Understanding Fetal Alcohol Spectrum Disorders (FASDs): Toward Identification of a Behavioral Phenotype (original) (raw)
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Cognitive and Behavioral Profiles of Children with Fetal Alcohol Spectrum Disorders
Current Developmental Disorders Reports, 2014
The last two decades have witnessed a rapid growth of published data on the cognitive and behavioral functioning of children with fetal alcohol spectrum disorders (FASD). The main of aim of this paper is to review cognitive and behavioral data on FASD using a causal modeling framework originally proposed by Morton and Frith [1, 2], according to which data pertinent to a neurodevelopmental disorder can be organized at three levels: neurobiology, cognition, and behavior. In this review, we confine ourselves to reviewing the studies of cognitive abilities and behavior in children with FASD. The studies of cognitive functions can be further divided into two groups: those of elementary functions (e.g., reflexive orienting responses) and those of complex functions (e.g., language, memory). There is evidence that children with FASD are slower at reflective orienting responses and exhibit deficits in associative learning. The pattern of results emerging from the studies of complex cognitive functions is that the FASD group shows performance decrements with increased task complexity. At the behavioral level, children with prenatal alcohol exposure are rated as showing deficient adaptive skills, particularly in the social domain. These children have also been observed to show deficits in executive functioning with notable behavioral and emotional regulatory problems. A broad range of risk factors including the alcohol's teratogenicity seem to interactively contribute to these cognitive and behavioral problems.
Rivista di psichiatria
It is now known that exposure to alcohol in utero produces a wide spectrum of morphological and behavioural outcomes in the offspring, commonly referred as fetal alcohol spectrum disorders (FASD). A large body of literature documents cognitive deficits and behavioural-emotional difficulties in children with FASD. Researchers have found that individuals with FASD often experience a range of adverse life outcomes, called secondary disabilities, which include disrupted school experience, troubles with the law, confinement, inappropriate sexual behaviours on repeated occasions, and alcohol/drug related problems. Additionally, despite considerable data published on cognitive and behavioural disabilities in children with FASD, relatively little information is available on behavioural or pharmacological interventions for alcohol affected children. This paper will provide a comprehensive review of the neuropsychological and behavioural effects of prenatal alcohol exposure, including a discu...
Alcoholism-clinical and Experimental Research, 2010
Background: A primary goal of recent research is the development of neurobehavioral profiles that specifically define fetal alcohol spectrum disorders (FASD), which may assist differential diagnosis or improve treatment. In the current study, we define a preliminary profile using neuropsychological data from a multisite study. Methods: Data were collected using a broad neurobehavioral protocol from 2 sites of a multisite study of FASD. Subjects were children with heavy prenatal alcohol exposure and unexposed controls. The alcohol-exposed group included children with and without fetal alcohol syndrome (FAS). From 547 neuropsychological variables, 22 variables were selected for analysis based on their ability to distinguish children with heavy prenatal alcohol exposure from nonexposed controls. These data were analyzed using latent profile analysis (LPA). Results: The results indicated that a 2-class model best fit the data. The resulting profile was successful at distinguishing subjects with FAS from nonexposed controls without FAS with 92% overall accuracy; 87.8% of FAS cases and 95.7% of controls were correctly classified. The same analysis was repeated with children with heavy prenatal alcohol exposure but without FAS and nonexposed controls with similar results. The overall accuracy was 84.7%; 68.4% of alcoholexposed cases and 95% of controls were correctly classified. In both analyses, the profile based on neuropsychological variables was more successful at distinguishing the groups than was IQ alone. Conclusions: We used data from 2 sites of a multisite study and a broad neuropsychological test battery to determine a profile that could be used to accurately identify children affected by prenatal alcohol exposure. Results indicated that measures of executive function and spatial processing are especially sensitive to prenatal alcohol exposure.
Toward a Neurobehavioral Profile of Fetal Alcohol Spectrum Disorders
Alcoholism: Clinical and Experimental Research, 2010
Background-A primary goal of recent research is the development of neurobehavioral profiles that specifically define fetal alcohol spectrum disorders (FASD), which may assist differential diagnosis or improve treatment. In the current study we define a preliminary profile using neuropsychological data from a multisite study.
Further Development of a Neurobehavioral Profile of Fetal Alcohol Spectrum Disorders
Alcoholism: Clinical and Experimental Research, 2012
Background-Heavy prenatal alcohol exposure (AE) results in a broad array of neurobehavioral deficits. Recent research has focused on identification of a neurobehavioral profile or profiles that will improve identification of children affected by AE. The current study aimed to build on our preliminary neurobehavioral profile in order to improve classification accuracy and test the specificity of the resulting profile in an alternate clinical group. Methods-A standardized neuropsychological test battery was administered to three groups of children: subjects with AE (n = 209), typically developing controls (CON, n = 185), and subjects with attention-deficit/hyperactivity disorder (ADHD, n = 74). We assessed a large sample from six sites in the U.S. and South Africa, using standardized methodology. Data were analyzed using three latent profile analyses (LPA) including: (1) subjects with FAS and controls, (2) subjects with
Background: Chronic prenatal alcohol exposure causes a spectrum of deleterious effects in offspring, collectively termed fetal alcohol spectrum disorders (FASD), and deficits in executive function are prevalent in FASD. The goal of this research was to test the hypothesis that children with FASD exhibit performance deficits in tasks that assess attention, planning and spatial working memory. Methods: Subjects (8–15 years male and female children) with a diagnosis of fetal alcohol syndrome (FAS), partial FAS (pFAS), or alcohol-related neurodevelopmental disorder (ARND), and age-and sex-matched controls, completed four tasks selected from the Cambridge Neuropsychological Tests Automated Battery (CANTAB Ò). Results: Compared with age-matched control children (n = 92), subjects with FASD (n = 89) exhibited longer reaction and decision times (effect size range; Cohen's d = .51 to .73), suggesting deficits in attention. Children with FASD demonstrated deficits in planning and spatial working memory that became more pronounced when task difficulty increased. The largest effect size in this study population (Cohen's d = 1.1) occurred in the spatial working memory task. Only one outcome measure revealed differences across the diagnostic subgroups, although all groups were different from control. Conclusion: This study demonstrates that deficits in multiple executive function domains, including set shifting, planning and strategy use, attention and spatial working memory, can be assessed in children with FASD using an easy to administer, brief battery of computer-based neuropsychological tasks. The tasks appear to be equally sensitive for brain injury resulting from prenatal exposure to alcohol, regardless of the presence of facial dysmorphology.
Fetal Alcohol Spectrum Disorders: An Overview with Emphasis on Changes in Brain and Behavior
Experimental Biology and Medicine, 2005
Fetal alcohol spectrum disorders constitute a major public health problem. This article presents an overview of important issues that surround these disorders and emphasizes the structural and neurobehavioral consequences associated with prenatal exposure to alcohol. Diagnostic criteria are discussed, and possible moderating factors for the range of outcomes are mentioned. In addition, the prevalence of fetal alcohol spectrum disorders is described, and estimates of the financial impact of these disorders are given. Heavy prenatal alcohol exposure can severely affect the physical and neurobehavioral development of a child. Autopsy and brain imaging studies indicate reductions and abnormalities in overall brain size and shape, specifically in structures such as the cerebellum, basal ganglia, and corpus callosum. A wide range of neuropsychological deficits have been found in children prenatally exposed to alcohol, including deficits in visuospatial functioning, verbal and nonverbal le...
Journal of Developmental & Behavioral Pediatrics, 2013
Objective-To provide an analysis of multiple predictors of cognitive and behavioral traits for children with fetal alcohol spectrum disorders (FASD). Method-Multivariate correlation techniques were employed with maternal and child data from epidemiologic studies in a community in South Africa. Data on 561 first grade children with fetal alcohol syndrome (FAS), partial FAS (PFAS), and not FASD and their mothers were analyzed by grouping 19 maternal variables into categories (physical, demographic, childbearing, and drinking) and employed in structural equation models (SEM) to assess correlates of child intelligence (verbal and non-verbal) and behavior. Results-A first SEM utilizing only seven maternal alcohol use variables to predict cognitive/ behavioral traits was statistically significant (B = 3.10, p < .05), but explained only 17.3% of the variance. The second model incorporated multiple maternal variables and was statistically significant explaining 55.3% of the variance.
Child Neuropsychology, 2017
Intra-individual variability (IIV) is defined as systematic within person variation in performance either across testing occasions (e.g., test/re-test performance on the same task) or within an occasion (e.g., variations in performance on multiple trials of a single task). Higher levels of IIV)) have been noted as a characteristic of neurodevelopmental disorders such as Attention Deficit/ Hyperactivity Disorder (Geurts et al., 2008), but IIV is yet to be investigated in Fetal Alcohol Spectrum Disorder (FASD). FASD is a term used to describe several conditions resulting from prenatal exposure to alcohol. As part of a comprehensive neuropsychological battery, four study groups (1. fetal alcohol syndrome ⁄ partial fetal alcohol syndrome; 2. static encephalopathy ⁄ alcohol exposed; 3. neurobehavioral disorder ⁄ alcohol exposed as diagnosed using the University of Washington FASD 4-Digit Code; and 4. healthy age-matched children with no prenatal alcohol exposure) were administered measures of motor response and inhibitory control, attention, and adaptive behavior. Results indicated increased levels of IIV in those with FASD compared to controls. IIV was found to uniquely contribute to predicting adaptive behavior above and beyond attention, while attention partially mediated the relationship between IIV and adaptive behavior. This is the first study to our knowledge to show the presence of increased IIV in children with FASD. It additionally provides evidence that IIV measures some inherent variability in performance independent of poor attention in children with FASD.