Prenatal Alcohol Exposure, Attention-Deficit/Hyperactivity Disorder, and Sluggish Cognitive Tempo

Authors

  • Diana M. Graham,

    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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  • 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, 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. Developmental Cognitive Neuroimaging Laboratory, Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, 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 L. Jones,

    1. Department of Pediatrics, School of Medicine, University of California, 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

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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), University of New Mexico and Northern Plains (P.A. May, W. Kalberg), University of California, Los Angeles (E.P. Sowell), Emory University, Atlanta, GA (C.D. Coles, J.A. Kable). Additional sites include the University of Cape Town, South Africa (C.M. Adnams).

Reprint requests: Sarah N. Mattson, PhD, 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

Children with heavy prenatal alcohol exposure often meet criteria for attention-deficit/hyperactivity disorder (ADHD). ADHD research has examined subtype differences in symptomatology, including sluggish cognitive tempo (SCT). This construct is defined by behavioral symptoms including hypoactivity and daydreaming and has been linked to increased internalizing behaviors. The current study examined whether similar findings are displayed in children with prenatal alcohol exposure.

Methods

As part of a multisite study, caregivers of 272 children (8 to 16 years) completed the SCT Scale and Child Behavior Checklist (CBCL). Four groups were included: alcohol-exposed children with ADHD (ALC+; n = 75), alcohol-exposed children without ADHD (ALC−; n = 35), nonexposed children with ADHD (ADHD; n = 60), and nonexposed children without ADHD (CON; n = 102). SCT and CBCL scores were analyzed using 2 (exposure) × 2 (ADHD) analyses of variance. Pearson's correlations measured the relationships between SCT, CBCL, and Full Scale IQ (FSIQ). Discriminant function analysis examined whether SCT items could accurately classify groups.

Results

Analyses revealed significant main effects of exposure and ADHD on SCT and internalizing and externalizing scores and significant interaction effects on SCT and internalizing scores. SCT significantly correlated with internalizing, externalizing, and attention ratings in all groups and with FSIQ in ALC+. Discriminant function analysis indicated that specific SCT items could distinguish ALC− from CON.

Conclusions

Alcohol-exposed children exhibited elevated SCT scores. Elevations were related to increased parent ratings of internalizing and externalizing behaviors and attention. These findings are observed in alcohol-exposed children regardless of ADHD symptoms and specific SCT items proved useful in distinguishing exposed children, suggesting clinical utility for this measure in further defining the neurobehavioral profile related to prenatal alcohol exposure.

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