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

The 90 respondents were recruited through the authors' own networks and social media, so they are unlikely to represent Australian occupational therapists as a whole. Everything measured is self-report: confidence and preparedness, not tested knowledge or observed practice. Feeling confident is not the same as being competent, and the paper did not directly measure FASD knowledge. The survey instrument was not formally validated and was piloted with only two therapists. Respondents were not asked what proportion of their caseload involved FASD, so we cannot tell how much any of this reflects day-to-day practice. The survey was open for only 8 weeks, which may have limited who took part. Client age at first contact and caseload duration were excluded from analysis because 64.4% of responses were missing, so nothing can be said about them. The design is cross-sectional: nothing here shows that training causes confidence, or that confidence changes what happens to clients. Recruitment was skewed to private practice (65.6%) with one participant from an Aboriginal Community Controlled Health Organisation, so some settings and populations are barely represented.

The authors declare no competing interests. The work was funded by the University of the Sunshine Coast, School of Health. Grammarly (paid version) was used to edit the manuscript's English.

Do not read the strong link between professional development and confidence as evidence that training improves practice or client outcomes. This is a one-off survey of self-reported confidence, so it cannot show that training came first, and feeling confident is not the same thing as knowing about FASD or managing it well.