For Warlpiri man Lachlan Sharpe, the Alice Springs youth crime crisis is much more than children causing chaos on the streets.
As a teacher at a local Aboriginal school, some of these children could be his students and he knows their stories.
"A lot of the time these kids are just misunderstood," Mr Sharpe says.
"A lot of our kids, they're portrayed a certain way when they've got underlying issues that aren't being met."
Alice Springs has been the focus of fevered national attention in recent weeks amid escalating calls for governments to do more to address the town's crime crisis.
But for those on the frontline, there are concerns a key issue is being ignored.
It's an underdiagnosed condition, known as fetal alcohol spectrum disorder (FASD).
The result of alcohol exposure in pregnancy, FASD can lead to physical issues and can affect behaviour and learning.
Research shows some symptoms – including impaired impulse control, poor social judgement, anger and aggression – can increase risks of criminal activity.
But experts say there's little focus and even less funding in this space.
And in Alice Springs, it takes more than 18 months for a child to be diagnosed – unless they end up in juvenile detention.
But at that point, many are already caught in cycles of crime.
And the social services sector believes there are many more children undiagnosed who are falling through the cracks.
"I think it's hugely neglected," Nicole Hewlett, a Palawa woman and FASD researcher, says.
"We're not talking about FASD, which is really underpinning and should be at the heart of any of these conversations that we're having, especially in Alice Springs."
Desperate calls for funding
Only one publicly funded service – Central Australian Aboriginal Congress — provides FASD diagnoses and treatment in Alice Springs.
In 2018, Congress established a service to support children in town who are developmentally vulnerable.
Accepting referrals from families, schools and doctors, they've swiftly grown into a multidisciplinary team of 11.
But according to Congress's paediatric clinical neuropsychologist, Amelia Paterson, it's not nearly enough.
"Ideally, we would like to see families as soon as a referral is made," she said.
"I can't even imagine how much more staff we'd need to do that. Four times our current capacity, or six."
Ms Paterson said any delays in treatment could have serious ramifications.
"We talk about FASD increasing the risk of criminal behaviour but from my perspective it's poorly-supported FASD," she said.
School provides therapeutic support
Concerned too many students were going undiagnosed, Yipirinya School staff recently decided to take matters into their own hands.
"We had a team of psychologists, paediatricians, speech therapists and occupational therapists," principal Gavin Morris says.
"We flew them in from all over the country and they stayed on-site at the school across one week."
In that time, Mr Morris says, the team was able to assess 18 students – 12 received a diagnosis with nine given an NDIS plan.
The school has also worked to provide ongoing, wrap-around support to these students through their Happy Heart Hub – a therapeutic team established at the school in early 2022.
"I feel like there's a lot of hope for our kids," Mr Sharpe said.
"Because with a lot of our kids, whether it be FASD, or any other health issues, it's only going to help us understand them a lot better."
Trauma a key consideration
Researchers estimate up to 2 per cent of the Australian population lives with FASD but the true figure remains a mystery.
But while there's little reliable data, rates are believed to be much higher in the NT, which has the highest per capita consumption of alcohol in the country.
FASD is also believed to be 10-to-40 times more prevalent among children in First Nations populations, correctional facilities and foster care, compared to the general population.
According to Congress, 30 per cent of the children they see at the local youth detention centre have FASD – consistent with the rates they see in the clinic – while 20 per cent have an intellectual disability.
"The thing is, when we're seeing these young people, at least 80 per cent of them have a trauma background," Ms Paterson said.
"So it's really important that we're having conversations about neurodevelopment in the context of a trauma experience."
No FASD care in remote communities
But while FASD diagnosis waitlists are long in Alice Springs, the picture is even more bleak in the rest of Central Australia.
Congress is only funded to provide care to children in town, meaning families in outlying remote communities have to make the long trek to Alice Springs for care.
Ms Paterson said this was a huge hurdle for those who don't have access to accommodation or money for food and petrol.
"There are also fly-in-fly-out fee-for-service providers who can go to remote communities, but it's quite expensive," she said.
Additionally, Congress can only provide care to First Nations children, meaning non-Indigenous children have to fly out of Alice Springs for diagnosis and treatment.
This means many are going undiagnosed, and there's scarce data on how prevalent FASD is in non-Indigenous populations.
There are also concerns this only fuels a misconception that FASD is an "Aboriginal problem".
Heavy drinking culture increases risks
It's a misconception Noongar woman and FASD researcher Robyn Williams says is widespread.
"FASD is not an Indigenous problem, globally or in Australia. It cuts across all sectors of society," she said.
But despite this, it went largely unrecognised as a disability, with limited diagnostic clinics available.
"More funding is needed," she said.
"Diagnostic and intervention supports will contribute to a better quality of life for children and families and save millions in taxpayer dollars."
In Australia, about 50 per cent of pregnancies are unplanned, meaning many women consume alcohol before realising they're pregnant.
About 70 per cent of mothers stop drinking alcohol when they discover they're expecting.
But Ms Paterson said a mother's choice to continue drinking was hugely influenced by her environment – and the normalisation of a heavy drinking culture only increased risks.
"Along with FASD education, we need to reshape our culture so that heavy drinking isn't as normal," she said.
"And we need to support women to make informed choices about having babies at the time of their choosing – that's adequate contraception and access to basic medical care."
There's also been an ongoing battle to improve the prominence of warning labels on alcohol products and for better education around drinking while pregnant.
"There are more warnings on my Vicks Vapo rub than there is on a bottle of vodka around use during pregnancy," Ms Hewlett said.
There are also concerns deep shame and stigma around the issue prevent families from seeking support.
"Part of this is that we say 'it's all on the mother'," Ms Hewlett said.
"Of course, it's not all on the mother. The mother sits with a partner, with a father, in a family, in a context, in a social situation."
The root of the issue
NT Chief Minister Natasha Fyles said the territory government did provide assessments for FASD through a multidisciplinary team, including through "a number of Aboriginal-controlled health organisations and the paediatrics ward at Royal Darwin Hospital".
"When a young person enters the youth justice system they do receive an assessment, however we are looking at how we can make assessments more available," she said.
The NT and federal governments are currently considering a new report calling for further alcohol restrictions to be implemented across Central Australia.
However the NT government has repeatedly rejected returning to alcohol bans, arguing they are "race-based" policies.
But Ms Hewlett argues governments are ignoring community requests, and "bowing to the alcohol industry".
"When it's placed on a community that hasn't asked for it, yes, that is a race-based policy. But when it has been fought for, often by our women ... it is not race-based," she said.
Ms Hewlett said, for Aboriginal communities, FASD was a dark legacy of colonisation when rights were stripped but liquor was used "as a currency".
"People have capitalised on this opportunity where people's spirits have been broken," she said.
Therapeutic approach the prime solution
In recent months, there have been growing calls for a "tougher on crime" approach in Alice Springs.
But many say only therapeutic care – for conditions like FASD – will create lasting change.
"We're not tough on crime," Ms Hewlett said.
"We're tough on disability. We're tough on those with childhood trauma. We're tough on mental illness.
"Our prisons are full of broken people that have been caged and tortured further, and they come out even more broken, and the system calls that justice.
"That is our national shame."
