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Executive Function Predicts Adaptive Behavior in Children with Histories of Heavy Prenatal Alcohol Exposure and Attention-Deficit/Hyperactivity Disorder

Authors

  • Ashley L. Ware,

    1. Center for Behavioral Teratology, San Diego State University, San Diego, California
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  • Nicole Crocker,

    1. Center for Behavioral Teratology, San Diego State University, San Diego, California
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  • Jessica W. O'Brien,

    1. Center for Behavioral Teratology, San Diego State University, San Diego, California
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  • Benjamin N. Deweese,

    1. Center for Behavioral Teratology, San Diego State University, San Diego, California
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  • Scott C. Roesch,

    1. Department of Psychology, San Diego State University, San Diego, California
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  • Claire D. Coles,

    1. Department of Psychiatry and Behavior Sciences and Pediatrics, Emory University School of Medicine, Atlanta, Georgia
    2. Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia
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  • Julie A. Kable,

    1. Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia
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  • Philip A. May,

    1. Department of Nutrition, Gillings School of Global Public Health, University of North Carolina Nutrition Research Institute, Kannapolis, North Carolina
    2. Center on Alcoholism, Substance Abuse and Addictions, The University of New Mexico, Albuquerque, New Mexico
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  • Wendy O. Kalberg,

    1. Center on Alcoholism, Substance Abuse and Addictions, The University of New Mexico, Albuquerque, New Mexico
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  • Elizabeth R. Sowell,

    1. Department of Pediatrics, Developmental Cognitive Neuroimaging Laboratory, Keck School of Medicine, University of Southern California
    2. Division of Research on Children, Youth, and Families, Department of Pediatrics, Children's Hospital Los Angeles, Los Angeles, California
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  • Kenneth Lyons Jones,

    1. Department of Pediatrics, School of Medicine, University of California, San Diego, San Diego, California
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  • Edward P. Riley,

    1. Center for Behavioral Teratology, San Diego State University, San Diego, California
    2. Department of Psychology, San Diego State University, San Diego, California
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  • Sarah N. Mattson,

    Corresponding author
    1. Department of Psychology, San Diego State University, San Diego, California
    • Center for Behavioral Teratology, San Diego State University, San Diego, California
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  • the CIFASD


Reprint requests: Sarah N. Mattson, PhD, Center for Behavioral Teratology, San Diego State University, 6330 Alvarado Court, Suite 100, San Diego, CA 92120; Tel.: 619-594-7228; Fax: 619-594-1895; E-mail: smattson@sunstroke.sdsu.edu

Abstract

Background

Prenatal exposure to alcohol often results in disruption to discrete cognitive and behavioral domains, including executive function (EF) and adaptive functioning. In the current study, the relation between these 2 domains was examined in children with histories of heavy prenatal alcohol exposure, nonexposed children with a diagnosis of attention-deficit/hyperactivity disorder (ADHD), and typically developing controls.

Methods

As part of a multisite study, 3 groups of children (8 to 18 years, M = 12.10) were tested: children with histories of heavy prenatal alcohol exposure (ALC, n = 142), nonexposed children with ADHD (ADHD, n = 82), and typically developing controls (CON, n = 133) who did not have ADHD or a history of prenatal alcohol exposure. Children completed subtests of the Delis–Kaplan Executive Function System (D-KEFS), and their primary caregivers completed the Vineland Adaptive Behavior Scales-II. Data were analyzed using regression analyses.

Results

Analyses showed that EF measures were predictive of adaptive abilities, and significant interactions between D-KEFS measures and group were present. For the ADHD group, the relation between adaptive abilities and EF was more general, with 3 of the 4 EF measures showing a significant relation with adaptive score. In contrast, for the ALC group, this relation was specific to the nonverbal EF measures. In the CON group, performance on EF tasks did not predict adaptive scores over the influence of age.

Conclusions

These results support prior research in ADHD, suggesting that EF deficits are predictive of poorer adaptive behavior and extend this finding to include children with heavy prenatal exposure to alcohol. However, the relation between EF and adaptive ability differed by group, suggesting unique patterns of abilities in these children. These results provide enhanced understanding of adaptive deficits in these populations, as well as demonstrate the ecological validity of laboratory measures of EF.

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