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Author Notes:

Claire D. Coles, ccoles@emory.edu

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 information about CIFASD can be found at www.cifasd.org.

We would also like to acknowledge the cooperation of OMNInet, Ukraine without which the study could not be carried out as well as the families and children who volunteered their time to this project.

No potential conflict of interest was reported by the author(s).


Research Funding:

This research was supported by the National Institute on Alcohol Abuse and Alcoholism (NIH/NIAAA) through cooperative agreements with Christine D. Chambers, PhD (PI) and CIFASD. NIH/NIAAA 5U01 AA014835, and through the NIH Office of Dietary Supplements.


  • Science & Technology
  • Life Sciences & Biomedicine
  • Clinical Neurology
  • Neurosciences & Neurology
  • Prenatal alcohol exposure (PAE)
  • Fetal Alcohol Spectrum Disorder (FASD)
  • preschool assessment
  • executive function (EF)

Measurement of neurodevelopmental effects of prenatal alcohol exposure in Ukrainian preschool children


Journal Title:



Volume 27, Number 8


, Pages 1088-1103

Type of Work:

Article | Post-print: After Peer Review


Effects of prenatal alcohol exposure (PAE) are rarely measured in preschool children due to relative insensitivity of assessment methods at this age. To examine the potential of a nonverbal battery in early identification of cognitive problems in alcohol-exposed children, 291 prospectively identified Ukrainian children were evaluated using a test battery focusing on early executive functioning (EF) and visuospatial skills, areas of cognitive development particularly sensitive to PAE in older children. Tests included the Differential Ability Scales, 2nd Edition (DAS-2) and several NEPSY/NEPSY-II subtests, standardized in the United States. Others were adapted from commonly used non-standardized neuropsychological measures of EF (Preschool Spatial Span, Imitation Hand Game, A not B, Delayed Attention, Subject Ordered Pointing). Children in two sites in Ukraine, Rivne and Khmelnitsky, were tested at 3 ½-4 ½ years to identify effects of PAE. Although most children performed within the average range, Alcohol-Exposed preschoolers had lower scores on DAS-II Summary Scores as well as on specific subtests. To evaluate the effects of alcohol dose during the pre-pregnancy recognition period and during mid-gestation of pregnancy, generalized linear regression models were used controlling for demographic and individual variables. In addition to DAS-II variables, measures reflecting sustained attention, working memory and ability to shift cognitive set were impacted by alcohol dose. Early executive function appears to subsume these performance differences. In conclusion, findings indicate that the effects of PAE can be identified in the preschool period and reliably measured using tests assessing nonverbal and spatial skills supported by executive functioning.

Copyright information:

This is an Open Access work distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (https://creativecommons.org/licenses/by-nc/4.0/rdf).
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