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Fetal Alcohol Spectrum Disorder, neuropsychological profile, diagnosis
Children with FASD display a heterogeneous profile and may have deficits in physical, behavioural, emotional, and social functioning, as the result of prenatal alcohol exposure. The major objective of the current study was to identify if a specific pattern of neuropsychological functioning exists among children prenatally exposed to alcohol who received a diagnosis, versus exposed children who did not. We compared groups on domains of intellectual functioning, memory, attention, executive functioning, motor functioning, language/communication and achievement.
One hundred and seventy children who were seen in the clinic between 2005 and 2009 were included in this study. Out of the total 170 children seen, 109 received an FASD diagnosis.
We identified a specific neuropsychological profile that typifies children diagnosed with an FASD versus those exposed prenatally to alcohol, who did not receive a diagnosis. Diagnosed children displayed a neuropsychological profile characterized by weaknesses in the areas of verbal reasoning, memory, overall language functioning, math reasoning and calculation. Groups did not differ on measures of attention or executive functioning.
The information gained from these analyses, are essential for informing best practices for diagnosis and treatment.
2. Jones K, Smith D. Recognition of the fetal alcohol syndrome in early infancy. Lancet 1973;302:999-1001.
3. Kodituwakku PW. Defining the behavioral phenotype in children with fetal alcohol spectrum disorders: A review. Neurosci Biobehav Rev. 2006; 31,:192-201
4. Streissguth AP, Bookstein FL, Barr HM, Press S, Sampson PD.A fetal alcohol behavior scale. Alcohol Clin Exp Res. 1998 Apr;22:325-33.
5. Nash K, Rovet J, Greenbaum R, Fantus E, Nulman I, Koren G.. Identifying the behavioural phenotype in fetal alcohol spectrum disorder: sensitivity, specificity and screening potential. Archives of Women’s Mental Health 2006;9:181-6.
6. May AP, Gossage JP. Estimating the prevalence of fetal alcohol syndrome: a summary. Alcohol Res Health 2001;25:159-167.
7. Nulman I, O’Hayan B, Gladstone J, & Koren G.. The effects of alcohol on the fetal brain; the central nervous system tragedy. In Chang, LW & Slikker W. eds. Handbook of Developmental Neurotoxicology San Diego, CA; Academy Press. 1998;567-586.
8. Stade B, Ungar WJ, Stevens B, Beyene J, Koren G. The burden of prenatal exposure to alcohol: measurement of cost. Journal of FAS International 2006;4:e5.
9. Nash K, Sheard E, Rovet J, Koren G. Understanding fetal alcohol spectrum disorders (FASDs): toward identfication of a behavioral phenotype. Scientific World Journal 2008;8:873-882.
10. Greenbaum R, Stevens S, Nash K, Koren G., Rovet J. Social cognitive and emotion processing abilities of children with fetal alcohol spectrum disorders: a comparison with attention deficit hyperactivity disorder. Alcohol Clin Exp Res 2009;33:1-15.
11. Schonfeld AM, Mattson SN, Riley EP. Moral maturity and delinquency after prenatal alcohol exposure. J Stud Alcohol 2005;66:545-54.
12. Streissguth AP, Barr H, Kogan J. Understanding the Occurrence of Secondary Disabilities in Clients with Fetal Alcohol Syndrome (FAS) and Fetal Alcohol Effects (FAE). Final Report. Seattle, Washington: University of Washington School of Medicine. 1996.
13. Noland JS, Singer LT, Arendt RE, Minnes S, Short EJ, Bearer CF. Executive functioning in preschool-age children prenatally exposed to alcohol, cocaine, and marijuana. Alcohol Clin Exp Res 2005;27:647-656.
14. Green CR, Mihic AM, Nikkel SM, et al. Executive function deficits in children with fetal alcohol spectrum disorders (FASD) measured using the Cambridge Neuropsychological Tests Automated Battery (CANTAB). J Child Psych and Psychiat 2009.
15. Rasmussen C, Horne KA, Witol A. Neurobehavioral functioning in children with Fetal Alcohol Spectrum Disorder. Child Neuro 2006;12:453-468.
16. Rasmussen C. Executive functioning and working memory in fetal alcohol spectrum disorder. Alcohol Clin Exp Res 2005;29:1359- 1367.
17. Streissguth AP, Bookstein FL, Barr HM, Sampson PD, O'Malley K, Young JK. Risk factors for adverse life outcomes in fetal alcohol syndrome and fetal alcohol effects. J Dev Behav Pediatr 2004;25:228-238.
18. Schonfeld AM, Paley B, Frankel F, O'Connor MJ. Executive functioning predicts social skills following prenatal alcohol exposure. Child Neuro 2006;12:439-452.
19. Fryer SL, McGee CL, Matt GE, Riley EP, Mattson SN. Evaluation of psychopathological conditions in children with heavy prenatal alcohol exposure. Pediatr 2007; 119:733-41.
20. Astley SJ, Clarren SK. Diagnosing the full spectrum of fetal alcohol-exposed individuals: introducing the 4-digit diagnostic code. Alcohol 1999;35:400-10.
21. Mattson SN, Riley EP. A review of the neurobehavioral deficits in children with fetal alcohol syndrome or prenatal exposure to alcohol. Alcohol Clin Exp Res 1998; 22:279- 292.
22. Institute of Medicine (IOM) of the National Academy of Sciences Committee to study Fetal Alcohol Syndrome. Diagnosis and Clinical Evaluation of Fetal Alcohol Syndrome. In Strattion, K., Howe, C., & Battaglia, F. eds. Fetal Alcohol Syndrome Diagnosis, Epidemiology, Prevention, and Treatment. Washington, D.C.: National Academy Press. 1996:63-81.
23. Greenbaum R, Nulman I, Rovet J, Koren G. The Toronto experience in diagnosing Alcohol Related Neurodevelopmental Disorder (ARND): a unique profile of deficits and assets. Can J Clin Pharm 2002;9:215-225.
24. Astley SJ, Aylward EH, Carmichael Olson H, Kerns K, Brooks A, Coggins TE, et al. Magnetic resonance imaging outcomes from a comprehensive magnetic resonance study of children with fetal alcohol spectrum disorders. Alcoholism Clin Exp Res 2009;33:1671-1689.
25. Bishop S, Gahagan S, Lord C. Re-examining the core features of autism: a comparison of autism spectrum disorder and fetal alcohol spectrum disorder. J Child Psych Psychi 2007;48:1111-1121.