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Katherine R Wyper
Carmen R Rasmussen


Fetal Alcohol Spectrum Disorder, language, communication



Fetal Alcohol Spectrum Disorder (FASD) is associated with a range of disabilities, including physical, behavioural, and cognitive deficits. One specific area of concern in children with FASD is the use and development of speech and language. Language deficits in FASD have been linked to learning problems and social difficulties.



The current study sought to examine the language difficulties of children with FASD, and to identify areas of deficit that may be particularly pronounced among these children.



Fifty children, aged 5 to 13, (27 with FASD, 23 control children) were tested on the CREVT-2, the TOLD-P:3, and the TOLD-I:3.



Children with FASD had significantly lower scores than control children on both receptive and expressive subtests of the CREVT-2. Younger children scored significantly lower than controls on the Relational Vocabulary and Sentence Imitation subtests of the TOLD-P:3, and older children were significantly delayed on the Word Ordering, Grammatic Comprehension, and Malapropisms subtests of the TOLD-I:3.



This study identified several areas of marked difficulty in children with FASD, adding to the current understanding of language development in this population. The results have implications for tailoring early interventions, and for providing evidence-based support to children prenatally exposed to alcohol.

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1. Chudley AE, Conry J, Cook JL, Loock C, Rosales T, LeBlanc N. Fetal Alcohol Spectrum Disorder: Canadian guidelines for diagnosis. Can Med Assoc J 2005;172:S1–21.
2. Becker M, Warr-Leeper GA, Leeper HA. Fetal Alcohol Syndrome: A description of oral motor, articulatory, short-term memory, grammatical, and semantic abilities. J Commun Disord 1990;23: 97–124.
3. Coggins TE, Timler GR, Olswang LB. A state of double jeopardy: Impact of prenatal alcohol exposure and adverse environments on the social communicative abilities of school-age children with Fetal Alcohol Spectrum disorder. Lang Speech Hear Serv Sch 2007;38:117–27.
4. Janzen LA, Nanson JL, Block GW. Neuropsychological evaluation of preschoolers with Fetal Alcohol Syndrome. Neurotoxicol Teratol 1995;17:273–9.
5. 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;22:279–94.
6. Church MW, Kaltenbach JA. Hearing, speech, language, and vestibular disorders in the Fetal Alcohol Syndrome: A literature review. Alcohol Clin Exp Res 1997;21:495–512.
7. Coggins TE, Olswang LB, Carmichael Olson H, Timler GR. On becoming socially competent communicators: The challenge for children with Fetal Alcohol Exposure. Int Rev Res Ment Retard 2003; 27:121–50.
8. Shaywitz SE, Caparulo BK, Hodgson ES. Developmental language disability as a consequence of prenatal exposure to ethanol. Pediatrics 1981;68:850–5.
9. Iosub S, Fuchs M, Bingol N, Gromisch DS. Fetal Alcohol Syndrome revisited. Pediatrics 1981;68:475–9.
10. Carmichael Olson C. The effects of prenatal alcohol exposure on child development. Infants Young Child 1994;6:10–25.
11. Don A, Rourke BP. Fetal Alcohol Syndrome. In: Rourke HP, ed. Syndrome of Nonverbal Learning Disabilities. New York, NY: Guilford Press, 1995:372–405.
12. LaDue RA, Streissguth AP, Randels SP. Clinical considerations pertaining to adolescents and adults with Fetal Alcohol Syndrome. In: Sonderegger TB, ed. Perinatal Substance Abuse: Research Findings and Clinical Implications. Baltimore, MD: Johns Hopkins University Press, 1992:104–31.
13. Russell M, Czarnecki DM, Cowan R, McPherson E, Mudar PJ. Measures of maternal alcohol use as predictors of development in early childhood. Alcohol Clin Exp Res 1991;14:991–1000.
14. Streissguth AP. The behavioral teratology of alcohol: Performance, behavioral, and intellectual deficits in prenatally exposed children. In: West JR, ed. Alcohol and Brain Development. New York, NY: Oxford University Press, 1986:3–44.
15. Gusella JL, Fried PA. Effects of maternal social drinking and smoking on offspring at 13 months. Neurobehav Toxicol Teratol 1984;6:13–7.
16. Aragon AS, Coriale G, Fiorentino D, et al. Neuropsychological characteristics of Italian children with Fetal Alcohol Spectrum Disorders. Alcohol Clin Exp Res 2008;32:1909–19.
17. Kodituwakku PW, Adnams CM, Hay A, et al. Letter and category fluency in children with Fetal Alcohol Syndrome from a community in South Africa. J Stud Alcohol Drugs 2006;67:502–9.
18. Jenkins MR, Culbertson JL. Prenatal exposure to alcohol. In: Adams RL, Parsons OA, Culbertson JL, Nixon SJ, eds. Neuropsychology for Clinical Practice: Etiology, Assessment, and Treatment of Common Neurological Disorders. Washington, DC: American Psychological Association 1996;409–52.
19. Malisza KL. Neuroimaging cognitive function in Fetal Alcohol Spectrum Disorders. Int J Disabil Hum Dev 2007;6:171–88.
20. Lemoine P, Harousseau H, Borteyru J-P, Menuet JC. Les enfants des parents alcooliques: Anomalies observées. A propos de 127 cas [Children of alcoholic parents: Abnormalities observed in 127 cases]. Ouest Med 1968;21:476–82.
21. Carney L, Chermak G. Performance of American Indian children with Fetal Alcohol Syndrome on the Test of Language Development. J Commun Disord 1991;24:123– 34.
22. McGee CL, Bjorkquist OA, Riley EP, Mattson SN. Impaired language performance in young children with heavy prenatal alcohol exposure. Neurotoxicol Teratol 2009;31:71–5.
23. Church MW, Eldis F, Blakley BW, Bawle EV. Hearing, language, speech, vestibular, and dentofacial disorders in Fetal Alcohol Syndrome. Alcohol Clin Exp Res 1997;21:227– 37.
24. Adnams CM, Sorour P, Kalberg WO, et al. Language and literacy outcomes from a pilot intervention study for children with Fetal Alcohol Spectrum Disorders in South Africa. Alcohol 2007;41: 403–14.
25. Greene T, Ernhart C, Martier S, Sokol R, Ager J. Prenatal alcohol exposure and language development. Alcohol Clin Exp Res 1990;14:937–45.
26. Fried PA, O’Connell CM, Watkinson B. 60- and 72-month follow-up of children prenatally exposed to marijuana, cigarettes, and alcohol: Cognitive and language assessment. J Dev Behav Pediatr 1992;13:383–91.
27. O’Leary C, Zubrick SR, Taylor CL, Dixon G, Bower C. Prenatal alcohol exposure and language delay in 2-year-old children: The importance of dose and timing on risk. Pediatrics 2009;123:547–54.
28. Kodituwakku PW. Defining the behavioral phenotype in children with Fetal Alcohol Spectrum Disorders: A review. Neurosci Biobehav Rev 2007;31:192–201.
29. Kodituwakku PW. Neurocognitive profile in children with Fetal Alcohol Spectrum Disorders. Dev Disabil Res Rev 2009;15:218–24.
30. Abkarian GG. Communication effects of prenatal alcohol exposure. J Commun Disord 1992;25:221–40.
31. Hamilton M. (1981). Linguistic abilities of children with Fetal Alcohol Syndrome. Unpublished Master’s thesis, University of Washington, Seattle, 1981.
32. Cone-Wesson B. Prenatal alcohol and cocaine exposure: Influences on cognition, speech, language, and hearing. J Commun Disord 2005;38:279–302.
33. Astley SJ. Diagnostic guide for Fetal Alcohol Spectrum Disorders: The 4-digit diagnostic code. University of Washington, Seattle: FAS Diagnostic and Prevention Network, 2004.
34. Wallace G, Hammill DD. Comprehensive Receptive and Expressive Vocabulary Test, 2nd ed. Austin, TX: Pro-Ed Inc., 2002.
35. Newcomer PL, Hammill DD. Test of Language Development – Primary, 3rd ed. Austin, TX: Pro- Ed Inc., 1997.
36. Hammill DD, Newcomer PL. Test of Language Development – Intermediate, 3rd ed. Austin, TX: Pro-Ed Inc., 1997.
37. Thorne JC, Coggins TE, Carmichael Olson H, Astley SJ. Exploring the utility of narrative analysis in diagnostic decision making: Picturebound reference, elaboration, and Fetal Alcohol Spectrum Disorders. J Speech Lang Hear Res 2007;50:459–74.
38. Henry J, Sloane M, Black-Pond C. Neurobiology and neurodevelopmental impact of childhood traumatic stress and prenatal alcohol exposure. Lang Speech Hear Serv Sch 2007;38:99–108.
39. Hyter YD, Way I. Understanding children who have been affected by maltreatment and prenatal alcohol exposure: future directions. Lang Speech Hear Serv Sch 2007;38:157–9.
40. Koponen AM, Kalland M, Autti-Rämö I. Caregiving environment and socio-emotional development of foster-placed FASD-children. Child Youth Serv Rev 2009;31:1049–56.