Higher functioning children with prenatal alcohol exposure: Is there a specific neurocognitive profile?

Abstract

Recent attempts to identify a neurocognitive profile of children with prenatal alcohol exposure (PAE) have led to an emerging “generalized deficit” conceptualization marked by diffuse information processing and integration difficulties as opposed to a specific profile. This study examines whether this conceptualization can be extended to higher functioning children with PAE who are without intellectual disability and addresses several limitations of previous research. One hundred twenty-five children aged 6–12 years with social skills deficits, 97 of whom met diagnostic criteria for a Fetal Alcohol Spectrum Disorder (FASD), underwent a comprehensive, multi-informant assessment of neurocognitive, emotional, social, behavioral, and adaptive functioning. Multivariate analyses of variance examined differences in functioning between the PAE group and a nonexposed comparison group with and without controlling for child IQ. Results indicated that the PAE group returned significantly poorer scores than the nonexposed group on every construct assessed, including executive functioning, attention, working/visuospatial memory, linguistic abstraction, adaptive behavior, emotional/behavioral functioning, and social cognition. These differences largely maintained after controlling for IQ and were similar regardless of informant, although teachers reported somewhat fewer group differences. Within the PAE group, no differences were found across FASD subtypes. These results provide evidence extending the emerging generalized deficit conceptualization of children with PAE to those higher functioning individuals without global intellectual disability.

• Fetal alcohol spectrum disorders
• Prenatal alcohol exposure
• Alcohol-related neurodevelopmental disorder
• Neurodevelopment
• Fetal alcohol syndrome

We thank Vivien Keil, PhD, Marleen Castaneda, and Gerhardt Hellemann, PhD, for their assistance on this study. This research was supported by the Centers for Disease Control and Prevention Grant Numbers UDD000041 (M. O’Connor, PI) and CCU920158 (M. O’Connor, PI). The contents do not necessarily represent the positions or policies of the Centers for Disease Control and Prevention and endorsement by the Federal Government should not be assumed.