Further Development of a Neurobehavioral Profile of Fetal Alcohol Spectrum Disorders

• Authors: Sarah N. Mattson, San Diego State University; Scott C. Roesch, San Diego State University; Leila Glass, San Diego State University; Benjamin N. Deweese, San Diego State University; Claire Coles, Emory University; Julie A Kable, Emory University; Philip A. May, University of North Carolina; Wendy O. Kalberg, University of New Mexico; Elizabeth R. Sowell, University of Southern California; Colleen M. Adnams, University of Cape Town; Kenneth Lyons Jones, University of California San Diego; Edward P. Riley, San Diego State University
• Journal Title: Alcoholism: Clinical and Experimental Research
• Volume: Volume 37, Number 3
• Publisher: Wiley: 12 months | 2013-03-01, Pages 517-528
• Type of Work: Article | Post-print: After Peer Review
• Publisher DOI: http://doi.org/10.1111/j.1530-0277.2012.01952.x
• Subjects: Biology, Neuroscience; Psychology, Behavioral
• Keywords: Science & Technology; Life Sciences & Biomedicine; Substance Abuse; Fetal Alcohol Syndrome (FAS); Prenatal Alcohol Exposure; Neurobehavioral Profile; Attention-Deficit; Hyperactivity Disorder (ADHD); Latent Profile Analysis (LPA); ATTENTION-DEFICIT/HYPERACTIVITY DISORDER; DEFICIT HYPERACTIVITY DISORDER; PHYSICAL FEATURES; RISK-FACTORS; CHILDREN; EXPOSURE; IDENTIFICATION; PREVALENCE; PHENOTYPE; DIAGNOSIS

Abstract

Background: Heavy prenatal alcohol exposure (AE) results in a broad array of neurobehavioral deficits. Recent research has focused on identification of a neurobehavioral profile or profiles that will improve the identification of children affected by AE. This study aimed to build on our preliminary neurobehavioral profile to improve classification accuracy and test the specificity of the resulting profile in an alternate clinical group. Methods: A standardized neuropsychological test battery was administered to 3 groups of children: subjects with AE (n = 209), typically developing controls (CON, n = 185), and subjects with attention-deficit/hyperactivity disorder (ADHD, n = 74). We assessed a large sample from 6 sites in the United States and South Africa, using standardized methodology. Data were analyzed using 3 latent profile analyses including (i) subjects with fetal alcohol syndrome (FAS) and controls, (ii) subjects with AE without FAS and controls, and (iii) subjects with AE (with or without FAS) and subjects with ADHD. Results: Classification accuracy was moderate but significant across the 3 analyses. In analysis 1, overall classification accuracy was 76.1% (77.2% FAS, 75.7% CON). In the second analysis, overall classification accuracy was 71.5% (70.1% AE/non-FAS, 72.4% CON). In the third analysis, overall classification accuracy was 73.9% (59.8% AE, 75.7% ADHD). Subjects that were misclassified were examined for systematic differences from those that were correctly classified. Conclusions: The results of this study indicate that the neuropsychological effects of AE are clinically meaningful and can be used to accurately distinguish alcohol-affected children from both typically developing children and children with ADHD. Further, in combination with other recent studies, these data suggest that approximately 70% of children with heavy prenatal alcohol exposure are neurobehaviorally affected, while the remaining 30% are spared these often-devastating consequences, at least those in the domains under study. Refining the neurobehavioral profile will allow improved identification and treatment development for childr en affected by prenatal alcohol exposure.