Further Development of a Neurobehavioral Profile of Fetal Alcohol Spectrum Disorders

Authors

  • 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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  • Scott C. Roesch,

    1. Department of Psychology , San Diego State University, San Diego, California
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  • Leila Glass,

    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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  • 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, Los Angeles, California
    2. Department of Pediatrics , Division of Research on Children, Youth, and Families, Children's Hospital Los Angeles, Los Angeles, California
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  • Colleen M. Adnams,

    1. Department of Psychiatry and Mental Health , University of Cape Town, Cape Town, South Africa
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  • Kenneth Lyons 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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  • 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), the University of New Mexico and Northern Plains (P.A. May, W.O. Kalberg), University of California, Los Angeles (E.R. Sowell), Emory University (C.D. Coles and J.A. Kable), and the University of Cape Town, South Africa (C. 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: sarah.mattson@sdsu.edu

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 (= 209), typically developing controls (CON,= 185), and subjects with attention-deficit/hyperactivity disorder (ADHD,= 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 children affected by prenatal alcohol exposure.

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