Effects of Prenatal Alcohol Exposure and Attention- Deficit/ Hyperactivity Disorder on Adaptive Functioning

• Type of Material: Article
• Authors: Ashley L. Ware, San Diego State University; Leila Glass, San Diego State University; Nicole Crocker, San Diego State University; Benjamin N. Deweese, San Diego State University; Claire Coles, Emory University; Julie A Kable, Emory University; Phillip A. May, University of North Carolina; Wendy O. Kalberg, University of New Mexico; Elizabeth R. Sowell, University of Southern California; Kenneth Lyons Jones, University of California, San Diego; Edward P. Riley, San Diego State University; Sarah N. Mattson, San Diego State University
• Language: English
• Date: 2014-05-01
• Publisher: Wiley: 12 months
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2014 by the Research Society on Alcoholism.
• Final Published Version (URL): http://dx.doi.org/10.1111/acer.12376
• Title of Journal or Parent Work: Alcoholism: Clinical and Experimental Research
• ISSN: 0145-6008
• Volume: 38
• Issue: 5
• Start Page: 1439
• End Page: 1447
• Grant/Funding Information: All or part of this work was done in conjunction with the Collaborative Initiative on Fetal Alcohol Spectrum Disorders (CIFASD), which is funded by grants from the National Institute on Alcohol Abuse and Alcoholism (NIAAA).; Additional funding was provided through grants F31 AA020142; F31 AA022261; and T32 AA013525.; Research described in this paper was supported by NIAAA grants U01 AA014834 (Mattson); U24 AA014811 (Riley); U24 AA014818 (Barnett); and U24 AA014815 (Jones).
• Keywords: BEHAVIOR; Substance Abuse; Attention-Deficit; FETAL ALCOHOL; Science & Technology; CHILDREN; Fetal Alcohol Syndrome (FAS); DIAGNOSIS; NEURODEVELOPMENTAL DISORDERS; RISK-FACTORS; Life Sciences & Biomedicine; Adaptive Behavior; DEFICIT/HYPERACTIVITY DISORDER; ADHD; Hyperactivity Disorder (ADHD); SLUGGISH COGNITIVE TEMPO; SPECTRUM DISORDERS; Fetal Alcohol Spectrum Disorders (FASD)
• Research Categories: Psychology, Developmental; Psychology, Behavioral; Health Sciences, Toxicology

Abstract

Background: Heavy prenatal alcohol exposure and attention-deficit/hyperactivity disorder (ADHD) are associated with adaptive behavior deficits. This study examined the interaction between these 2 factors on parent ratings of adaptive behavior. Methods: As part of a multisite study, primary caregivers of 317 children (8 to 16 years, M = 12.38) completed the Vineland Adaptive Behavior Scales-Second Edition (VABS-II). Four groups of subjects were included: children with prenatal alcohol exposure with ADHD (AE+, n = 82), children with prenatal alcohol exposure without ADHD (AE-, n = 34), children with ADHD (ADHD, n = 71), and control children (CON, n = 130). VABS-II domain scores (Communication, Daily Living Skills, Socialization) were examined using separate 2 (Alcohol Exposure [AE]) × 2 (ADHD diagnosis) between-subjects analyses of covariance. Results: There were significant main effects of AE (p < 0.001) and ADHD (p < 0.001) on all VABS-II domains; alcohol-exposed children had lower scores than children without prenatal alcohol exposure and children with ADHD had lower scores than those without ADHD. There was a significant AE × ADHD interaction effect for Communication, F(1, 308) = 7.49, p = 0.007, partial η 2 = 0.024, but not Daily Living Skills or Socialization domains (ps > 0.27). Follow-up analyses in the Communication domain indicated the effects of ADHD were stronger in comparison subjects (ADHD vs. CON) than exposed subjects (AE+ vs. AE-), and the effects of alcohol exposure were stronger in subjects without ADHD (AE- vs. CON) than in subjects with ADHD (AE+ vs. ADHD). Conclusion: As found previously, both prenatal alcohol exposure and ADHD increase adaptive behavior deficits in all domains. However, these 2 factors interact to cause the greatest impairment in children with both prenatal alcohol exposure and ADHD for communication abilities. These results further demonstrate the deleterious effects of prenatal alcohol exposure and broaden our understanding of how ADHD exacerbates behavioral outcomes in this population.