July 21, 2009

Prenatal Alcohol Exposure Leads to Behavioral Problems

Children with fetal alcohol spectrum disorders (FASD) have significantly weakened social cognition and emotion-processing abilities, according to a study that is the first to compare cognitive factors and social behavior in children with FASD and attention deficit hyperactivity disorder (ADHD).

 "Behaviorally, FASD and ADHD can look quite similar, particularly with respect to problems with very limited attention, physical restlessness, and extreme impulsivity," Rachel Greenbaum, a clinical psychologist with the Children's Mental Health Team at Surrey Place Centre in Toronto, who conducted the study as part of her doctoral dissertation, was quoted as saying.

Greenbaum and her colleagues recruited three groups of 9-year-old children. The first group of 33 had FASD; the second group of 30 were diagnosed with ADHD. A "normal" control group of 34 was taken from a pre-existing data pool of clinics, communities and schools in the greater Toronto area. All children were asked to complete tasks designed to measure social cognition and emotion processing. In addition, parents and teachers administered standard questionnaires and scales to assess the children's behavioral problems and social skills.
"Our findings show that "¦ overall, children with FASD have more severe behavioral problems," Joanne Rovet, a professor at the University of Toronto and senior scientist in neurosciences and mental health at the Hospital for Sick Children, and supervisor of the fetal alcohol research program was quoted as saying. She added that a "profile" of children with FASD would include items such as high distractibility and restlessness, as well as behaviors described as "out of control" and "juvenile."

"Based on previous work from our lab, children and adolescents with FASD were more likely than children with ADHD to engage in antisocial behaviors, such as cheating and acting young, as well as sociopathic behaviors including lying and stealing," Rovet said. "Importantly, the findings from our present study, specifically the significant differences in social cognition and emotional processing between children with FASD and ADHD, may underlie the severe conduct problems observed in children prenatally exposed to alcohol."

"In other words," Piyadasa W. Kodituwakku, associate professor of pediatrics and neurosciences at the University of New Mexico School of Medicine was quoted as saying, "children with FASD and ADHD have social difficulties, but what is contributing to these difficulties may be different. . . . This difference has implications for the development of social-skills training programs. That is, a training program designed for a child with ADHD may include procedures targeting how to translate what the child already knows into actions, while a program designed for a child with FASD may address both building specific cognitive skills and practicing appropriate actions."

"One of the major contributions of this study pertains to understanding what children with FASD look like from a truly clinical perspective," said Greenbaum, "helping to clarify for clinicians trying to diagnose and treat the full extent and specific nature of their previously unidentified problems, thus extending treatment possibilities that may help alleviate some of their more debilitating antisocial and behavioral problems."

SOURCE:  Alcoholism: Clinical & Experimental Research, October 2009