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Christie LM Petrenko
Mary E. Pandolfino
Julie Quamma
Heather Carmichael Olson


fetal alcohol spectrum disorders, emotional understanding, prenatal alcohol exposure, neurodevelopmental disorders, intervention, fetal alcohol syndrome


Children with fetal alcohol spectrum disorders (FASD) are at high risk for secondary conditions, including mental health difficulties. Data on both children with typical development and other clinical conditions suggest that limited emotional understanding (EU) raises risk for psychopathology, but little is known about EU in FASD.
To determine if EU is a reasonable treatment target for children with FASD.
56 children (6–13 years) with FASD completed the Kusche Affective Interview-Revised, a verbal interview measure of EU.
Children showed striking delays in EU (2–5 years delay) relative to published normative data, despite mean IQ (IQ=94.56) within normal limits. Individual variability was considerable even after accounting for age and verbal IQ.
Despite variability in individual differences, treatments targeting EU may benefit children with FASD as components within a comprehensive, tailored intervention focused on child self-regulation and caregiver behaviour management.
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1. May PA, Baete A, Russo J, et al. Prevalence and characteristics of fetal alcohol spectrum disorders. Pediatrics 2014;134:855–66. http://pediatrics.aappublications.org/content/early/2014/10/21/peds.2013-3319
2. Kodituwakku PW. Neurocognitive profile in children with fetal alcohol spectrum disorders. Dev Disabil Res Rev 2009;15(3):218–24. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3104937/
3. Mattson SN, Crocker N, Nguyen TT. Fetal alcohol spectrum disorders: neuropsychological and behavioral features. Neuropsychol Rev 2011;21(2):81–101. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3410672/
4. Streissguth AP, Bookstein FL, Barr HM, et al. Risk factors for adverse life outcomes in fetal alcohol syndrome and fetal alcohol effects. J Dev Behav Pediatr 2004;25(4):228–38. Available at: http://journals.lww.com/jrnldbp/Abstract/2004/08000/Risk_Factors_for_Adverse_Life_Outcomes_in_Fetal.2.aspx
5. Jones DE, Greenberg M, Crowley M. Early social-emotional functioning and public health: The relationship between kindergarten social competence and future wellness. Am J Public Health 205;105(11): 2283–90. Available at: http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2015.302630
6. Moffitt TE, Arseneault L, Belsky D, et al. A gradient of childhood self-control predicts health, wealth, and public safety. Proc Natl Acad Sci USA 2011;108(7):2693–98. Available at: http://www.pnas.org/content/108/7/2693.full
7. Denham SA. Emotional Development in Young Children. New York: The Guilford Press; 1998.
8. Southam-Gerow MA, Kendall PC. Emotion regulation and understanding: Implications for child psychopathology and therapy. Clin Psychol Rev 2002;22(2):189–222. Available at: http://www.sciencedirect.com/science/article/pii/S0272735801000873
9. Gross AL, Ballif B. Children's understanding of emotion from facial expressions and situations: A review. Dev Rev 1991;11(4):368–98. Available at: http://www.sciencedirect.com/science/article/pii/027322979190019K
10. Saarni C. The Development of Emotional Competence. New York: The Guilford Press; 1999.
11. Carroll JJ, Steward MS. The role of cognitive development in children's understandings of their own feelings. Child Dev 1984;55(4):1486–92. Available at: https://www.jstor.org/stable/1130018?seq=1#page_scan_tab_contents
12. Cook ET, Greenberg MT, Kusche CA. The relations between emotional understanding, intellectual functioning, and disruptive behavior problems in elementary-school-aged children. J Abnorn Child Psychol 1994; 22(2):205–19. Available at: http://link.springer.com/article/10.1007/BF02167900
13. Denham SA, Zoller D, Couchoud EA. Socialization of preschoolers' emotion understanding. Dev Psychol 1994;30(6):928–36. Available at: http://psycnet.apa.org/index.cfm?fa=buy.optionToBuy&id=1995-09067-001
14. Pons F, Lawson J, Harris PL, De Rosnay M. Individual differences in children's emotion understanding: Effects of age and language. Scand J Psychol 2003;44(4):347–53. Available at: http://onlinelibrary.wiley.com/doi/10.1111/1467-9450.00354
15. Bosacki SL, Moore C. Preschoolers' understanding of simple and complex emotions: Links with gender and language. Sex Roles 2004;50(9):659–75. Available at: http://link.springer.com/article/10.1023/B:SERS.0000027568.26966.27
16. Brown JR, Dunn J. Continuities in emotion understanding from three to six years. Child Dev 1996;67(3):789–802. Available at: http://onlinelibrary.wiley.com/doi/10.1111/j.1467-8624.1996.tb01764.x/full
17. Pons F, Harris P. Longitudinal change and longitudinal stability of individual differences in children's emotion understanding. Cogn Emot 2005;19(8):1158–74. Available at: http://www.tandfonline.com/doi/abs/10.1080/02699930500282108?journalCode=pcem20
18. Eisenberg N, Cumberland A, Spinrad TL. Parental socialization of emotion. Psychol Inq 1998;9(4):241–73. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1513625/
19. Greenbaum RL, Stevens SA, Nash K, Koren G, Rovet J. Social cognitive and emotional processing abilities of children with fetal alcohol spectrum disorders: A comparison with attention deficit hyperactivity disorder. Alcohol Clin Exp Res 2009;33:1656–70. Available at: http://onlinelibrary.wiley.com/doi/10.1111/j.1530-0277.2009.01003.x/full
20. Kerns KA, Siklos S, Baker L, Müller U. Emotion recognition in children with Fetal Alcohol Spectrum Disorders. Child Neuropsychol 2016;22(3):255–75. Available at: http://www.tandfonline.com/doi/abs/10.1080/09297049.2014.993310?journalCode=ncny20
21. Way EL, Rojahn J. Psycho-social characteristics of children with prenatal alcohol exposure, compared to children with Down syndrome and typical children. J Dev Phys Disabil 2012;24(3):247–68. Available at: http://link.springer.com/article/10.1007/s10882-012-9269-1
22. Stevens SA, Dudek J, Nash K, Koren G, Rovet J. Social perspective taking and empathy in children with fetal alcohol spectrum disorders. J Intl Neuropsychol Soc 2015; 21:74–84. Available at: https://www.cambridge.org/core/journals/journal-of-the-international-neuropsychological-society/article/div-classtitlesocial-perspective-taking-and-empathy-in-children-with-fetal-alcohol-spectrum-disordersdiv/E1BEBCCCA2ED011575E48F7FA8D1EE8A
23. Bertrand J, Interventions for Children with Fetal Alcohol Spectrum Disorders Research Consortium. Interventions for children with fetal alcohol spectrum disorders (FASDs): Overview of findings for five innovative research projects. Res Dev Disabil 2009;30(5):986–1006. Available at: http://www.sciencedirect.com/science/article/pii/S0891422209000274
24. Astley SJ. Diagnostic guide for fetal alcohol spectrum disorders: The 4-digit diagnostic code. Seattle, WA: University of Washington; 2004.
25. Beilke RL, Kusche CA, Greenberg MT. Coding manual for the Kusche Affective Interview–Revised. Unpublished manuscript, Seattle, WA: University of Washington; 1988.
26. Kaufman AS, Kaufman NL. Kaufman Brief Intelligence Test. Circle Pines, MN: American Guidance Service, Inc; 1990.
27. Greenberg MT, Kusche CA, Cook ET, Quamma JP. Promoting emotional competence in school-aged children: The effects of the PATHS curriculum. Dev Psychopathol 1995;7:117–36. Available at: https://www.cambridge.org/core/journals/development-and-psychopathology/article/div-classtitlepromoting-emotional-competence-in-school-aged-children-the-effects-of-the-paths-curriculumdiv/AC0E5865EC8777B8AC797F4978AE72B8
28. Izard CE, King KA, Trentacosta CJ, et al. Accelerating the development of emotion competence in Head Start children: Effects on adaptive and maladaptive behavior. Dev Psychopathol 2008;20(01):369–97. Available at: https://www.cambridge.org/core/journals/development-and-psychopathology/article/div-classtitleaccelerating-the-development-of-emotion-competence-in-head-start-children-effects-on-adaptive-and-maladaptive-behaviordiv/82060B84CF144DBC4E1AC53CEC26A494
29. Kodituwakku PW. A neurodevelopmental framework for the development of interventions for children with fetal alcohol spectrum disorders. Alcohol 2010;44(7):717–28. Available at: http://www.sciencedirect.com/science/article/pii/S0741832909001797
30. Laugeson EA, Paley B, Schonfeld AM, et al. Adaptation of the children's friendship training program for children with fetal alcohol spectrum disorders. Child Fam Behav Ther 2007;29(3):57–69. Available at: http://www.tandfonline.com/doi/abs/10.1300/J019v29n03_04
31. Olson HC, Montague RA. An innovative look at early intervention for children affected by prenatal alcohol exposure. In: Adubato S, Cohen D eds. Prenatal Alcohol Use and FASD: A Model for Diagnosis, Assessment and New Directions in Research and Multimodal Treatment. Maryland: Bentham Science Publishers; 2011.
32. Kable JA, O’Connor MJ, Olson HC, et al. Neurobehavioral disorder associated with prenatal alcohol exposure (ND-PAE): proposed DSM-5 diagnosis. Child Psychiatry Hum Dev 2016;47(2):335–46. Available at: http://link.springer.com/article/10.1007%2Fs10578-015-0566-7
33. Tsang TW, Lucas BR, Olson HC, et al. Prenatal alcohol exposure, FASD, and child behavior: A meta-analysis. Pediatrics 2016;137(30):e20152542. Available at: http://pediatrics.aappublications.org/content/early/2016/02/19/peds.2015-2542

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