Toward a Neurobehavioral Profile of Fetal Alcohol Spectrum Disorders

Authors

  • Sarah N. Mattson,

    1. From the Center for Behavioral Teratology (SNM, EPR), San Diego State University; Department of Psychology (SNM, SCR, EPR), San Diego State University, San Diego, California; Folkhälsan Research Center (AF), Helsinki; Psychology Department (AF), Åbo Akademi University, Turku, Finland; Department of Child Neurology (IAR), HUCH Hospital for Children and Adolescents; Research Department (IAR), The Social Insurance Institution, Helsinki, Finland; Division of Dysmorphology/Teratology (KLJ), Department of Pediatrics, University of California, San Diego; School of Medicine (KLJ), La Jolla, California; Center on Alcoholism (PAM), Substance Abuse and Addictions, University of New Mexico, Albuquerque, New Mexico; Department of Psychiatry and Mental Health (CMA), University of Cape Town, Cape Town, South Africa; and Institute of Psychiatry (VK), Moscow, Russia.
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  • Scott C. Roesch,

    1. From the Center for Behavioral Teratology (SNM, EPR), San Diego State University; Department of Psychology (SNM, SCR, EPR), San Diego State University, San Diego, California; Folkhälsan Research Center (AF), Helsinki; Psychology Department (AF), Åbo Akademi University, Turku, Finland; Department of Child Neurology (IAR), HUCH Hospital for Children and Adolescents; Research Department (IAR), The Social Insurance Institution, Helsinki, Finland; Division of Dysmorphology/Teratology (KLJ), Department of Pediatrics, University of California, San Diego; School of Medicine (KLJ), La Jolla, California; Center on Alcoholism (PAM), Substance Abuse and Addictions, University of New Mexico, Albuquerque, New Mexico; Department of Psychiatry and Mental Health (CMA), University of Cape Town, Cape Town, South Africa; and Institute of Psychiatry (VK), Moscow, Russia.
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  • Åse Fagerlund,

    1. From the Center for Behavioral Teratology (SNM, EPR), San Diego State University; Department of Psychology (SNM, SCR, EPR), San Diego State University, San Diego, California; Folkhälsan Research Center (AF), Helsinki; Psychology Department (AF), Åbo Akademi University, Turku, Finland; Department of Child Neurology (IAR), HUCH Hospital for Children and Adolescents; Research Department (IAR), The Social Insurance Institution, Helsinki, Finland; Division of Dysmorphology/Teratology (KLJ), Department of Pediatrics, University of California, San Diego; School of Medicine (KLJ), La Jolla, California; Center on Alcoholism (PAM), Substance Abuse and Addictions, University of New Mexico, Albuquerque, New Mexico; Department of Psychiatry and Mental Health (CMA), University of Cape Town, Cape Town, South Africa; and Institute of Psychiatry (VK), Moscow, Russia.
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  • Ilona Autti-Rämö,

    1. From the Center for Behavioral Teratology (SNM, EPR), San Diego State University; Department of Psychology (SNM, SCR, EPR), San Diego State University, San Diego, California; Folkhälsan Research Center (AF), Helsinki; Psychology Department (AF), Åbo Akademi University, Turku, Finland; Department of Child Neurology (IAR), HUCH Hospital for Children and Adolescents; Research Department (IAR), The Social Insurance Institution, Helsinki, Finland; Division of Dysmorphology/Teratology (KLJ), Department of Pediatrics, University of California, San Diego; School of Medicine (KLJ), La Jolla, California; Center on Alcoholism (PAM), Substance Abuse and Addictions, University of New Mexico, Albuquerque, New Mexico; Department of Psychiatry and Mental Health (CMA), University of Cape Town, Cape Town, South Africa; and Institute of Psychiatry (VK), Moscow, Russia.
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  • Kenneth Lyons Jones,

    1. From the Center for Behavioral Teratology (SNM, EPR), San Diego State University; Department of Psychology (SNM, SCR, EPR), San Diego State University, San Diego, California; Folkhälsan Research Center (AF), Helsinki; Psychology Department (AF), Åbo Akademi University, Turku, Finland; Department of Child Neurology (IAR), HUCH Hospital for Children and Adolescents; Research Department (IAR), The Social Insurance Institution, Helsinki, Finland; Division of Dysmorphology/Teratology (KLJ), Department of Pediatrics, University of California, San Diego; School of Medicine (KLJ), La Jolla, California; Center on Alcoholism (PAM), Substance Abuse and Addictions, University of New Mexico, Albuquerque, New Mexico; Department of Psychiatry and Mental Health (CMA), University of Cape Town, Cape Town, South Africa; and Institute of Psychiatry (VK), Moscow, Russia.
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  • Philip A. May,

    1. From the Center for Behavioral Teratology (SNM, EPR), San Diego State University; Department of Psychology (SNM, SCR, EPR), San Diego State University, San Diego, California; Folkhälsan Research Center (AF), Helsinki; Psychology Department (AF), Åbo Akademi University, Turku, Finland; Department of Child Neurology (IAR), HUCH Hospital for Children and Adolescents; Research Department (IAR), The Social Insurance Institution, Helsinki, Finland; Division of Dysmorphology/Teratology (KLJ), Department of Pediatrics, University of California, San Diego; School of Medicine (KLJ), La Jolla, California; Center on Alcoholism (PAM), Substance Abuse and Addictions, University of New Mexico, Albuquerque, New Mexico; Department of Psychiatry and Mental Health (CMA), University of Cape Town, Cape Town, South Africa; and Institute of Psychiatry (VK), Moscow, Russia.
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  • Colleen M. Adnams,

    1. From the Center for Behavioral Teratology (SNM, EPR), San Diego State University; Department of Psychology (SNM, SCR, EPR), San Diego State University, San Diego, California; Folkhälsan Research Center (AF), Helsinki; Psychology Department (AF), Åbo Akademi University, Turku, Finland; Department of Child Neurology (IAR), HUCH Hospital for Children and Adolescents; Research Department (IAR), The Social Insurance Institution, Helsinki, Finland; Division of Dysmorphology/Teratology (KLJ), Department of Pediatrics, University of California, San Diego; School of Medicine (KLJ), La Jolla, California; Center on Alcoholism (PAM), Substance Abuse and Addictions, University of New Mexico, Albuquerque, New Mexico; Department of Psychiatry and Mental Health (CMA), University of Cape Town, Cape Town, South Africa; and Institute of Psychiatry (VK), Moscow, Russia.
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  • Valentina Konovalova,

    1. From the Center for Behavioral Teratology (SNM, EPR), San Diego State University; Department of Psychology (SNM, SCR, EPR), San Diego State University, San Diego, California; Folkhälsan Research Center (AF), Helsinki; Psychology Department (AF), Åbo Akademi University, Turku, Finland; Department of Child Neurology (IAR), HUCH Hospital for Children and Adolescents; Research Department (IAR), The Social Insurance Institution, Helsinki, Finland; Division of Dysmorphology/Teratology (KLJ), Department of Pediatrics, University of California, San Diego; School of Medicine (KLJ), La Jolla, California; Center on Alcoholism (PAM), Substance Abuse and Addictions, University of New Mexico, Albuquerque, New Mexico; Department of Psychiatry and Mental Health (CMA), University of Cape Town, Cape Town, South Africa; and Institute of Psychiatry (VK), Moscow, Russia.
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  • Edward P. Riley,

    1. From the Center for Behavioral Teratology (SNM, EPR), San Diego State University; Department of Psychology (SNM, SCR, EPR), San Diego State University, San Diego, California; Folkhälsan Research Center (AF), Helsinki; Psychology Department (AF), Åbo Akademi University, Turku, Finland; Department of Child Neurology (IAR), HUCH Hospital for Children and Adolescents; Research Department (IAR), The Social Insurance Institution, Helsinki, Finland; Division of Dysmorphology/Teratology (KLJ), Department of Pediatrics, University of California, San Diego; School of Medicine (KLJ), La Jolla, California; Center on Alcoholism (PAM), Substance Abuse and Addictions, University of New Mexico, Albuquerque, New Mexico; Department of Psychiatry and Mental Health (CMA), University of Cape Town, Cape Town, South Africa; and Institute of Psychiatry (VK), Moscow, Russia.
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  • the CIFASD

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    • *

      The Collaborative Initiative on Fetal Alcohol Spectrum Disorders (CIFASD) (E. Riley, San Diego State University, Principal Investigator) includes 16 different centers where data collection and analysis take place. The data collection sites and associated investigators described in this paper are: San Diego State University (S.N. Mattson) and Folkhälsan Research Center-Helsinki (I. Autti-Rämö, Å. Fagerlund, M. Korkman). Additional sites include the University of New Mexico and Northern Plains (P.A. May, W. Kalberg, A. Aragon), University of Cape Town (C. Adnams), and the Moscow Institute of Psychiatry (V. Konovalova, G. Marintcheva).


Reprint requests:Sarah N. Mattson, PhD, 6363 Alvarado Court, Suite 209, San Diego, CA 92120; Tel: +619-594-7228; Fax: +619-594-1895; E-mail: smattson@sunstroke.sdsu.edu

Abstract

Background:  A primary goal of recent research is the development of neurobehavioral profiles that specifically define fetal alcohol spectrum disorders (FASD), which may assist differential diagnosis or improve treatment. In the current study, we define a preliminary profile using neuropsychological data from a multisite study.

Methods:  Data were collected using a broad neurobehavioral protocol from 2 sites of a multisite study of FASD. Subjects were children with heavy prenatal alcohol exposure and unexposed controls. The alcohol-exposed group included children with and without fetal alcohol syndrome (FAS). From 547 neuropsychological variables, 22 variables were selected for analysis based on their ability to distinguish children with heavy prenatal alcohol exposure from nonexposed controls. These data were analyzed using latent profile analysis (LPA).

Results:  The results indicated that a 2-class model best fit the data. The resulting profile was successful at distinguishing subjects with FAS from nonexposed controls without FAS with 92% overall accuracy; 87.8% of FAS cases and 95.7% of controls were correctly classified. The same analysis was repeated with children with heavy prenatal alcohol exposure but without FAS and nonexposed controls with similar results. The overall accuracy was 84.7%; 68.4% of alcohol-exposed cases and 95% of controls were correctly classified. In both analyses, the profile based on neuropsychological variables was more successful at distinguishing the groups than was IQ alone.

Conclusions:  We used data from 2 sites of a multisite study and a broad neuropsychological test battery to determine a profile that could be used to accurately identify children affected by prenatal alcohol exposure. Results indicated that measures of executive function and spatial processing are especially sensitive to prenatal alcohol exposure.

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