean difference (MD) ± SD: -5.0 ± 1.8; confidence interval: -8.6 to -1.5). There was no difference between children with PAE than without (MD ± SE: -2.2 ± 1.5; confidence interval: -5.1 to 0.80). The prevalence of motor impairment (≥-2SD) was 1.9% in the entire cohort, 9.5% in children with FASD, 3.3% in children with PAE and 0.0% both in children without PAE or FASD.
  
  
  
  Almost of 10% of children with FASD has significant motor impairment. Evaluation of motor function should routinely be included in assessments for FASD, to document impairment and enable targeted early intervention.[Lucas BR, Doney R, Latimer J, Watkins RE, Tsang TW, Hawkes G, Fitzpatrick JP, Oscar J, Carter M, Elliott EJ. Impairment of motor skills in children with fetal alcohol spectrum disorders in remote Australia: The Lililwan Project. Drug Alcohol Rev 2016;35:719-727].
authors.affiliation: Discipline of Paediatrics and Child Health, The University of Sydney, The Children's Hospital at Westmead, Clinical School, Sydney, Australia.|The George Institute for Global Health, Sydney Medical School, The University of Sydney, Sydney, Australia.|Poche Centre for Indigenous Health, Sydney Medical School, The University of Sydney, Sydney, Australia.|Physiotherapy Department, Royal North Shore Hospital, Sydney, Australia.
authors.forename: Barbara R
authors.initials: BR
authors.lastname: Lucas
authors.affiliation: School of Public Health, Curtin University, Perth, Australia.
authors.forename: Robyn
authors.initials: R
authors.lastname: Doney
authors.affiliation: The George Institute for Global Health, Sydney Medical School, The University of Sydney, Sydney, Australia.
authors.forename: Jane
authors.initials: J
authors.lastname: Latimer
authors.affiliation: Discipline of Paediatrics and Child Health, The University of Sydney, The Children's Hospital at Westmead, Clinical School, Sydney, Australia.|Telethon Kids Institute, The University of Western Australia, Perth, Australia.
authors.forename: Rochelle E
authors.initials: RE
authors.lastname: Watkins
authors.affiliation: Discipline of Paediatrics and Child Health, The University of Sydney, The Children's Hospital at Westmead, Clinical School, Sydney, Australia.
authors.forename: Tracey W
authors.initials: TW
authors.lastname: Tsang
authors.affiliation: Derby Allied Health Service, Western Australian Country Health Services, Derby, Australia.
authors.forename: Genevieve
authors.initials: G
authors.lastname: Hawkes
authors.affiliation: Discipline of Paediatrics and Child Health, The University of Sydney, The Children's Hospital at Westmead, Clinical School, Sydney, Australia.|The George Institute for Global Health, Sydney Medical School, The University of Sydney, Sydney, Australia.|Telethon Kids Institute, The University of Western Australia, Perth, Australia.
authors.forename: James P
authors.initials: JP
authors.lastname: Fitzpatrick
authors.affiliation: Marninwarntikura Women's Resource Centre, Fitzroy Crossing, Australia.|University of Notre Dame, Broome, Australia.
authors.forename: June
authors.initials: J
authors.lastname: Oscar
authors.affiliation: Nindilingarri Cultural Health Services, Fitzroy Crossing, Australia.
authors.forename: Maureen
authors.initials: M
authors.lastname: Carter
authors.affiliation: Discipline of Paediatrics and Child Health, The University of Sydney, The Children's Hospital at Westmead, Clinical School, Sydney, Australia.|The George Institute for Global Health, Sydney Medical School, The University of Sydney, Sydney, Australia.|The Sydney Children's Hospital Networks (Westmead), Sydney, Australia.
authors.forename: Elizabeth J
authors.initials: EJ
authors.lastname: Elliott
mesh_terms: D001315:Australia; D002648:Child; D002657:Child Development / Q000502:physiology*; D004185:Disability Evaluation; D005260:Female; D063647:Fetal Alcohol Spectrum Disorders / Q000175:diagnosis* / Q000503:physiopathology*; D006801:Humans; D008297:Male; D009048:Motor Skills / Q000502:physiology*; D012424:Rural Population; D012720:Severity of Illness Index
keywords: Aborigines; Australian; child development; culture; fetal alcohol spectrum disorders; motor skills