NEUROPSYCHOLOGICAL IMPAIRMENTS AND AGE-RELATED DIFFERENCES IN CHILDREN AND ADOLESCENTS WITH FETAL ALCOHOL SPECTRUM DISORDERS
Main Article Content
Keywords
Fetal alcohol spectrum disorders, neuropsychological impairments, age - related differences, children and adolescents
Abstract
Background
Children and adolescents with Fetal Alcohol Spectrum Disorders (FASD) exhibit a range of physical, cognitive, behavioral, and/or learning deficits, as wells as poor executive functioning (EF). Children and adolescents with FASD often show greater impairments on complex neuropsychological tasks. However, little is known about age-related differences among children and adolescents with FASD.
Objectives
The goals of this cross-sectional study were to explore the overall profile of neuropsychological impairments and extended previous reports on age-related differences among children and adolescents with FASD.
Method
We compared 117 children and adolescents diagnosed with an FASD (aged 5 - 17 years), clinically assessed on a broad range of tests covering 6 neurobehavioral domains. Data from a clinical database was used to generate profiles of neuropsychological impairments for clinically referred children and a dolescents evaluated for FASD between 2001 and 2005.
Results
Children and adolescents were impaired (relative to the norm) on a number of domains that include academic achievement, language, verbal memory, EF, visual - motor integration, and motor abilities. Older participants with FASD (relative to the norm) showed greater difficulty in areas involving EF or processing of complex information than younger participants.
Conclusions
These results suggest that for children and adolescents with FASD impairments in those areas important for independent functioning may become more pronounced with increasing age. However, further longitudinal research is needed to ascertain age changes over time.
References
1. Chudley AE, Conry J, Cook LL, Loock C, Rosales T, LeBlanc N. Fetal alcohol spectrum disorder: Canadian guidelines for diagnosis. CMAJ 2005; 172 (5): S1 - S21.
2. May PA, Gossage JP, Kalberg WO, Robinson LK, Buckley D, Manning M. et al. Prevalence and epidemiologic characteristics of fasd from various research methods with an emphasis on recent in-school studies. Dev Disabil Res Rev 2009;15 (3):176 - 192.
3. Jones KL, Smith DW. Recognition of fetal alcohol syndrome in early infancy. Lancet 1973; 2 (7 836): 999 - 1001.
4. 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(2):279 - 294.
5. Spadoni AD, McGee CL, Fryer SL, Riley EP. Neuroimaging and fetal alcohol spectrum disorders. Neurosci Biobehav Rev 2007 ;31 (2):239 - 245.
6. Streissguth, AP. Fetal alcohol syndrome: A guide for families and communities. Baltimore, MD, US, 1997.
7. Kodituwakku PW. Neurocognitive profile in children with fetal alcohol spectrum disorders. Dev Disabil Res Rev 2009; 15 (3):218 - 224.
8. Mattson SN, Crocker N, & Nguyen T. Fetal alcohol spectrum disorders: Neuropsychological and behavioral features. Neuropsychol Rev 2011 ;21 (2):81 - 101.
9. Kerns KA, Don A, Mateer CA, Streissguth AP. Neuropsychological impairments in nonretarded adults with fetal alcohol syndrome. J Learn Disabil 1997; 30 (6):685 - 693.
10. Olson HC, Feldman JJ, Streissguth AP, Sampson PD, & Bookstein FL. Neuropsychological impairments in adolescents with fetal alcohol syndrome: Clinical findings. Alcohol Clin Exp Res 1998; 22 (9):1998 - 2012.
11. Mattson SN, Goodman AM, Caine C, Delis DC, Riley EP. Executive functioning in children with heavy prenatal alcohol exposure. Alcohol Clin Exp Res 1999 ;23 (11):1808 - 1815.
12. Mattson SN, Riley EP. Parent ratings of behavior in children with heavy prenatal alcohol exposure and IQ - matched controls. Alcohol Clin Exp Res 2000;24(2):226 – 231.
13. Rasmussen C, Tamana S, Baugh L, Andrew G, Tough S, Zwaigenbaum L. Neuropsychological impairments on the NEPSY - II among children with FASD. Child Neuropsychol 2013;19(4): 337 - 49. doi:10.1080/09297049.2012.658768.
14. Howell KK, Lynch ME, Platzman KA, Smith H, Coles CD. Prenatal alcohol exposure and ability, academic achievement, and school functioning in adolescence: A Longitudinal Follow - up. J Pediatr Psychol 2006;31(1):116 - 126.
15. Streissguth AP, Barr HM, Bookstein FL, Sampson PD, Olson HC. The long - term neurocognitive consequences of prenatal alcohol exposure: A 14 - year study. Psychol Sci 1999; 10 (3):186 - 190.
16. Streissguth A. Off spring effects of prenatal alcohol exposure from birth to 25 years: The Seattle prospective longitudinal study. J Clin Psychol Med Settings 2007; 14 (2):81 - 101.
17. Streissguth AP, Sampson PD, Olson HC, Bookstein FL, Barr HM, Scott M, et al. Maternal drinking during pregnancy: Attention and short - term memory in 14 - year - old offspring -- a longitudinal prospective study. Alcohol Clin Exp Res 1994; 18 (1): 202 - 218.
18. Rasmussen C, Bisanz J. Executive functioning in children with fetal alcohol spectrum disorders: Profiles and age-related differences. Child Neuropsychol 2009; 15 (3): 201 - 215.
19. Rasmussen C, McAuley R, & Andrew G. Parental ratings of children with fetal alcohol spectrum disorder on the Behavior Rating Inventory of Executive Functioning (BRIEF). J FAS Int 2007;5 ;e2.
20. Wozniak JR, Muetzel RL. What does diffusion tensor imaging reveal about the brain and cognition in fetal alcohol spectrum disorders? Neuropsychology Review 2011 ;
21 (2):133 - 147. doi:10.1007/s11065 - 011 - 9162 - 1 21. Stutton K, Howe C, Battaglia F. Fetal Alcohol Syndrome Diagnosis, Epidemiology, Prevention, and Treatment. Washington, DC: National Academy Press, 1996.
22. Goldschmidt L, Richardson GA, Stoffer, DS, Geva D, & Day NL. Prenatal alcohol exposure and academic achievement at age six: A nonlinear fit. Alcohol Clin Exp Res, 1996;20(4):763 - 770.
23. Streissguth AP, Barr HM, Sampson PD. Moderate prenatal alcohol exposure: Effects on child IQ and learning problems at age 7 years. Alcohol Clin Exp Res 1990;14: 662 – 669.
24. Rasmussen C, & Bisanz J. Exploring mathematics difficulties in children with fetal alcohol 1. spectrum disorders. Child Dev Perspect 2009; 3 (2):125 - 130.
25. Mattson SN, Riley EP, Gramling L, Delis DC, & Jones KL. Neuropsychological comparison of alcohol-exposed children with or without physical features of fetal alcohol syndrome. Neuropsychology 1998; 12 (1):146 - 153.
26. Rasmussen C, Wyper K, Talwar, V. The relation between theory of mind and executive functions in children fetal alcohol spectrum disorders. Can J Clin Pharmacol 2009;16(2):e370 - e380.
27. Mattson SN, Ril ey EP, Delis DC, Stern C, Jones KL. Verbal learning and memory in children with fetal alcohol syndrome. Alcohol Clin Exp Res 1996; 20 (5): 810 - 816.
28. Vaurio L, Riley EP, Mattson SN. Neuropsychological comparison of children with heavy prenatal alcohol exposur e and an IQ - matched comparison group. J Int Neuropsychol Soc 2011; 17 (3):463 - 473.
29. Crocker N, Vaurio L, Riley EP, Mattson SN. Comparison of adaptive behavior in children with heavy prenatal alcohol exposure or attention - Impairment/Hyperactivity disorder. Al cohol Clin Exp Res 2009; 33 (11):2015 - 2023.
30. Roebuck - Spencer TM, Mattson SN. Implicit strategy affects learning in children with heavy prenatal alcohol exposure. Alcohol Clin Exp Res 2004; 28 (9):1424 - 1431.
31. Mattson SN, Roesch SC, Fagerlund A, Autti - Ramo I, Jo nes KL, May PA, et al. Toward a neurobehavioral profile of fetal alcohol spectrum disorders. Alcohol Clin Exp Res 2010 ;34 (9):1640 - 1650.
32. Jirikowic T, Kartin D, Carmichael Olson H. Children with fetal alcohol spectrum disorders: a descriptive profile of ada ptive function. Can J Occu Ther 2008;75(4):238 – 248
33. Uecker A, Nadel L. Spatial locations gone awry: Object and spatial memory impairments in children with fetal alcohol syndrome. Neuropsychologia, 1996; 34 (3):209 - 223.
34. Conry J. Neuropsychological impairment s in fetal alcohol syndrome and fetal alcohol effects. Alcohol Clin Exp Res 1990;14(5):650 – 655.
35. Janzen LA, Nanson JL, Block GW. Neuropsycho - logical evaluation of preschoolers with fetal alcohol syndrome. Neurotoxicology and Teratology 1995;17(3):273 – 279.
36. B arr HM, Streissguth, AP, Darby BL, Sampson PD. Prenatal Alcohol Exposure to alcohol, caffeine, tobacco, and aspirin: Effects on fine and gross motor performance in 4 - year old children. Dev Psychol 1990;26(3):339 - 348.
37. Rasmussen C, Bisanz J. The relation be tween mathematics and working memory in young children with Fetal Alcohol Spectrum Disorders. J Spec Ed 2010;45(3):184 - 191.
38. Connor PD, Sampson PD, Bookstein FL, Barr HM, Streissguth AP. Direct and indirect effects of prenatal alcohol damage on executive f unction. Dev Neuropsychol 2000;18 (3): 331 - 354.
39. Willford JA, Richardson GA, Leech SL, Day NL. Verbal and visuospatial learning and memory function in children with moderate prenatal alcohol exposure. Alcohol Clin Exp Res 2004; 28 (3):497 - 507.
40. van den Burg W, Kingma A. Performance of 225 dutch school children on rey's auditory verbal learning test (RAVLT): Parallel test - retest reliabilities with an interval of 3 months and normative data. Arc Clin Neuropsychol 1999;14 (6):545 - 559.
41. Quattlebaum JL, O’Connor MJ. Higher functioning children with prenatal alcohol exposure: is there a specific neurocognitive profiles? Child Neuropsychol 2013; 19(5);561 - 78.
2. May PA, Gossage JP, Kalberg WO, Robinson LK, Buckley D, Manning M. et al. Prevalence and epidemiologic characteristics of fasd from various research methods with an emphasis on recent in-school studies. Dev Disabil Res Rev 2009;15 (3):176 - 192.
3. Jones KL, Smith DW. Recognition of fetal alcohol syndrome in early infancy. Lancet 1973; 2 (7 836): 999 - 1001.
4. 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(2):279 - 294.
5. Spadoni AD, McGee CL, Fryer SL, Riley EP. Neuroimaging and fetal alcohol spectrum disorders. Neurosci Biobehav Rev 2007 ;31 (2):239 - 245.
6. Streissguth, AP. Fetal alcohol syndrome: A guide for families and communities. Baltimore, MD, US, 1997.
7. Kodituwakku PW. Neurocognitive profile in children with fetal alcohol spectrum disorders. Dev Disabil Res Rev 2009; 15 (3):218 - 224.
8. Mattson SN, Crocker N, & Nguyen T. Fetal alcohol spectrum disorders: Neuropsychological and behavioral features. Neuropsychol Rev 2011 ;21 (2):81 - 101.
9. Kerns KA, Don A, Mateer CA, Streissguth AP. Neuropsychological impairments in nonretarded adults with fetal alcohol syndrome. J Learn Disabil 1997; 30 (6):685 - 693.
10. Olson HC, Feldman JJ, Streissguth AP, Sampson PD, & Bookstein FL. Neuropsychological impairments in adolescents with fetal alcohol syndrome: Clinical findings. Alcohol Clin Exp Res 1998; 22 (9):1998 - 2012.
11. Mattson SN, Goodman AM, Caine C, Delis DC, Riley EP. Executive functioning in children with heavy prenatal alcohol exposure. Alcohol Clin Exp Res 1999 ;23 (11):1808 - 1815.
12. Mattson SN, Riley EP. Parent ratings of behavior in children with heavy prenatal alcohol exposure and IQ - matched controls. Alcohol Clin Exp Res 2000;24(2):226 – 231.
13. Rasmussen C, Tamana S, Baugh L, Andrew G, Tough S, Zwaigenbaum L. Neuropsychological impairments on the NEPSY - II among children with FASD. Child Neuropsychol 2013;19(4): 337 - 49. doi:10.1080/09297049.2012.658768.
14. Howell KK, Lynch ME, Platzman KA, Smith H, Coles CD. Prenatal alcohol exposure and ability, academic achievement, and school functioning in adolescence: A Longitudinal Follow - up. J Pediatr Psychol 2006;31(1):116 - 126.
15. Streissguth AP, Barr HM, Bookstein FL, Sampson PD, Olson HC. The long - term neurocognitive consequences of prenatal alcohol exposure: A 14 - year study. Psychol Sci 1999; 10 (3):186 - 190.
16. Streissguth A. Off spring effects of prenatal alcohol exposure from birth to 25 years: The Seattle prospective longitudinal study. J Clin Psychol Med Settings 2007; 14 (2):81 - 101.
17. Streissguth AP, Sampson PD, Olson HC, Bookstein FL, Barr HM, Scott M, et al. Maternal drinking during pregnancy: Attention and short - term memory in 14 - year - old offspring -- a longitudinal prospective study. Alcohol Clin Exp Res 1994; 18 (1): 202 - 218.
18. Rasmussen C, Bisanz J. Executive functioning in children with fetal alcohol spectrum disorders: Profiles and age-related differences. Child Neuropsychol 2009; 15 (3): 201 - 215.
19. Rasmussen C, McAuley R, & Andrew G. Parental ratings of children with fetal alcohol spectrum disorder on the Behavior Rating Inventory of Executive Functioning (BRIEF). J FAS Int 2007;5 ;e2.
20. Wozniak JR, Muetzel RL. What does diffusion tensor imaging reveal about the brain and cognition in fetal alcohol spectrum disorders? Neuropsychology Review 2011 ;
21 (2):133 - 147. doi:10.1007/s11065 - 011 - 9162 - 1 21. Stutton K, Howe C, Battaglia F. Fetal Alcohol Syndrome Diagnosis, Epidemiology, Prevention, and Treatment. Washington, DC: National Academy Press, 1996.
22. Goldschmidt L, Richardson GA, Stoffer, DS, Geva D, & Day NL. Prenatal alcohol exposure and academic achievement at age six: A nonlinear fit. Alcohol Clin Exp Res, 1996;20(4):763 - 770.
23. Streissguth AP, Barr HM, Sampson PD. Moderate prenatal alcohol exposure: Effects on child IQ and learning problems at age 7 years. Alcohol Clin Exp Res 1990;14: 662 – 669.
24. Rasmussen C, & Bisanz J. Exploring mathematics difficulties in children with fetal alcohol 1. spectrum disorders. Child Dev Perspect 2009; 3 (2):125 - 130.
25. Mattson SN, Riley EP, Gramling L, Delis DC, & Jones KL. Neuropsychological comparison of alcohol-exposed children with or without physical features of fetal alcohol syndrome. Neuropsychology 1998; 12 (1):146 - 153.
26. Rasmussen C, Wyper K, Talwar, V. The relation between theory of mind and executive functions in children fetal alcohol spectrum disorders. Can J Clin Pharmacol 2009;16(2):e370 - e380.
27. Mattson SN, Ril ey EP, Delis DC, Stern C, Jones KL. Verbal learning and memory in children with fetal alcohol syndrome. Alcohol Clin Exp Res 1996; 20 (5): 810 - 816.
28. Vaurio L, Riley EP, Mattson SN. Neuropsychological comparison of children with heavy prenatal alcohol exposur e and an IQ - matched comparison group. J Int Neuropsychol Soc 2011; 17 (3):463 - 473.
29. Crocker N, Vaurio L, Riley EP, Mattson SN. Comparison of adaptive behavior in children with heavy prenatal alcohol exposure or attention - Impairment/Hyperactivity disorder. Al cohol Clin Exp Res 2009; 33 (11):2015 - 2023.
30. Roebuck - Spencer TM, Mattson SN. Implicit strategy affects learning in children with heavy prenatal alcohol exposure. Alcohol Clin Exp Res 2004; 28 (9):1424 - 1431.
31. Mattson SN, Roesch SC, Fagerlund A, Autti - Ramo I, Jo nes KL, May PA, et al. Toward a neurobehavioral profile of fetal alcohol spectrum disorders. Alcohol Clin Exp Res 2010 ;34 (9):1640 - 1650.
32. Jirikowic T, Kartin D, Carmichael Olson H. Children with fetal alcohol spectrum disorders: a descriptive profile of ada ptive function. Can J Occu Ther 2008;75(4):238 – 248
33. Uecker A, Nadel L. Spatial locations gone awry: Object and spatial memory impairments in children with fetal alcohol syndrome. Neuropsychologia, 1996; 34 (3):209 - 223.
34. Conry J. Neuropsychological impairment s in fetal alcohol syndrome and fetal alcohol effects. Alcohol Clin Exp Res 1990;14(5):650 – 655.
35. Janzen LA, Nanson JL, Block GW. Neuropsycho - logical evaluation of preschoolers with fetal alcohol syndrome. Neurotoxicology and Teratology 1995;17(3):273 – 279.
36. B arr HM, Streissguth, AP, Darby BL, Sampson PD. Prenatal Alcohol Exposure to alcohol, caffeine, tobacco, and aspirin: Effects on fine and gross motor performance in 4 - year old children. Dev Psychol 1990;26(3):339 - 348.
37. Rasmussen C, Bisanz J. The relation be tween mathematics and working memory in young children with Fetal Alcohol Spectrum Disorders. J Spec Ed 2010;45(3):184 - 191.
38. Connor PD, Sampson PD, Bookstein FL, Barr HM, Streissguth AP. Direct and indirect effects of prenatal alcohol damage on executive f unction. Dev Neuropsychol 2000;18 (3): 331 - 354.
39. Willford JA, Richardson GA, Leech SL, Day NL. Verbal and visuospatial learning and memory function in children with moderate prenatal alcohol exposure. Alcohol Clin Exp Res 2004; 28 (3):497 - 507.
40. van den Burg W, Kingma A. Performance of 225 dutch school children on rey's auditory verbal learning test (RAVLT): Parallel test - retest reliabilities with an interval of 3 months and normative data. Arc Clin Neuropsychol 1999;14 (6):545 - 559.
41. Quattlebaum JL, O’Connor MJ. Higher functioning children with prenatal alcohol exposure: is there a specific neurocognitive profiles? Child Neuropsychol 2013; 19(5);561 - 78.